Nurses’ perceptions of end-of-life care in neonatal and pediatric intensive care units in Korea: a qualitative descriptive study using thematic analysis
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Purpose: To explore nurses’ perceptions of end-of-life care in neonatal and pediatric in- tensive care units, focusing on the components, facilitators, and challenges of such care in daily practice. Methods: A qualitative descriptive study was conducted. Data were collected from June to October 2023 through semi-structured individual interviews with 17 nurses from the neonatal and pediatric intensive care units of four tertiary general hospitals in a metro- politan area of South Korea, and were analyzed using thematic analysis techniques. Results: We identified three themes and nine subthemes: (1) supporting families’ emo- tional and relational closure, (2) perceiving relational and systemic support as enabling end-of-life care, and (3) feeling constrained by systemic and practical challenges. Partici- pants perceived fostering an emotional connection with the child, ensuring opportunities for meaningful farewell, and supporting emotional acceptance of death as ways to sup- port families’ emotional and relational closure with their child. Although relational and systemic support, such as collaborative teamwork, clear communication, shared plan- ning, and structured tools, enabled compassionate care, participants also felt unprepared, burdened by heavy workloads, and hindered by environmental barriers. Conclusion: The findings highlight that delivering quality end-of-life care in neonatal and pediatric intensive care units requires supporting families’ emotional needs, strengthening relational and systemic support, and addressing practical challenges. Fur- ther research is needed to develop and test practical strategies (e.g., specialized education in compassionate communication, standardized protocols, and supportive care environ- ments) that can improve the quality of end-of-life care for neonatal and pediatric patients and their families.
Abstract
Purpose: To explore nurses’ perceptions of end-of-life care in neonatal and pediatric in- tensive care units, focusing on the components, facilitators, and challenges of such care in daily practice. Methods: A qualitative descriptive study was conducted. Data were collected from June to October 2023 through semi-structured individual interviews with 17 nurses from the neonatal and pediatric intensive care units of four tertiary general hospitals in a metro- politan area of South Korea, and were analyzed using thematic analysis techniques. Results: We identified three themes and nine subthemes: (1) supporting families’ emo- tional and relational closure, (2) perceiving relational and systemic support as enabling end-of-life care, and (3) feeling constrained by systemic and practical challenges. Partici- pants perceived fostering an emotional connection with the child, ensuring opportunities for meaningful farewell, and supporting emotional acceptance of death as ways to sup- port families’ emotional and relational closure with their child. Although relational and systemic support, such as collaborative teamwork, clear communication, shared plan- ning, and structured tools, enabled compassionate care, participants also felt unprepared, burdened by heavy workloads, and hindered by environmental barriers. Conclusion: The findings highlight that delivering quality end-of-life care in neonatal and pediatric intensive care units requires supporting families’ emotional needs, strengthening relational and systemic support, and addressing practical challenges. Fur- ther research is needed to develop and test practical strategies (e.g., specialized education in compassionate communication, standardized protocols, and supportive care environ- ments) that can improve the quality of end-of-life care for neonatal and pediatric patients and their families.