Regoaling: a conceptual model of how parents of children with serious illness change medical care goals.

TitleRegoaling: a conceptual model of how parents of children with serious illness change medical care goals.
Publication TypeJournal Article
Year of Publication2014
AuthorsHill DL, Miller VA, Walter JK, Carroll KW, Morrison WE, Munson D, Kang TI, Hinds PS, Feudtner C
JournalBMC Palliat Care
Volume13
Issue1
Pagination9
Date Published03/2014
ISSN1472-684X
Abstract

BACKGROUND: Parents of seriously ill children participate in making difficult medical decisions for their child. In some cases, parents face situations where their initial goals, such as curing the condition, may have become exceedingly unlikely. While some parents continue to pursue these goals, others relinquish their initial goals and generate new goals such as maintaining the child's quality of life. We call this process of transitioning from one set of goals to another regoaling.

DISCUSSION: Regoaling involves factors that either promote or inhibit the regoaling process, including disengagement from goals, reengagement in new goals, positive and negative affect, and hopeful thinking. We examine these factors in the context of parental decision making for a seriously ill child, presenting a dynamic conceptual model of regoaling. This model highlights four research questions that will be empirically tested in an ongoing longitudinal study of medical decision making among parents of children with serious illness. Additionally, we consider potential clinical implications of regoaling for the practice of pediatric palliative care.

SUMMARY: The psychosocial model of regoaling by parents of children with a serious illness predicts that parents who experience both positive and negative affect and hopeful patterns of thought will be more likely to relinquish one set of goals and pursue a new set of goals. A greater understanding of how parents undergo this transition may enable clinicians to better support them through this difficult process.

DOI10.1186/1472-684X-13-9
Alternate JournalBMC Palliat Care
PubMed ID24625345
PubMed Central IDPMC3975157