Pain perception and attitudes toward life-sustaining treatment in pediatric patients with disorders of consciousness: a survey of Chinese healthcare professionals - Summary - MDSpire
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Pain perception and attitudes toward life-sustaining treatment in pediatric patients with disorders of consciousness: a survey of Chinese healthcare professionals
To investigate the attitudes of Chinese healthcare professionals (HCPs) toward pain perception and life-sustaining treatment (LST) in pediatric patients with disorders of consciousness (DoC).
Approach:
Survey Methodology: A cross-sectional survey was conducted among 656 Chinese HCPs from March to November 2025, evaluating LST limitation and pain perception for unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) from third-person and first-person perspectives.
Key Findings:
52.1% of HCPs supported limiting LST for UWS compared to 31.6% for MCS in third-person contexts (p < 0.001).
Support for limiting LST dropped to 34.0% for UWS and 18.7% for MCS in first-person scenarios.
High income (>20,000 CNY) was a predictor for LST limitation for UWS in third-person context (AOR = 2.87).
Nursing (AOR = 0.46) and rehabilitation therapists (AOR = 0.55) were less likely to limit LST for their own child with UWS.
Childlessness was associated with a greater willingness to continue LST (AOR = 2.14).
Pain perception was recognized in 89.9% of MCS and 65.1% of UWS cases, significantly reducing willingness to limit LST in UWS from a first-person perspective (p = 0.002).
Interpretation:
Chinese HCPs exhibit caution in limiting LST for pediatric DoC, influenced by diagnosis and kinship perspective.
Limitations:
The study is limited to Chinese healthcare professionals and may not be generalizable to other cultural contexts.
The reliance on self-reported data may introduce bias in the attitudes expressed.
Conclusion:
A decision-support framework is needed to integrate neuroplasticity, socioeconomic realities, and pain ethics in LST decisions for pediatric DoC.
