Korean J Hosp Palliat Care.  2022 Jun;25(2):85-97. 10.14475/jhpc.2022.25.2.85.

Nurses’ Perceived Needs and Barriers Regarding Pediatric Palliative Care: A Mixed-Methods Study

  • 1College of Nursing, Sahmyook University, Seoul, Korea
  • 2Department of Nursing, Sangji University, Wonju, Korea
  • 3College of Nursing, Seoul National University, Seoul, Korea
  • 4College of Health Science, Department of Nursing, Kangwon National University, Samcheok, Korea
  • 5Department of Family Health Nursing, College of Nursing, The Catholic University of Korea, Seoul, Korea
  • 6Research Institute for Hospice/Palliative Care, The Catholic University of Korea, Seoul, Korea
  • 7College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea
  • 8Yonsei University College of Nursing & Mo-Im Kim Nursing Research Institute, Seoul, Korea
  • 9Department of Nursing, Korea National University of Transportation, Jeungpyeong, Korea
  • 10Hospice & Palliative Care Center, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
  • 11Regional Hospice Care Team, Regional Hospice Center, Chungnam National University Hospital, Daejeon, Korea


This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC).
Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques.
The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC.
In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.


Child; Adolescent; Palliative care; Nurses; Perception
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