The Benefits and Burdens of Pediatric Palliative Care and End-of-Life Research: A Systematic Review

J Palliat Med. 2019 Aug;22(8):915-926. doi: 10.1089/jpm.2018.0483. Epub 2019 Mar 5.

Abstract

Objective: The aim of this study is to report the benefits and burdens of palliative research participation on children, siblings, parents, clinicians, and researchers. Background: Pediatric palliative care requires research to mature the science and improve interventions. A tension exists between the desire to enhance palliative and end-of-life care for children and their families and the need to protect these potentially vulnerable populations from untoward burdens. Methods: Systematic review followed PRISMA guidelines with prepared protocol registered as PROSPERO #CRD42018087304. MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and The Cochrane Library were searched (2000-2017). English-language studies depicting the benefits or burdens of palliative care or end-of-life research participation on either pediatric patients and/or their family members, clinicians, or study teams were eligible for inclusion. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results: Twenty-four studies met final inclusion criteria. The benefit or burden of palliative care research participation was reported for the child in 6 papers; siblings in 2; parents in 19; clinicians in 3; and researchers in 5 papers. Benefits were more heavily emphasized by patients and family members, whereas burdens were more prominently emphasized by researchers and clinicians. No paper utilized a validated benefit/burden scale. Discussion: The lack of published exploration into the benefits and burdens of those asked to take part in pediatric palliative care research and those conducting the research is striking. There is a need for implementation of a validated benefit/burden instrument or interview measure as part of pediatric palliative and end-of-life research design and reporting.

Keywords: benefits and burdens; palliative care research; pediatric palliative care.

Publication types

  • Research Support, N.I.H., Intramural
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Attitude of Health Personnel
  • Biomedical Research*
  • Child
  • Child, Preschool
  • Family / psychology*
  • Female
  • Health Personnel / psychology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Palliative Care / psychology*
  • Pediatrics*
  • Professional-Family Relations*
  • Qualitative Research
  • Terminal Care / psychology*