Publication
Understanding complexity in pediatric palliative care: A qualitative study of specialist physicians’ perception
Corvest V, Frache S · Med. Palliative · 2025
Objectives Studies addressing the complexity of pediatric palliative care are highly limited. The aim of this qualitative study was to identify the criteria of this complexity and, more broadly, to provide insight into this issue by analyzing the perception of physicians specialized in pediatric palliative care. Materials and methods Data were obtained from semi-structured interviews conducted with physicians working in regional resource teams and a mobile pediatric palliative care team in France. Data were transcribed, coded, and analyzed using thematic analysis. Results Interviews revealed four key themes: contextual factors of vulnerability and constraint, difficulties related to care pathways, overall suffering, and feeling of failure in the face of problem insolubility. Sixteen sub-themes were identified. Analogies with certain theoretical and systemic approaches to complexity in adult palliative care were highlighted. Psycho-social, familial, relational, and communication issues emerged as central concerns, along with the notion of cumulative complexity. Conclusion This study proposes an initial conceptual framework for understanding complexity in pediatric palliative care, characterizing it in its various dimensions and supporting improved responses to complex pediatric palliative situations. This work may serve as a foundation for the development of multidimensional practical tools for identifying situations where the involvement of a specialized palliative care team would be indicated.
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