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Wang CH, Chen YK, Tsao SH, Lee CH. Trends in Palliative Care Research During the COVID-19 Pandemic. Am J Hosp Palliat Care 2023; 40:1271-1278. [PMID: 36503251 PMCID: PMC9748525 DOI: 10.1177/10499091221145202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
To demonstrate the trends and variety of research on palliative care during the COVID-19 pandemic. A systematic search of the Web of Science database. Since the outbroke of the COVID-19 pandemic, the adjustment of palliative care systems is warranted to maintain a high quality of care. The COVID-19 -related palliative care studies account for approximately 4% of all publications on palliative care. However, there is a dearth of research investigating the nature of these studies. A total of 293 studies were included. Of the included studies, those related to system improvement were the most common (181/293, 61.8%), followed by those related to patient care (79/293, 27.0%), bereavement support for patients or family members (19/293, 6.5%), and the mental health of frontline practitioners (14/293, 4.8%). From these studies, 82, 137, and 74 studies were published in 2020, 2021, and 2022 (until August 1), respectively. The research trends of palliative care demonstrate the flexibility and rapid response of the global palliative care system to the COVID-19 pandemic and show how the palliative care system is evolving. While most studies are interested in system improvement, patient care, and bereavement support, the mental health of frontline practitioners has received less attention. Our findings provide palliative care practitioners with current valuable information and highlight possible future trends.
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Affiliation(s)
- Chien-Ho Wang
- Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yu-Kai Chen
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Han Tsao
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Hsing Lee
- Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
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2
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Guraya SS, Menezes P, Lawrence IN, Guraya SY, Rashid-Doubell F. Evaluating the impact of COVID-19 pandemic on the physicians' psychological health: A systematic scoping review. Front Med (Lausanne) 2023; 10:1071537. [PMID: 37056734 PMCID: PMC10086257 DOI: 10.3389/fmed.2023.1071537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundCOVID-19 has endangered healthcare systems at multiple levels worldwide. Published data suggests that moral dilemmas faced during these unprecedented times have placed physicians at the intersections of ethical and unethical considerations. This phenomenon has questioned the physicians' morality and how that has affected their conduct. The purpose of our review is to tap into the spectrum of the transforming optics of patient care during the pandemic and its impact on psychological wellbeing of physicians.MethodsWe adopted the Arksey and O'Malley's framework, defining research questions, identifying relevant studies, selecting the studies using agreed inclusion and exclusion criteria, charting the data, and summarizing and reporting results. Databases of PubMed/Medline, Web of Science, Scopus, Science Direct, CINAHL, and PsycInfo were searched using a predefined search string. The retrieved titles and abstracts were reviewed. Later, a detailed full-text analysis of the studies which matched our inclusion criteria was performed.ResultsOur first search identified 875 titles and abstracts. After excluding duplicates, irrelevant, and incomplete titles, we selected 28 studies for further analysis. The sample size in 28 studies was 15,509 with an average size of 637 per study. Both quantitative and qualitative approaches were used, with cross-sectional surveys being utilized in all 16 quantitative studies. Using the data from semi-structured interviews, several discrete codes were generated, which led to the identification of five main themes; mental health, individual challenges, decision-making, change in patient care, and support services.ConclusionThis scoping review reports an alarming rise in psychological distress, moral injury, cynicism, uncertainty, burnout, and grief among physicians during the pandemic. Decision-making and patient care were mostly regulated by rationing, triaging, age, gender, and life expectancy. Poor professional controls and institutional services potentially led to physicians' crumbling wellbeing. This research calls for the remediation of the deteriorating mental health and a restoration of medical profession's advocacy and equity.
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Affiliation(s)
- Shaista S. Guraya
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
| | - Prianna Menezes
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
| | | | - Salman Yousuf Guraya
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- *Correspondence: Salman Yousuf Guraya
| | - Fiza Rashid-Doubell
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
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3
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Levoy K, Foxwell A, Rosa WE. Palliative care delivery changes during COVID-19 and enduring implications in oncology nursing: a rapid review. Curr Opin Support Palliat Care 2022; 16:94-101. [PMID: 35929556 PMCID: PMC9364779 DOI: 10.1097/spc.0000000000000603] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW A rapid review was conducted to synthesize evidence of palliative care delivery changes during the COVID-19 pandemic. Changes were synthesized according to the eight domains of high-quality palliative care and enduring implications for oncology nurses beyond the pandemic discussed. RECENT FINDINGS The most significant changes occurred in the structure and processes of palliative care (Domain 1), where increased utilization of telehealth was critical in circumventing barriers imposed by COVID-19 mitigation. The suboptimal availability of community-based psychosocial supports for patients and caregivers and inadequate health system-based psychosocial supports for healthcare providers were highlighted (Domains 3-5). The pandemic also ushered in an increased emphasis on the need for advance care planning (ACP), where integrating its delivery earlier in the outpatient setting and shifting policy to promote subsequent virtual documentation (Domain 8) were essential to ensure care preferences were clarified and accessible before health crises occurred. SUMMARY Continuing to embrace and sustain systems-level changes with respect to telehealth, psychosocial supports, and ACP are critical to bridging gaps in palliative care delivery underscored by the pandemic. Oncology nurses are well positioned to fill these gaps in care beyond the pandemic by providing evidence-based, palliative care throughout the cancer continuum.
