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We examined parental preferences in raising Spanish/English bilingual children. We identified factors influencing their decisions, and the strategies used to promote bilingualism. Focus groups were conducted with Spanish-primary-language parents of children 3 to 7 years old. These groups were audiotaped and transcribed. Three reviewers independently analyzed transcripts for themes using margin-coding and grounded theory; disagreements were resolved by consensus. Thirteen Spanish-primary-language parents participated in two focus groups. The results show that parents wanted their children to be bilingual. Parents also stated that the benefits of bilingualism included better career opportunities, and preservation of culture and native language. Family members, schools, and prior parental experiences influenced the parents' decisions to raise bilingual children. Parents preferred English-only school classes and to teach Spanish at home. Strategies identified for raising bilingual children included reading bilingual books and having children speak only Spanish at home. Schools and pediatricians are used as resources.

1. Utilizing a case-based and interactive approach, participants will self-report greater confidence in discussing a potential wean of HHFNC with patients and families. 2. Utilizing a case-based and interactive approach, participants will self-report greater confidence in eliciting and exploring existential, cultural, and religious concerns in patients considering a palliative oxygen wean from maximum HHFNC. This presentation addresses the holistic, multidisciplinary management of existential distress as well as religious and cultural considerations when counseling patients who are unable to wean from heated high flow nasal cannula (HHFNC). These vulnerable patients have highly specialized needs in end-of-life discussions since they are often awake and alert with minimal symptoms and must consider sedation to tolerate oxygen weaning. Heated high flow nasal cannula (HHFNC) is a lifesaving technology that allows patients to receive positive pressure ventilation and a high level of oxygen support while still being able to eat, talk, and participate in activities like physical therapy. This life support device can support patients who hope their lungs can heal while avoiding the adverse effects associated with mechanical ventilation. However, some patients don't recover enough lung function to wean from HHFNC and are thus unable to leave an acute care setting. Healthcare providers must discuss treatment options with these patients, including the option to elect for compassionate withdrawal of oxygen support. To tolerate weaning from maximum oxygen support, patients usually require palliative sedation because of the high burden of anxiety and dyspnea with this procedure. This presentation will address the distress that this conversation can cause in patients and their healthcare providers, and how we effectively utilize palliative care multidisciplinary teams to address existential distress, cultural and religious concerns, and thus create culturally competent patient-centered care with the available resources. The authors review and contrast two patient cases in which the withdrawal of HHFNC is discussed. After discussing withdrawal of HHFNC, both patients subsequently grappled with the idea of picking a date and time to transition from being fully awake and alert to undergoing palliative sedation. The patients' main concerns were about how to know when it is time to stop a life support treatment, whether stopping life support would be "acting against God's plan," and how to be sure their families were also spiritually supported. Palliative care chaplain and social work support helped with patient and family concerns. The palliative care multidisciplinary team is instrumental in helping patients and families cope with discussions about weaning HHFNC and the resultant existential and spiritual distress. Managing Suffering and Distress; Existential / Humanities / Spirituality / Religion [ABSTRACT FROM AUTHOR]

We examined parental preferences in raising Spanish/English bilingual children. We identified factors influencing their decisions, and the strategies used to promote bilingualism. Focus groups were conducted with Spanish-primary-language parents of children 3 to 7 years old. These groups were audiotaped and transcribed. Three reviewers independently analyzed transcripts for themes using margin-coding and grounded theory; disagreements were resolved by consensus. Thirteen Spanish-primary-language parents participated in two focus groups. The results show that parents wanted their children to be bilingual. Parents also stated that the benefits of bilingualism included better career opportunities, and preservation of culture and native language. Family members, schools, and prior parental experiences influenced the parents' decisions to raise bilingual children. Parents preferred English-only school classes and to teach Spanish at home. Strategies identified for raising bilingual children included reading bilingual books and having children speak only Spanish at home. Schools and pediatricians are used as resources.