Evidence map›Paper›PMID 39188642›Full record

ArticleFrontiers in pediatrics2024

Navigating the shadows: medical professionals' values and perspectives on end-of-life care within pediatric intensive care units in Croatia.

Marko Curkovic, Filip Rubic, Ana Jozepovic, Milivoj Novak, Boris Filipovic-Grcic, Julije Mestrovic, Kristina Lah Tomulic, Branimir Peter, Diana Spoljar, Štefan Grosek and 5 more

Abstract read
In one paragraph

Article in Frontiers in pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Marko CurkovicUniversity Psychiatric Hospital Vrapče, Zagreb, Croatia.
Filip RubicDepartment of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia.
Ana JozepovicDepartment of Anesthesiology, University Hospital Centre Zagreb, Zagreb, Croatia.
Milivoj NovakDepartment of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia.
Boris Filipovic-GrcicSchool of Medicine, University of Zagreb, Zagreb, Croatia.
Julije MestrovicDepartment of Pediatrics, University Hospital Centre Split, Split, Croatia.
Kristina Lah TomulicDepartment of Pediatrics, University Hospital Centre Rijeka, Rijeka, Croatia.
Branimir PeterDepartment of Gynecology and Obstetrics, University Hospital Centre Rijeka, Rijeka, Croatia.
Diana SpoljarPalliative Care Service, Community Health Center Zagreb, Zagreb, Croatia.
Štefan GrosekDepartment of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Sunčana JankovićDepartment of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia.
Jurica VukovicSchool of Medicine, University of Zagreb, Zagreb, Croatia.
Mirjana Kujundžić TiljakAndrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
Andrija ŠtajduharAndrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
Ana BoroveckiAndrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and aim: This study explores healthcare professionals' perspectives on end-of-life care in pediatric intensive care units (ICUs) in Croatia, aiming to illuminate their experiences with such practices, underlying attitudes, and major decision-making considerations. Amid the high variability, complexity, and emotional intensity of pediatric end-of-life decisions and practices, understanding these perspectives is crucial for improving care and policies. Methods: The study utilized a cross-sectional survey intended for physicians and nurses across all pediatric ICUs in Croatia. It included healthcare professionals from six neonatal and four pediatric ICUs in total. As the data from neonatal and pediatric ICUs were examined jointly, the term pediatric ICU was used to denominate both types of ICUs. A statistical analysis was performed using Python and JASP, focusing on professional roles, professional experience, and regional differences. Results: The study included a total of 103 participants (with an overall response rate-in relation to the whole target population-of 48% for physicians and 29% for nurses). The survey revealed diverse attitudes toward and experiences with various aspects of end-of-life care, with a significant portion of healthcare professionals indicating infrequent involvement in life-sustaining treatment (LST) limitation discussions and decisions, as well as somewhat ambiguous attitudes regarding such practices. Notably, discrepancies emerged between different professional roles and, in particular, regions, underscoring the high variability of LST limitation-related procedures. Conclusions: The findings highlight a pressing need for more straightforward guidelines, legal frameworks, support mechanisms, and communication strategies to navigate the complex terrain of rather burdensome end-of-life pediatric care, which is intrinsically loaded with profound ethical quandaries.

Indexed as

end-of-lifeethicshealthcare professionalsintensive careintensive care unitspediatricswithdrawingwithholding

Identifiers

PMID39188642
PMCPMC11345198

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.