An analysis of paediatric palliative care in the state of Victoria

Sutton, David F (2005) An analysis of paediatric palliative care in the state of Victoria. Research Master thesis, Victoria University.


The concept of palliative care as an holistic approach to the management of patients with incurable conditions has its roots in the hospice movement. It has since grown into an established field of practice for health professionals of all disciplines and has been recognised as a medical specialty since 1987. Palliative care remains relatively underdeveloped in the paediatric setting for a number of reasons. Firstly, death in childhood is now relatively rare due to the advent of antibiotics, immunisation and advances in the treatment of malignancies. This means that any health professional's individual exposure to palliative care issues is limited, making the development and maintenance of skills difficult. Secondly, the traditional model of palliative care, as a path to be taken when all curative options have been explored, does not adequately serve children and adolescents where the transition to palliative care may be less clear due to a broader range of diagnoses and patterns of disease progression. Children also present added dimensions to palliative care including developmental, ethical and physiological considerations. The involvement of parents as care givers and decision makers further increases the complexity of providing palliative care. Research is lacking and the evidence on which to base practice is limited. Nevertheless, there are theoretical constructs that can be utilised to build a framework for research in this area. The works of Glaser and Strauss, Corr and Copp on theories of death and dying coupled with earlier works by Freud, Erikson and Piaget on theories of childhood development provide a suitable theoretical framework. Corr's 'task' based model described in 1992 allows us to view the process of providing pediatric palliative care from many different perspectives, and thus provides for a rich multi-dimensional model of pediatric palliative care to be constructed. This study was done to analyse and investigate the knowledge, attitudes and needs of both providers and recipients of palliative care in a major tertiary paediatric hospital, the Royal Children's Hospital (RCH), Melbourne, Australia and, in addition, to examine various models of delivery of paediatric palliative care in use around the world, and to identify from the literature the constituents of care that make up 'best practice' as regards paediatric palliative care. From this investigation it is hoped to develop a model of care that will best serve the RCH and its patients.

Additional Information

Master of Health Science

Item type Thesis (Research Master thesis)
Subjects Historical > FOR Classification > 1110 Nursing
Historical > FOR Classification > 1114 Paediatrics and Reproductive Medicine
Historical > Faculty/School/Research Centre/Department > School of Nursing and Midwifery
Keywords paediatric nursing, palliative treatment, patient care, community services
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