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Affiliation(s)
- Kristin Levoy
- Department of Community and Health Systems, Indiana University School of Nursing
- Indiana University Center for Aging Research, Regenstrief Institute
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana
| | - Anessa Foxwell
- Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - William E. Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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4
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Nicholas DB, Zulla RT, Conlon O, Dimitropoulos G, Urschel S, Rapoport A, Katz SL, Bruce A, West LJ, Belletrutti M, Cullen E, Zwaigenbaum L. Les effets de la pandémie de COVID-19 sur la santé mentale des enfants atteints de problèmes de santé physique ou d’incapacités, des familles et des professionnels de la santé. Paediatr Child Health 2022; 27:S115-S122. [PMID: 36092296 PMCID: PMC9455651 DOI: 10.1093/pch/pxac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Résumé
Objectifs
La pandémie de COVID-19 a influé sur la santé mentale de la population. Les familles des enfants qui ont des vulnérabilités en matière de santé ont été démesurément touchées par les politiques liées à la pandémie et les perturbations aux services, car elles s’appuient beaucoup sur le système de soins de santé et de services sociaux. Les chercheurs ont établi les répercussions de la pandémie de COVID-19 sur les enfants ayant des vulnérabilités en matière de santé physique et des incapacités, les familles et les professionnels de la santé.
Méthodologie
Des enfants ayant diverses vulnérabilités en matière de santé (transplantation cardiaque, affections respiratoires, anémie falciforme, trouble du spectre de l’autisme, troubles de santé mentale et approche de la fin de vie en raison d’une série de causes sous-jacentes), leurs parents et leurs professionnels de la santé ont participé à des entrevues semi-structurées. Les chercheurs ont utilisé des méthodes d’analyse qualitative et en ont extrait les thèmes liés aux effets et les recommandations en vue d’améliorer la pratique.
Résultats
Au total, 262 participants (30 enfants, 76 parents, 156 professionnels de la santé) ont été interviewés. Les enfants ont décrit leur solitude et leur isolement, les parents, leur épuisement, et les professionnels de la santé, la pression ressentie et un sentiment de détresse morale. Les thèmes reflétaient les effets de la pandémie sur la santé mentale des enfants, des familles et des professionnels de la santé, de même que les ressources insuffisantes pour soutenir la santé mentale, les influences organisationnelles et politiques qui ont façonné la prestation des services et les recommandations pour améliorer la prestation de ces services.
Conclusion
Les restrictions sanitaires imposées par la pandémie et les modifications aux soins ont eu de profondes répercussions sur la santé mentale des enfants qui ont des vulnérabilités en matière de santé, les familles et les professionnels de la santé. Les recommandations incluent la rédaction et l’adoption d’information ciblée sur la pandémie et la mise en œuvre de services de soutien en santé mentale. Ces résultats amplifient la nécessité de renforcer les capacités, y compris des stratégies proactives et la planification de mesures d’atténuation du risque dans l’éventualité d’une future pandémie.
