{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:30:51Z","timestamp":1785429051078,"version":"3.56.0"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"unspecified","delay-in-days":175,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526103046_sec1a\">\n                    <jats:title>Objectives.<\/jats:title>\n                    <jats:p>While parental prognostic awareness is a vital concept, its complexity can sometimes be underestimated. Our study aimed to understand how parents of children with serious illness engage with the idea of their child\u2019s death from a lived experience perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103046_sec2b\">\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>Bereaved parents of children known to a statewide pediatric palliative care service, who died at the age of 16\u00a0years or younger from any medical condition, participated in semi-structured interviews. Reflexive thematic analysis was employed, informed by a phenomenological framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103046_sec3c\">\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Twenty bereaved parents (6 fathers) participated; children ranged in age from 1\u00a0day to 16\u00a0years. Findings were categorized into 2 main themes: (1) Daily realities of engaging with the idea of death, with subthemes: variability in contemplating death, conversations with their child, conversations with family and friends, conversations with clinicians, making treatment decisions, and not engaging with death, and (2) factors influencing engagement, with subthemes: implicit factors, changes in clinical condition, and clinician communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103046_sec4d\">\n                    <jats:title>Significance of results.<\/jats:title>\n                    <jats:p>Parents\u2019 engagement with the idea of their child\u2019s death was individual and dynamic. Our findings offer tangible examples of how parents contemplate and operationalize this engagement over time, helping clinicians appreciate the complex and non-binary nature of prognostic awareness. Clinicians should explore how parents engage with the idea of their child\u2019s death both during and outside clinical encounters over time, acknowledge their role in supporting and guiding parents, and recognize that there is no single way for parents to process the idea of their child\u2019s death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526103046","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T06:59:08Z","timestamp":1782370748000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Shifting sands: How parents engage with the idea of their child\u2019s death"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-1895","authenticated-orcid":false,"given":"Naomi T.","family":"Katz","sequence":"first","affiliation":[{"name":"The Royal Children\u2019s Hospital Melbourne"},{"id":[{"id":"https:\/\/ror.org\/01ej9dk98","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Melbourne - Parkville Campus"},{"name":"Murdoch Children\u2019s Research Group"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny L.","family":"Hynson","sequence":"additional","affiliation":[{"name":"The Royal Children\u2019s Hospital Melbourne"},{"id":[{"id":"https:\/\/ror.org\/01ej9dk98","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Melbourne - Parkville Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Gillam","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01ej9dk98","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Melbourne - Parkville Campus"},{"name":"The Royal Children\u2019s Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"S1478951526103046_ref17","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00762"},{"key":"S1478951526103046_ref24","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5286"},{"key":"S1478951526103046_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70209-7"},{"key":"S1478951526103046_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/capr.12360"},{"key":"S1478951526103046_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-10190-6"},{"key":"S1478951526103046_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyaf344"},{"key":"S1478951526103046_ref18","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.6110"},{"key":"S1478951526103046_ref15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-044503"},{"key":"S1478951526103046_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31964"},{"key":"S1478951526103046_ref25","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2022.0265"},{"key":"S1478951526103046_ref30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.19.2469"},{"key":"S1478951526103046_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2025-099132"},{"key":"S1478951526103046_ref11","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2012.0547"},{"key":"S1478951526103046_ref19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.3170"},{"key":"S1478951526103046_ref22","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018488"},{"key":"S1478951526103046_ref9","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0238"},{"key":"S1478951526103046_ref10","first-page":"5975","article-title":"Associations of prognostic-awareness-transition patterns with end-of-life care in cancer patients\u2019 last month","volume":"30","author":"Chen","year":"2022","journal-title":"Supportive Care Cancer"},{"key":"S1478951526103046_ref21","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.5326"},{"key":"S1478951526103046_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15612"},{"key":"S1478951526103046_ref23","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2015.0472"},{"key":"S1478951526103046_ref4","volume-title":"Qualitative Research \u2013 A Practical Guide for Health and Social Care Researchers and 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e180"}}