title: Pediatric nurses' individual and group assessments of palliative, end-of-life, and bereavement care.
abstract: BACKGROUND
  Although pediatric nurses working in children's hospitals often provide care to dying children, little is known about their palliative care beliefs and experiences as individuals or members of groups within the hospital.
  
  
  OBJECTIVE
  To describe pediatric nurses' ratings of palliative care goals and problems, as individuals and members of clusters of nurses with similar views, and nurses' degree of collaboration with an inpatient palliative care team across hospital units.
  
  
  METHODS
  A cross-sectional survey of nurses at a freestanding children's hospital in 2005.
  
  
  RESULTS
  Nurses rated the most important goals as managing pain, maintaining the child's quality of life, and improving communication. Commonly cited problems were lack of opportunity to debrief after a patient's death, uncertainty about the goals of care, and the health care team's reluctance to discuss hospice with family. Based on individual views about goals and problems, nurses clustered into 5 groups that differed in terms of the adamancy of their views and the scope of the goals and problems they considered important or significant. The hospital unit was the most important factor in predicting nurses' degree of collaboration with the palliative care team even after accounting for individual characteristics.
  
  
  CONCLUSIONS
  Pediatric nurses broadly endorse both the importance of palliative care goals and the presence of problems yet perceive the importance of these goals and problems differently. Further, they vary in their level of collaborative practice with a palliative care team in ways that should be accounted for when planning and implementing palliative care programs.
authors.affiliation: University of Pennsylvania School of Nursing, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Tubbs-Cooley
authors.forename: Gina
authors.initials: G
authors.lastname: Santucci
authors.forename: Tammy I
authors.initials: TI
authors.lastname: Kang
authors.forename: James A
authors.initials: JA
authors.lastname: Feinstein
authors.forename: Kari R
authors.initials: KR
authors.lastname: Hexem
authors.forename: Chris
authors.initials: C
authors.lastname: Feudtner
mesh_terms: D001291:Attitude of Health Personnel; D001601:Bereavement; D003430:Cross-Sectional Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D009726:Nurses / Q000523:psychology; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010166:Palliative Care; D013727:Terminal Care