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Understanding parental behavior in pediatric palliative care: Attachment theory as a paradigm

Published online by Cambridge University Press:  13 February 2014

Joan A. Kearney  and
Mary W. Byrne
Joan A. Kearney*
Affiliation:
Columbia University School of Nursing, New York, New York
Mary W. Byrne
Affiliation:
Columbia University School of Nursing, New York, New York
*
Address correspondence and reprints requests to: Joan A. Kearney, Columbia University School of Nursing, 630 West 168th Street, New York, New York 10032. E-Mail: jak2165@columbia.edu.
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Abstract

Objective:

The objective of this conceptual paper was to present important constructs in attachment theory as they apply to parent and caregiver behavior in pediatric palliative care. Clarification of these constructs is provided with specific reference to their clinical application as well as their reflection in current empirical literature. Social attachment theory is proposed as a developmentally contextual model for the study of parenting in pediatric palliative and end-of-life care.

Method:

A comprehensive search was conducted of pertinent literatures. These included classic as well as recent theory and research in attachment theory in addition to the empirical literatures on parent and family experience in pediatric palliative care, serious illness, and beyond to parental bereavement. Other relevant literature was examined with respect to the phenomena of concern.

Results:

The empirical literature in pediatric palliative care supports the use of central concepts in attachment theory as foundational for further inquiry. This is evidenced in the emphasis on the importance of parental protection of the child, as well as executive activities such as decision making and other prominent parental operations, parental psychological resolution of the child's diagnosis and illness as well as coping and meaning making, and the core significance of parental relationships with providers who provide secure-base and safe-haven functions.

Significance of Results:

The promise for developing integrated, conceptually based interventions from construction through implementation is of urgent importance to children and families receiving pediatric palliative care services. Focusing on key parental behaviors and processes within the context of a well-studied and contextually appropriate model will inform this task efficiently. The attachment paradigm meets these criteria and has promise in allowing us to move forward in developing well-defined, inclusive, and conceptually grounded protocols for child and family psychosocial research, practice, and education in this specialty

Keywords

Pediatric palliative careParentingAttachment
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1559 - 1568
Copyright
Copyright © Cambridge University Press 2014 

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