Clinical Dietitians' Perspectives on Nutritional Management in Children's Palliative Care: A Qualitative Study
Bibliographic record
Abstract
BACKGROUND: Feeding disorders and gastrointestinal problems are among the most prevalent concerns in children who are eligible for palliative care. Many of these children require medical nutrition therapy and benefit from the involvement of healthcare professionals with expertise in nutrition, such as dietitians. Dietitians may help alleviate the practical and emotional burden parents experience when caring for their sick child at home. However, research is limited regarding dietitians' roles and contributions in children's palliative care. AIM: This study explores dietitians' experiences and perceptions of nutritional management and care of children in palliative care in Norway. METHODS: Semistructured interviews were conducted with 11 dietitians who provide nutritional management to children in palliative care, and the data were analysed using a reflexive thematic analysis approach, as described by Braun and Clarke. RESULTS: Four themes were developed through this analysis: First, nutrition is a core component of comprehensive palliative care; second, organisational placement affects dietitians' involvement; third, fragile structures for nutritional care; fourth, close bonds between the family and the dietitian. We found that dietitians face complex feeding and gastrointestinal challenges when working with children and view nutritional care as a responsibility best addressed by a multidisciplinary team, rather than a task for the dietitian to manage independently. Organisational structure impacts a dietitian's ability to collaborate effectively with other professionals in providing nutritional care. Dietitians' knowledge of children's palliative care is primarily experience-based, and they often lack professional support in decision-making processes. Nevertheless, dietitians maintain close, ongoing contact with the families of the children they treat and tailor their approach to meet these families' needs as the children's conditions progress. CONCLUSION: Nutrition is a core component of comprehensive palliative care and can impact the quality of life of children and their families. Therefore, it should be an integrated component of multidisciplinary palliative care for children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.008 | 0.008 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".