Challenges of professional performance during the implementation of palliative care in pediatrics: a qualitative study

Abstract

Introduction:  Within the Unified Health System, palliative care (PC) must be integrated into the care practice of any professional, team or institution.

Objective:  To analyze the challenges of professional performance during the implementation of pediatric palliative care.

Method:  Qualitative study in a maternal and child hospital from January to May 2020, with 32 professionals interviewed in a focus group, using thematic analysis.

Results:  1) Weaknesses and disagreements in the indication of PC, with participants admitting there are barriers to indicate and practice PC, lack of knowledge, associations with abandonment and terminality, doubts about use and benefits, resistance, and disorders in work processes. 2) Disagreements and contradictions in the provision of PC, with professionals not seeing themselves as responsible for it, questioning the existing consultative model, claiming overload and communication problems. 3) Initiatives that facilitate palliative practice, with strategies for incorporating PC into practice, such as team integration, exchange of information, empathetic postures, and use of a Singular Therapeutic Project.

Conclusion:  There is a need for training and awareness of care teams and greater integration with the PC team to standardize practices and foster the autonomy of professionals in care. In addition, values, beliefs, cultural and training issues need to be addressed to reduce resistance to PC.

Keywords:
palliative care; child care; pediatrics; professional practice