Page 78 - Ebook-Book JCMS 2025

Development of Practice Protocol in Bereavement Care for
Families of Children Underwent Palliative Care
Phawinee Piwngam, Lunliya Thampratankul, Somporn Poolpanitoopatum*
Division of Pediatrics Nursing, Department of Nursing, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University
*Corresponding Author E-mail: poolpanit.porn@gmail.com
Abstract
Palliative care for children is the active total care of body, mind, and spirit, and also involves family support. Currently,
there is no practice protocol for bereavement care for families of children undergoing palliative care. Therefore, this
study aimed to develop a practice protocol for bereavement care of the family of pediatric patients receiving palliative
care and to evaluate the outcomes. A pilot practice protocol was initially developed, tested in 3 participants, and adjusted
to suit our population. Purposive sampling was used, and 43 family members of deceased children who received
palliative care at the Pediatric Nursing Department, Faculty of Medicine Ramathibodi Hospital in 2021 were enrolled.
After informed consent, the Brief Grief Questionnaire (BGQ) was obtained at 2 weeks, 6 weeks, and 6 months follow-up.
Participants with a BGQ score of 5 or above were classified as having depression, and a psychiatric consultation was
advised. A family satisfaction questionnaire using a 5-point rating scale across 8 dimensions was evaluated at the
6-month follow-up. The results showed that the developed practice protocol had a strong content validity index (0.87
- 1.00) and could be successfully implemented in clinical practice. The BGQ scores showed a significantly substantial
decline over time, with medians of 4.00 (IQR = 2-10), 3.00 (IQR = 0-10), and 1.00 (IQR = 0-10) at the 2-week, 6-week,
and 6-month follow-ups, respectively (p = .000). Five subjects exhibited symptoms of depression. Family satisfaction
was high, with a mean score of 4.72 (SD 0.29). In conclusion, our developed practice protocol for bereavement care for
families of children undergoing palliative care is practical and beneficial with high satisfaction. Further clinical use and
also study involving a large population is recommended.
76 Joint Conference in Medical Sciences 2025