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Silent wounds: violence and adverse experiences in parents caring for terminally ill children in palliative care.

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Τίτλος: Silent wounds: violence and adverse experiences in parents caring for terminally ill children in palliative care.
Συγγραφείς: Guadarrama-Orozco J; Department of Palliative Care and Quality of Life, Hospital Infantil de México 'Federico Gómez', Mexico City, México. jessypedia@gmail.com., Romero-Mendoza M; Direction of Psychosocial and Epidemiological Research, Instituto Nacional de Psiquiatría 'Ramón de La Fuente Muñiz', Mexico City, Mexico., Mendoza-Martínez MG; Department of Palliative Care and Quality of Life, Hospital Infantil de México 'Federico Gómez', Mexico City, México., Peláez-Ballestas I; Rheumatology Unit, Hospital General de México 'Dr. Eduardo Liceaga', Mexico City, Mexico., Manrique de Lara A; Research Unit, Hospital General de México 'Dr. Eduardo Liceaga', Mexico City, Mexico., Muñoz-Pedraza M; Department of Palliative Care and Quality of Life, Hospital Infantil de México 'Federico Gómez', Mexico City, México.
Πηγή: BMC palliative care [BMC Palliat Care] 2026 May 11; Vol. 25 (1). Date of Electronic Publication: 2026 May 11.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BioMed Central Country of Publication: England NLM ID: 101088685 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-684X (Electronic) Linking ISSN: 1472684X NLM ISO Abbreviation: BMC Palliat Care Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central, [2002-
Ιατρικοί όροι (MeSH): Palliative Care*/methods , Palliative Care*/psychology , Palliative Care*/standards , Violence*/psychology , Violence*/statistics & numerical data , Parents*/psychology , Caregivers*/psychology , Terminally Ill*/psychology, Interviews as Topic/methods ; Humans ; Female ; Adult ; Qualitative Research ; Child ; Male ; Middle Aged ; Mexico ; Adolescent
Περίληψη: Background: Primary caregivers of paediatric palliative care patients-mostly women-are disproportionately exposed to adverse events and violence, both directly related to the experience of disease and to other stressful life events. These experiences have been associated with a higher risk of psychopathology, which in turn impacts the children under their care. The purpose of this study was to describe the experiences of violence among primary caregivers of palliative care patients in a children's hospital in Mexico City and to analyse how these experiences affect their caregiving capacity.
Methods: A qualitative study was conducted in which narratives were reconstructed from semi-structured interviews with primary caregivers, non-participant observations, and hospital documentation. Caregivers from 21 families with a child receiving palliative care participated in the study. Data analysis was performed using Atlas.ti software, with further triangulation between researchers and a multidisciplinary team of health professionals.
Results: Most caregivers narrated multiple and diverse experiences of violence across the lifespan, interwoven with intergenerational impacts. Experiences of violence were categorized into four groups: adverse childhood experiences, stressful life events in adulthood, onset of disease in the child, and consequences of disease. Violence was frequent among participants, and exposure to constant stressful life events had a negative impact on their ability to cope with adverse experiences, including the child's illness.
Conclusions: Recognizing and addressing the violence experienced by female caregivers is essential to paediatric palliative care practice. Prevention of re-traumatization and vicarious trauma among patients, families, and providers is needed to improve therapeutic interactions. Individualized interventions for survivors of violence could reduce the burden of disease on caregivers and disrupt intergenerational cycles of violence.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the principles of the Declaration of Helsinki and applicable national and institutional guidelines for research involving human participants. Ethical approval was obtained from Research Ethics Committee at the Children’s Hospital under protocol number HIM-2020—013, prior to data collection. All participants were fully informed about the purpose of the study, the voluntary nature of their participation, their right to withdraw at any time without consequence, and the confidentiality and anonymity of the information provided. Written and informed consent was obtained from all participants before the interviews were conducted. No personally identifiable information was retained during the coding and analysis process. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
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Contributed Indexing: Keywords: ACES; Caregivers; Paediatrics; Palliative medicine & chronic care; Quality of life; Violence
Entry Date(s): Date Created: 20260511 Date Completed: 20260716 Latest Revision: 20260716
Update Code: 20260717
PubMed Central ID: PMC13198043
DOI: 10.1186/s12904-026-02134-9
PMID: 42108452
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1472-684X
DOI:10.1186/s12904-026-02134-9