The Relationship Between Nurses' Perception Of Barriers Magnitude And Their Demographic Characteristics

Out of approximately 2.5 million deaths in the United States annually, only around 50,000 are those of infants or children. Heron et al.(2009) . Although rare, it is important to acknowledge that death occurs in pediatrics, and to provide these children with comprehensive and compassionate end-of-life (EOL) care within a familycentered and developmentally appropriate context Crozier and Honcock (2012). The term ''end-of-life care'' is often used interchangeably with various terms such as terminal care, hospice care, or palliative care (PC)Izumi, Nagae, Sakurai and Imamura (2012) . EOL care as defined in a recent Canadian Institute for Health Information (CIHI)(2011) report refers to care for people in decline who are deemed to be terminal or dying in the foreseeable (near) future. Compelling evidence revealed that many children dying in an intensive care unit have unmet physical, psychological, emotional and social needs (Burns, Mitchell, Griffith, and Truog, 2001; Carter, Hubble, and Weise, 2006) as signs of some deficiencies in providing optimal pediatric EOL care in intensive care settings. Significant barriers to the optimal pediatric EOL care range from the individual educational level to the institutional and health care system level, Anghelescu, Hinds et. al (2006), which may reside in three areas: patient-family-related factors, healthcare-professional related factors, and organization related factors. (Anghelescu etal. 2006; Moss, Demanelis, Murray, and Jack, 2005; Nelson, 2006) .Due to negative affect of such barriers on care quality outcomes, identifying barriers and seeking effective facilitators are essential to implement specific strategies to improve pediatric EOL care. Mesukko (2010). Throughout history, nurses have sought ways to improve quality of life for individuals, families, and communities during every phase