title: Supportive and palliative care needs of families of children who die from cancer: an Australian study.
abstract: OBJECTIVE
  To obtain feedback from parents of children who died from cancer about their understanding of palliative care, their experiences of palliative and supportive care received during their child's illness, and their palliative and supportive care needs.
  
  
  METHODS
  A qualitative study with semi-structured interviews.
  
  
  METHODS
  24 parents from Perth (n = 10), Melbourne (n = 5), Brisbane (n = 5) and Sydney (n = 4).
  
  
  METHODS
  Five Australian tertiary paediatric oncology centres. Results Parents whose children died from cancer live within a context of chronic uncertainty and apprehension. Parents construed palliative care negatively as an independent process at the end of their children's lives rather than as a component of a wider and continuous process where children and their families are offered both curative and palliative care throughout the cancer trajectory. The concept of palliative care was perceived to be misunderstood by key health professionals involved in the care of the child and family. The importance and therapeutic value of authentic and honest relationships between health professionals and parents, and between health professionals and children were highlighted as a critical aspect of care. Also highlighted was the need to include children and adolescents in decision making, and for the delivery of compassionate end-of-life care that is sensitive to the developmental needs of the children, their parents and siblings.
  
  
  CONCLUSIONS
  There is a need for health professionals to better understand the concept of palliative care, and factors that contribute to honest, open, authentic and therapeutic relationships of those concerned in the care of the dying child. This will facilitate a better understanding by both parents and their children with cancer, and acceptance of the integration of palliative and supportive care in routine cancer care.
authors.affiliation: Division of Health Sciences, Curtin University, Perth, Australia. leanne.monterosso@health.wa.gov.au
authors.forename: Leanne
authors.initials: L
authors.lastname: Monterosso
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Kristjanson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001293:Attitude to Death; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms; D010166:Palliative Care / Q000523:psychology*; D011368:Professional-Family Relations; D012944:Social Support; D013727:Terminal Care / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*