The problem of inadequate access to end-of-life care services for children diagnosed with a serious illness was explored. This interdisciplinary study integrates national pediatric initiatives that call for the provision of concurrent palliative and curative care, with the region's needs, as informed by this study's survey results. The objectives were to characterize what fosters equitable access to services, and to understand providers' conceptualizations of end-of-life care of children in order to address service-gaps. The study is timely, as more than 500 low-income families in the Fresno-area who could benefit from a 2011 Medi-Cal program face a community service-capacity of 25 families. The 148 online survey respondents were experienced social workers, nurses, and allied health professionals who encounter children with a life-limiting illness. Practice initiatives specific to children were weakly reflected in providers' perspectives, but were more evident in narrative responses. A majority showed use of adult care models when rating the timing and importance of services through a course of illness. Clinical providers' responses were significantly better aligned with best-practices compared to medical or allied health professionals. Narrative core themes included: provider education, timely referral, diverse staff, and inter-organizational collaboration. Next steps needed in research and community response were discussed. The implications for social workers to serve as a multi-system communication bridge were discussed from the profession's core values of social justice, an empowerment perspective and cultural competency.
|Commitee:||Capitman, John, Rondero Hernandez, Virginia|
|School:||California State University, Fresno|
|Department:||Social Work Education|
|School Location:||United States -- California|
|Source:||MAI 49/05M, Masters Abstracts International|
|Subjects:||Social work, Nursing, Health care management|
|Keywords:||Barriers, Child health policy, Palliative care, Pediatric hospice care, Referral behavior|
Copyright in each Dissertation and Thesis is retained by the author. All Rights Reserved
The supplemental file or files you are about to download were provided to ProQuest by the author as part of a
dissertation or thesis. The supplemental files are provided "AS IS" without warranty. ProQuest is not responsible for the
content, format or impact on the supplemental file(s) on our system. in some cases, the file type may be unknown or
may be a .exe file. We recommend caution as you open such files.
Copyright of the original materials contained in the supplemental file is retained by the author and your access to the
supplemental files is subject to the ProQuest Terms and Conditions of use.
Depending on the size of the file(s) you are downloading, the system may take some time to download them. Please be