title: Suffering indicators in terminally ill children from the parental perspective.
abstract: OBJECTIVE
  Suffering is a complex multifaceted phenomenon, which has received limited attention in relation to children with terminal illness. As part of a wider study we interviewed parents of children with terminal illness to elicit their perspectives on suffering, in order to provide initial understanding from which to develop observational indicators and further research.
  
  
  METHODS
  Qualitative descriptive study with semi-structured interviews made "ad hoc". Selection through deliberate sampling of mothers and fathers of hospitalised children (0-16 years old) with a terminal illness in Granada (Spain).
  
  
  RESULTS
  13 parents were interviewed. They described children's suffering as manifested through sadness, apathy, and anger towards their parents and the professionals. The isolation from their natural environment, the uncertainty towards the future, and the anticipation of pain caused suffering in children. The pain is experienced as an assault that their parents allow to occur.
  
  
  CONCLUSIONS
  The analysis of the interview with the parents about their perception of their ill children's suffering at the end of their lives is a valuable source of information to consider supportive interventions for children and parents in health care settings. An outline summary of the assessed aspects of suffering, the indicators and aspects for health professional consideration is proposed.
authors.affiliation: Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada, Av. de Madrid, s/n, 18071 Granada, Spain. Electronic address: rmontoya@ugr.es.
authors.forename: R
authors.initials: R
authors.lastname: Montoya-Juárez
authors.forename: M P
authors.initials: MP
authors.lastname: García-Caro
authors.forename: J
authors.initials: J
authors.lastname: Schmidt-Rio-Valle
authors.forename: C
authors.initials: C
authors.lastname: Campos-Calderón
authors.forename: C
authors.initials: C
authors.lastname: Sorroche-Navarro
authors.forename: R
authors.initials: R
authors.lastname: Sánchez-García
authors.forename: F
authors.initials: F
authors.lastname: Cruz-Quintana
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001293:Attitude to Death; D002648:Child; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D011788:Quality of Life; D013030:Spain; D013315:Stress, Psychological / Q000517:prevention & control / Q000523:psychology*; D013727:Terminal Care / Q000379:methods / Q000523:psychology; D019452:Terminally Ill / Q000523:psychology*
keywords: Children; Parents; Qualitative research; Suffering; Terminal care