A Mixed-Methods Exploration of Pediatric Intensivists' Attitudes toward End-of-Life Care in Vietnam

Priyal P. Fadadu, Joy C. Liu, Brenda M. Schiltz, Tran Dang Xoay, Phan Huu Phuc, Ashok Kumbamu, Yves Ouellette

Research output: Contribution to journalArticle

Abstract

Background: Although the need for palliative care is gaining recognition in Southeast Asia, knowledge about how decisions are made for children near the end of life remains sparse. Objective: To explore pediatric intensivists' attitudes and practices surrounding end-of-life care in Vietnam. Methods: This is a mixed-methods study conducted at a tertiary pediatric and neonatal intensive care unit in Hanoi. Physicians and nurses completed a quantitative survey about their views on end-of-life care. A subset of these providers participated in semistructured interviews on related topics. Analysis of surveys and interviews were conducted. Results were triangulated. Results: Sixty-eight providers (33 physicians and 35 nurses) completed the quantitative survey, and 18 participated in interviews. Qualitative data revealed three overarching themes with numerous subthemes and supporting quotations. The first theme was factors influencing providers' decision-making process to escalate or withdraw treatment. Quantitative data showed that 40% of providers valued the family's ability to pay to continue life-sustaining treatment. Second, communication dynamics in decision making were highlighted; 72% of providers would be willing to override a family's wishes to withdraw life-sustaining treatment. Third, provider perceptions of death varied, with 68% regarding their patients' deaths as a personal failure. Conclusions: We elicited and documented how pediatric intensivists in Vietnam currently think about and provide end-of-life care. These findings indicate a need to strengthen palliative care training, increase family involvement in decision making, implement standardized and official do-not-resuscitate documentation, and expand pediatric hospice services at the individual, hospital, and national levels in Vietnam.

Original languageEnglish (US)
Pages (from-to)885-893
Number of pages9
JournalJournal of Palliative Medicine
Volume22
Issue number8
DOIs
StatePublished - Aug 1 2019

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Terminal Care
Vietnam
Decision Making
Interviews
Pediatrics
Palliative Care
Nurses
Physicians
Southeastern Asia
Pediatric Intensive Care Units
Hospices
Aptitude
Neonatal Intensive Care Units
Documentation
Therapeutics
Communication
Surveys and Questionnaires

Keywords

  • end of life
  • ICU
  • pediatric
  • Vietnam

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

Cite this

A Mixed-Methods Exploration of Pediatric Intensivists' Attitudes toward End-of-Life Care in Vietnam. / Fadadu, Priyal P.; Liu, Joy C.; Schiltz, Brenda M.; Xoay, Tran Dang; Phuc, Phan Huu; Kumbamu, Ashok; Ouellette, Yves.

In: Journal of Palliative Medicine, Vol. 22, No. 8, 01.08.2019, p. 885-893.

Research output: Contribution to journalArticle

Fadadu, Priyal P. ; Liu, Joy C. ; Schiltz, Brenda M. ; Xoay, Tran Dang ; Phuc, Phan Huu ; Kumbamu, Ashok ; Ouellette, Yves. / A Mixed-Methods Exploration of Pediatric Intensivists' Attitudes toward End-of-Life Care in Vietnam. In: Journal of Palliative Medicine. 2019 ; Vol. 22, No. 8. pp. 885-893.
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