Children and their families have most of their needs met through the family and community networks. These networks include schools, churches, sporting groups, neighbours, friends and community health services. Some families can have specific people in the community (eg, Elders, spiritual or community leaders, or extended family members) who need to be involved in decision-making regarding health care. This particularly important to consider when working with Aboriginal and/or Torres Strait Islander families.[1]
Psychosocial, spiritual and cultural assessment includes consideration of:
- The child’s developmental stage
- The child’s experience of symptoms
- The effectiveness of communication between the child, family and healthcare team
- Practical factors affecting the family, including financial and living situation and social support
- The child and family’s religious or spiritual backgrounds and beliefs. Assessment tools such as the FICA Tool for spiritual history assessment can be useful
- The child and family’s cultural background and connections to culture and community. [2-3]
Communication with Aboriginal and Torres Strait Islander families regarding these aspects of care can be supported by using culturally-specific discussion-starter cards, such as the Yarning Companion Resources.
Adolescents have unique support needs as the dynamics involving the adolescent, their family and health professionals change. Psychosocial, hormonal changes, cognitive and physical growth and developmental changes occur in teenagers and adolescents that require unique care and communication. Transitioning adolescents to adult care facilities requires careful planning between adolescents, families and health professional teams.[4]
Strategies that assist with a successful transition of care to adult centres include:
- Healthcare transition plan in early adolescence
- Transition policy agreed upon by members of the healthcare team
- Preparation period and educational program for adolescent and family
- Network of palliative care services and youth and adult services
- Liaison personnel for paediatric and adult services. [4]
Children are cared for in a variety of settings including at home, hospice (in some states and territories) and acute care facilities. When children are cared for away from home, parents require unrestricted visiting, clear communication with staff and involvement in decision-making. [4]
Thinking Points
- What strategies might you use to identify the spiritual needs of a seven-year-old child?
- List some of the unique features of adolescence that could influence how they respond to a life-limiting illness.
- What strategies might you suggest to a teenager with a compromised immune system to maintain contact with friends?
References
- Paediatric Palliative Care Australia and New Zealand. 2023. A Practical Guide to Palliative Care in Paediatrics.
- McSherry, M. et al, 2007. Psychosocial and Spiritual Needs of Children Living with a Life-Limiting Illness. Pediatric Clinics of North America, 54(5), 609-629.
- Puchalski, C. 1999. FICA Spiritual Assessment Tool.
- Steinbeck, K. et al, 2007. Adolescent appropriate care in an adult hospital: the use of a youth care plan. Australian Journal of Advanced Nursing, 24(3), 49-53.
- McDonagh, JE & Kelly, DA. 2003. Transitioning care of the pediatric recipient to adult caregivers. Pediatric Clinics of North America, 50(6), 1561-1583.
- Meert, K. 2011. Parental bereavement needs in the pediatric intensive care unit: review of available measures. Journal of Palliative Medicine, 14(8), 951-64.