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      Primary Caregivers Caring for a Child at End of Life in Saudi Arabia

      research-article
      , PhD, MPA, RN 1 , 2 , * , , , PhD, RN, FAAN 2 , 3 , , PhD, MPH, RN 2 , 3 , , DrPH, MSc 4 , , PhD, RN, GCNS-BC 3 , , MD, MED 5
      Palliative Medicine Reports
      Mary Ann Liebert, Inc., publishers
      children at end of life, end of life, end of life care, primary caregivers, Saudi Arabia

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          Abstract

          Background:

          Caring for children at end of life (EOL) can be devastating for primary caregivers who are responsible for the physical, social, and emotional needs of their dying child. Limited information was found on resources in Saudi Arabia to manage the impact on primary caregivers from caring for a child receiving end of life care (EOLC).

          Purpose:

          The purpose of this study was to explore the experiences of primary caregivers caring for a child receiving EOLC within the Saudi Arabian health care system.

          Methods:

          A descriptive phenomenological study was conducted, and 24 female primary caregivers were interviewed individually. Participants were recruited from three hospitals and the surrounding community in Jeddah, Saudi Arabia. The data were collected over a period of seven weeks between August and September of 2019. Individual in-depth interviews were conducted using an 11-item investigator-developed interview guide derived from the literature on EOL. Thematic analysis was completed using transcripts from all interviews.

          Results:

          The findings suggest that primary caregivers caring for a child receiving EOLC were impacted psychologically, physically, socially, and financially. Primary caregivers expressed their heartbreak, lack of sleep, isolation, and financial challenges while caring for their child at EOL.

          Conclusions:

          Similar to what has been reported in the literature, primary caregivers caring for a child at EOL experience biopsychosocial and financial challenges. In addition, this study has implications for nursing education, practice, policy, and research regarding EOLC. Also, the findings can guide future research on EOL in Saudi Arabia and worldwide.

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          Most cited references19

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          Healthcare Finance in the Kingdom of Saudi Arabia: A Qualitative Study of Householders’ Attitudes

          Background The public sector healthcare system in Saudi Arabia, essentially financed by oil revenues and ‘free at the point of delivery’, is coming under increasing strain due to escalating expenditure and an increasingly volatile oil market and is likely to be unsustainable in the medium to long term. Objectives This study examines how satisfied the Saudi people are with their public sector healthcare services and assesses their willingness to contribute to financing the system through a national health insurance scheme. The study also examines public preferences and expectations of a future national health insurance system. Methods A total of 36 heads of households participated in face-to-face audio-recorded semi-structured interviews. The participants were purposefully selected based on different socio-economic and socio-demographic factors from urban and rural areas to represent the geographical diversity that would presumably influence individual views, expectations, preferences and healthcare experiences. Results The evidence showed some dissatisfaction with the provision and quality of current public sector healthcare services, including the availability of appointments, waiting times and the availability of drugs. The households indicated a willingness to contribute to a national insurance scheme, conditional upon improvements in the quality of public sector healthcare services. The results also revealed a variety of preferences and expectations regarding the proposed national health insurance scheme. Conclusions Quality improvement is a key factor that could motivate the Saudi people to contribute to financing the healthcare system. A new authority, consisting of a partnership between the public and private sectors under government supervision, could represent an acceptable option for addressing the variation in public preferences. Electronic supplementary material The online version of this article (doi:10.1007/s40258-017-0353-7) contains supplementary material, which is available to authorized users.
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            The Myth Regarding the High Cost of End-of-Life Care.

            Health care reform debate in the United States is largely focused on the highly concentrated health care costs among a small proportion of the population and policy proposals to identify and target this "high-cost" group. To better understand this population, we conducted an analysis for the Institute of Medicine Committee on Approaching Death using existing national data sets, peer-reviewed literature, and published reports. We estimated that in 2011, among those with the highest costs, only 11% were in their last year of life, and approximately 13% of the $1.6 trillion spent on personal health care costs in the United States was devoted to care of individuals in their last year of life. Public health interventions to reduce health care costs should target those with long-term chronic conditions and functional limitations.
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              • Article: not found

              The impact of losing a child on the clinical presentation of complicated grief.

              It is unclear whether bereaved parents with Complicated Grief (CG) struggle with their grief differently than others with CG. This study addressed this question by comparing CG severity, CG-related symptoms, thoughts and behaviors, and comorbid psychiatric diagnoses of bereaved parents with CG to the diagnoses and symptoms of others with CG.
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                Author and article information

                Journal
                Palliat Med Rep
                Palliat Med Rep
                pmr
                Palliative Medicine Reports
                Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA )
                2689-2820
                09 August 2022
                2022
                09 August 2022
                : 3
                : 1
                : 140-148
                Affiliations
                [ 1 ]Nursing Program, Batterjee Medical College, Aseer, Saudi Arabia.
                [ 2 ]Sigma Theta Tau International (STTI), Eta Nu Chapter, Milwaukee, Wisconsin, USA.
                [ 3 ]College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
                [ 4 ]School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
                [ 5 ]King Saud Ben Abdulaziz University for Health Science, Riyadh, Saudi Arabia.
                Author notes
                [*] [ * ]Address correspondence to: Shahad A. Hafez, PhD, MPA, RN, Nursing Program, Batterjee Medical College, King Fahad Road, Aseer, Hijlah 62451, Saudi Arabia. shahad.hafez@ 123456hotmail.com
                Article
                10.1089/pmr.2021.0072
                10.1089/pmr.2021.0072
                9438442
                36059911
                cb5dd2ca-84ee-45a8-a8f8-aedc393b40ed
                © Shahad A. Hafez et al., 2022; Published by Mary Ann Liebert, Inc.

                This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : Accepted July 17, 2022
                Page count
                Figures: 1, Tables: 3, References: 22, Pages: 9
                Categories
                Original Article

                children at end of life,end of life,end of life care,primary caregivers,saudi arabia

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