Development of psycho-social support system for families of intractable cancer children

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Many family members of intractable pediatric cancer patients have support needs around End-of-life discussions (EOLd).We found 23 barriers against EOLd with pediatric cancer patients. These barriers were classified as follows: healthcare provider factors, patient factors, parent factors, and institutional or cultural factors. In addition to barriers found in previous studies, some unique barriers were uncovered such as, "Uncertain responsibility for treatment decision-making," and "No compelling reason to discuss," "Inability of patients to comprehend terminal condition." Healthcare providers actively discussed the purpose of treatment and the patients' wishes and concerns; however, they were reluctant to deal with the patients' own impending death and their estimated prognosis.The result of this study will contribute to better EOLd.