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Popa MV, Mîndru DE, Hizanu (Dumitrache) M, Gurzu IL, Anton-Păduraru DT, Ștreangă V, Gurzu B, Guțu C, Elkan EM, Duceac LD. Stress Factors for the Paediatric and Adult Palliative Care Multidisciplinary Team and Workplace Wellbeing Solutions. Healthcare (Basel) 2024; 12:868. [PMID: 38727425 PMCID: PMC11083451 DOI: 10.3390/healthcare12090868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Palliative care is a challenging specialty, especially when it comes to caring for children with serious life-limiting conditions and supporting their families. Workers face significant challenges and experience major impacts on their wellbeing. We conducted a qualitative study to understand the sources of stress in the palliative care team, their work expectations, and how they can cope with the demands. METHODS We used an online questionnaire about the causes of stress, the impact of the COVID-19 pandemic and the ways in which support is needed in the workplace. RESULTS Of the 56 palliative care professionals who participated in the survey, 57.1% considered the main causes of stress to be high workload, difficult emotional burdens (55.4%) affecting their outlook on life (61.2%), the death of patients (46.4%), and communication with patients' families (26.8%). The COVID-19 pandemic increased stress levels for the majority of respondents (89.3%). The need for specialised training (53.6%), support groups, psychological counselling and adapted organisational policies was highlighted. CONCLUSIONS The study demonstrates the importance of understanding the needs of both paediatric and adult palliative care staff in order to provide optimal care and support their balance in this demanding area of the healthcare system.
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Affiliation(s)
- Maria Valentina Popa
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania; (M.V.P.); (M.H.)
| | - Dana Elena Mîndru
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Mihaela Hizanu (Dumitrache)
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania; (M.V.P.); (M.H.)
| | - Irina Luciana Gurzu
- Department of Preventive Medicine and Interdisciplinarity, Discipline of Occupational Health, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania;
| | - Dana Teodora Anton-Păduraru
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Violeta Ștreangă
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Bogdan Gurzu
- Department of Morfofunctional Sciences, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania;
| | - Cristian Guțu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ”Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
| | - Eva Maria Elkan
- Department of Morfofunctional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
| | - Letiția Doina Duceac
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
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Toro-Pérez D, Limonero JT, Guillen M, Bolancé C, Vilarrubí SN, Camprodon-Rosanas E. Evaluating quality of life in pediatric palliative care: a cross-sectional analysis of children's and parents' perspectives. Eur J Pediatr 2024; 183:1305-1314. [PMID: 38112799 PMCID: PMC10951001 DOI: 10.1007/s00431-023-05330-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/26/2023] [Accepted: 11/05/2023] [Indexed: 12/21/2023]
Abstract
The patient's perspective is an essential component of understanding the individual experience of suffering in children with palliative needs, but it is a perspective that is often overlooked. The aim of this study was to compare the perception of quality of life (QoL) of children with life-limiting and life-threatening conditions expressed by the children themselves and their parents. Through a cross-sectional study, the responses of 44 parent-child dyads were obtained and the analysis was performed with the statistics based on Student's t distribution and non-parametric tests. Children value QoL more positively (mean = 6.95, SD = 1.85) than their parents (mean = 5.39, SD = 2.43). This difference exists even if we consider sociodemographic and disease variables. The presence of exacerbated symptoms is the situation in which both parents (mean = 3.70; SD = 1.95) and children (mean = 5.60; SD = 1.17) evaluate QoL more negatively. CONCLUSIONS Children have a more optimistic view than their parents. When the child is the one who reports a lower QoL score than their parent, the child should be carefully monitored. The voice of the child and that of the family members can be collected to create a "family voice" and can be complementary. WHAT IS KNOWN • Children with life-limiting conditions experience multiple and changing symptoms that affect their QoL. • The child's perspective is often overlooked. WHAT IS NEW • Children value QoL more positively than their parents do, even if we control for sociodemographic variables and the disease itself. • When the child is the one who reports a lower QoL score than their parent, the child should be carefully monitored.
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Affiliation(s)
- Daniel Toro-Pérez
- School of Psychology, Stress and Health Research Group, Autonomous University of Barcelona, Barcelona, Spain.
- Palliative Care and Complex Chronic Patient Service (C2P2), Sant Joan de Déu Hospital in Barcelona, Barcelona, Spain.
- Children and Adolescent Mental Health Research Group, Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain.
- ANJANA Working Group, Catalan-Balearic Society of Palliative Care, Catalan Society of Pediatrics, Barcelona, Spain.
| | - Joaquin T Limonero
- School of Psychology, Stress and Health Research Group, Autonomous University of Barcelona, Barcelona, Spain
| | - Montserrat Guillen
- Department of Econometrics, Statistics and Applied Economics, University of Barcelona, Barcelona, Spain
| | - Catalina Bolancé
- Department of Econometrics, Statistics and Applied Economics, University of Barcelona, Barcelona, Spain
| | - Sergi Navarro Vilarrubí
- Palliative Care and Complex Chronic Patient Service (C2P2), Sant Joan de Déu Hospital in Barcelona, Barcelona, Spain
- ANJANA Working Group, Catalan-Balearic Society of Palliative Care, Catalan Society of Pediatrics, Barcelona, Spain
| | - Ester Camprodon-Rosanas
- Children and Adolescent Mental Health Research Group, Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
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Ruiz-Gil T, Ródenas-Rigla F. Quality of Care in Pediatric Palliative Care: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1922. [PMID: 38136124 PMCID: PMC10741525 DOI: 10.3390/children10121922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Palliative care (PC) enhances the quality of life for patients and families facing life-threatening conditions. While PC is well-established for adults, not all practices apply to pediatrics. Consequently, specific quality indicators for Pediatric Palliative Care (PPC) must be identified. This scoping review aimed to identify the variables associated with the quality of care of PPC patients in Spain, focusing specifically on three areas: structure and process of care, psychological aspects of care, and care of patients approaching the end of life. The review was conducted following PRISMA-ScR guidelines. Searches were performed in the PubMed, Scopus, Web of Science, Embase, ProQuest, and Dialnet databases covering the period extending from January 2000 to May 2023. Finally, 35 studies were identified for the complete review. A total of 30 studies include variables associated with the structure and process of care, 20 include variables associated with psychological aspects of care, and 23 studies integrate variables related to patient care at the end of life. Analysis suggests that enhancing professional training in aspects such as communication with patients and families, creating intimate spaces with flexible visiting hours, increasing emotional support, promoting frequent contact with healthcare teams, and transparently communicating about illness and imminent death to both families and minors could improve the quality of PPC.
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Affiliation(s)
- Tania Ruiz-Gil
- Polibienestar Research Institute, University of Valencia, 46022 Valencia, Spain;
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