title: Exploring perceptions of psychological services in a children's hospice in the United Kingdom.
abstract: BACKGROUND
  The provision of emotional and psychological support for all family members who need it is an essential element of holistic palliative care. Within East Anglia's Children's Hospice, teams of professionally trained and experienced workers offer psychosocial support to all family members at all times during the child's and family's journey. However, the effectiveness and appropriateness of current psychosocial provision is unclear, as is the requirement for any additional psychological services.
  
  
  OBJECTIVE
  The purpose of this study was to elicit perceptions about current psychological support within the hospice from a group of stakeholders (parents, hospice staff, and external professionals).
  
  
  METHODS
  Forty-five parents participated in family focus groups, telephone interviews, individual interviews in their home, or a web-based survey. Ninety-five hospice staff (including nurses, carers, play specialists, therapists, and family support practitioners) and 28 external staff (including physicians, nurses, and commissioning managers) were seen using a mixture of focus group and individual meetings. Focus groups and meetings were held at the hospice building or at an external venue. Interviews were recorded and transcribed verbatim and analyzed using thematic coding.
  
  
  RESULTS
  Two main themes addressing perceptions of current psychological provision emerged: "understanding psychological support" and "unmet psychological need." Subthemes linked to support included choice, staff roles and labels, communication, and flexibility, whereas the themes within unmet need had a stronger focus on people and problems.
  
  
  CONCLUSIONS
  Understanding different user perspectives is an important first step in enhancing current psychological provision; operationalizing the findings will be challenging.
authors.affiliation: Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
authors.forename: Jo
authors.initials: J
authors.lastname: Wray
authors.forename: Bruce
authors.initials: B
authors.lastname: Lindsay
authors.forename: Kenda
authors.initials: K
authors.lastname: Crozier
authors.forename: Lauren
authors.initials: L
authors.lastname: Andrews
authors.forename: Janet
authors.initials: J
authors.lastname: Leeson
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services / Q000458:organization & administration; D016638:Critical Illness / Q000523:psychology; D019988:Children with Disabilities / Q000523:psychology; D017144:Focus Groups; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D010166:Palliative Care / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D013315:Stress, Psychological / Q000517:prevention & control*; D006113:United Kingdom; D055815:Young Adult