Perspectives of Close Relatives in Pediatric Palliative Care: A Grounded Theory Approach

Perspectives of Close Relatives in Pediatric Palliative Care: A Grounded Theory Approach by Janelle Marie Feyh M.S., Emporia State University, 1993 B.A., Washburn University, 1990 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy School of Psychology Walden University May 2011 Abstract Pediatric palliative care has recently become a priority in the healthcare field and is implemented at the time of diagnosis rather than days or weeks before the child’s death. Social constructivism theory in which humans generate meaning from their experiences was utilized as a general framework to determine the impact of pediatric palliative care on close relatives. The purpose of this grounded theory study was to generate a substantive theory that explains how close relatives such as grandparents, aunts, and uncles of a child with cancer experience palliative care. The participants of the study included close relatives of children in palliative care. Semistructured interviews and journaling were used to collect data. Initial, focused, and selective coding procedures were used to manage the data and a content analysis of the textual data was performed. Findings from the data suggested a process of surrendering to the journey in which close relatives learn to let go of what they cannot control while holding on to what they can control. Social change implications of this study may include improving healthcare programming for close relatives utilizing supportive-expressive measures. This programming may promote mental health of the close relatives who will learn to deal with their adjustment difficulties and improve their coping skills.Pediatric palliative care has recently become a priority in the healthcare field and is implemented at the time of diagnosis rather than days or weeks before the child’s death. Social constructivism theory in which humans generate meaning from their experiences was utilized as a general framework to determine the impact of pediatric palliative care on close relatives. The purpose of this grounded theory study was to generate a substantive theory that explains how close relatives such as grandparents, aunts, and uncles of a child with cancer experience palliative care. The participants of the study included close relatives of children in palliative care. Semistructured interviews and journaling were used to collect data. Initial, focused, and selective coding procedures were used to manage the data and a content analysis of the textual data was performed. Findings from the data suggested a process of surrendering to the journey in which close relatives learn to let go of what they cannot control while holding on to what they can control. Social change implications of this study may include improving healthcare programming for close relatives utilizing supportive-expressive measures. This programming may promote mental health of the close relatives who will learn to deal with their adjustment difficulties and improve their coping skills. Perspectives of Close Relatives in Pediatric Palliative Care: A Grounded Theory Approach by Janelle Marie Feyh M.S., Emporia State University, 1993 B.A., Washburn University, 1990 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy School of Psychology Walden University May 2011 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent on the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. All rights reserved. This edition of the work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 1346 UMI 3457450 Copyright 2011 by ProQuest LLC. UMI Number: 3457450 Dedication This dissertation is dedicated to my son Daegen James Feyh who fought cancer for 2 years passed away at the age of 4. Daegen’s spirit touched everyone who knew him. My pursuit of a doctorate degree in psychology was a result of my experience and all that I learned from him. I am dedicating this dissertation to Daegen and to all children and families who continue to fight this dreadful disease. I am confident that one day there will be a cure, but until then I am dedicating my life to understanding the psychological and psychosocial impact of this disease on children and families.