TY - JOUR
T1 - Health professionals’ perception of appropriateness of care
T2 - A qualitative study in italian pediatric hospices
AU - Cappi, Valentina
AU - Riboni, Serena
AU - Grana, Marianna
AU - Pierotti, Emanuela
AU - Ravelli, Andrea
AU - Sutti, Stefania
AU - Testa, Sara
AU - Spacci, Alessio
AU - Artioli, Giovanna
AU - Sarli, Leopoldo
AU - Pellegatta, Federico
N1 - Publisher Copyright:
© Mattioli 1885.
PY - 2020
Y1 - 2020
N2 - Background: Appropriateness is particularly relevant in palliative care, an area in which it is essential to question the real need for treatments. Few studies explored the perception of appropriateness by professionals in pediatric palliative care, revealing the conflict sometimes faced when confronted with the uncertainty of prognosis and end-of-life decisions. Aims: The objective of this study is firstly to investigate the perception that doctors, nurses and psychologists, operating in Italian pediatric hospices, have of the appropriateness of the care they provide. Secondly, to understand what repercussions the perception of non-appropriateness has at individual and team level. Methods: A qualitative study was conducted between 2019 and 2020 through semi-structured interviews with a convenience sample of 17 professionals working it Italian pediatric hospices. Results: The interviewees do not refer to a common concept of appropriateness, but compare the latter to: the quality of life, the global care of the assisted person, the proportionality of care, the early recognition of the need for palliative care. The discussion within the team emerges as a privileged place to manage the discomfort of individual professionals in the face of treatment choices in conflict with their own values. Conclusion: the non-referring to a univocal conception of appropriateness deprives professionals of an objective criterion to resolve the most difficult decisions. However, it allows them to establish what from time to time seems to be the most appropriate care pathway for a given patient, at a given time and context, preserving the goal of personalized care. (www.actabiomedica.it).
AB - Background: Appropriateness is particularly relevant in palliative care, an area in which it is essential to question the real need for treatments. Few studies explored the perception of appropriateness by professionals in pediatric palliative care, revealing the conflict sometimes faced when confronted with the uncertainty of prognosis and end-of-life decisions. Aims: The objective of this study is firstly to investigate the perception that doctors, nurses and psychologists, operating in Italian pediatric hospices, have of the appropriateness of the care they provide. Secondly, to understand what repercussions the perception of non-appropriateness has at individual and team level. Methods: A qualitative study was conducted between 2019 and 2020 through semi-structured interviews with a convenience sample of 17 professionals working it Italian pediatric hospices. Results: The interviewees do not refer to a common concept of appropriateness, but compare the latter to: the quality of life, the global care of the assisted person, the proportionality of care, the early recognition of the need for palliative care. The discussion within the team emerges as a privileged place to manage the discomfort of individual professionals in the face of treatment choices in conflict with their own values. Conclusion: the non-referring to a univocal conception of appropriateness deprives professionals of an objective criterion to resolve the most difficult decisions. However, it allows them to establish what from time to time seems to be the most appropriate care pathway for a given patient, at a given time and context, preserving the goal of personalized care. (www.actabiomedica.it).
KW - Appropriateness
KW - Health Professionals
KW - Interviews
KW - Italy
KW - Palliative Care
KW - Pediatric Hospice
KW - Perceptions
KW - Qualitative study
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U2 - 10.23750/abm.v91i12-S.10859
DO - 10.23750/abm.v91i12-S.10859
M3 - Article
C2 - 33263346
AN - SCOPUS:85097025804
VL - 91
SP - 1
EP - 10
JO - Acta Biomedica de l'Ateneo Parmense
JF - Acta Biomedica de l'Ateneo Parmense
SN - 0392-4203
IS - 12-S
M1 - e2020013
ER -