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Affiliation(s)
- David B Nicholas
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Rosslynn T Zulla
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Olivia Conlon
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Gina Dimitropoulos
- Faculté de travail social, Université de Calgary, Calgary (Alberta)Canada
| | - Simon Urschel
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Adam Rapoport
- The Hospital for Sick Children, Toronto (Ontario)Canada.,Emily's House Children's Hospice, Toronto (Ontario)Canada.,Département de pédiatrie, Université de Toronto, Toronto (Ontario)Canada
| | - Sherri Lynne Katz
- Centre hospitalier pour enfants de l'est de l'Ontario, Ottawa (Ontario)Canada.,Département de pédiatrie, Université d'Ottawa, Ottawa (Ontario)Canada.,Institut de recherche du Centre hospitalier pour enfants de l'est de l'Ontario, Ottawa (Ontario)Canada
| | - Aisha Bruce
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Lori J West
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Mark Belletrutti
- British Columbia Children's Hospital, Vancouver (Colombie-Britannique)Canada.,Départment de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
| | - Emma Cullen
- Faculté de travail social, Université de Calgary, Calgary (Alberta)Canada
| | - Lonnie Zwaigenbaum
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada.,Glenrose Rehabilitation Hospital, Edmonton (Alberta)Canada
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5
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Scott HM, Coombes L, Braybrook D, Roach A, Harðardóttir D, Bristowe K, Ellis-Smith C, Higginson I, Gao W, Bluebond-Langner M, Farsides B, Murtagh FE, Fraser LK, Harding R. COVID-19: Impact on Pediatric Palliative Care. J Pain Symptom Manage 2022; 64:e1-e5. [PMID: 35231592 PMCID: PMC8881421 DOI: 10.1016/j.jpainsymman.2022.02.330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 11/23/2022]
Abstract
CONTEXT Children and young people with life-limiting or life-threatening conditions and their families are potentially vulnerable during COVID-19 lockdowns due to pre-existing high clinical support needs and social participation limitations. OBJECTIVES To explore the impact of the COVID-19 pandemic and lockdowns on this population. METHODS Sub-analysis of an emergent COVID-19 related theme from a larger semi-structured interview study investigating priority pediatric palliative care outcomes. One hundred and six United Kingdom-wide purposively-sampled Children and young people with life-limiting or life-threatening conditions, parent/carers, siblings, health professionals, and commissioners. RESULTS COVID-19 was raised by participants in 12/44 interviews conducted after the United Kingdom's first confirmed COVID-19 case. Key themes included loss of vital social support, disruption to services important to families, and additional psychological distress. CONCLUSION Continued delivery of child- and family-centered palliative care requires innovative assessment and delivery of psycho-social support. Disruptions within treatment and care providers may compound support needs, requiring cordination for families facing multiagency delays.
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Affiliation(s)
- Hannah May Scott
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK.
| | - Lucy Coombes
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care (L.C.), Cicely Saunders Institute, King's College London, London, UK; Royal Marsden NHS Foundation Trust, London, UK
| | - Debbie Braybrook
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK
| | - Anna Roach
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care (A.R.), Cicely Saunders Institute, King's College London, London, UK; University College London, London, UK
| | - Daney Harðardóttir
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK
| | - Katherine Bristowe
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK
| | - Clare Ellis-Smith
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK
| | - Irene Higginson
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK
| | - Wei Gao
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK
| | - Myra Bluebond-Langner
- University College London (M.B.L.), Louis Dundas Centre for Children's Palliative Care, London, UK; Rutgers University, New Jersey, USA
| | - Bobbie Farsides
- Brighton and Sussex Medical School (B.F.), University of Sussex, Brighton, UK
| | - Fliss Em Murtagh
- Wolfson Palliative Care Research Centre (F.EM.M.), Hull York Medical School, University of Hull, Hull, UK
| | - Lorna K Fraser
- Martin House Research Centre (L.K.F.), Department of Health Sciences, University of York, York, UK
| | - Richard Harding
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute (H.M.S, D.B., D.H., K.B., C.ES., I.H., W.G., R.H.), King's College London, London, UK
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6
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Hamre TJ, O'Shea ER, Hinderer KA, Mosha MH, Wentland BA. Impact of an Evidence-Based Pediatric Palliative Care Program on Nurses' Self-Efficacy. J Contin Educ Nurs 2022; 53:264-272. [PMID: 35647631 DOI: 10.3928/00220124-20220505-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background The purpose of this study was to determine the effect of a 1-day evidence-based pediatric palliative care continuing professional development program on nurses' and advanced practice registered nurses' perceived self-efficacy regarding palliative care. Method The revised Pediatric Palliative Care Questionnaire was administered to participants before and after a 7½-hour program. A multimodal approach was used to teach topics specific to pediatric palliative care. Results Thirty-one participants completed questionnaires. Notably, most of the participants had provided palliative or end-of-life care, but few had previous education specific to pediatrics. The self-efficacy scores of the participants significantly increased after program attendance (Z = 3.53, p < .001). Conclusion Continuing professional development in pediatric palliative care improves nurses' and advanced practice registered nurses' confidence in their skills to provide this care. Findings of this study support the need for pediatric-specific education in nursing training programs and continuing professional development offerings. Continuing education may be the key to improving access to high-quality care for children living with serious illness and their families. [J Contin Educ Nurs. 2022;53(6):264-272.].
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7
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Nicholas DB, Zulla RT, Conlon O, Dimitropoulos G, Urschel S, Rapoport A, Katz SL, Bruce A, West LJ, Belletrutti M, Cullen E, Zwaigenbaum L. Mental health impacts of the COVID-19 pandemic on children with underlying health and disability issues, and their families and health care providers. Paediatr Child Health 2022; 27:S33-S39. [PMID: 35620553 PMCID: PMC9126279 DOI: 10.1093/pch/pxab103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/21/2021] [Indexed: 11/14/2022] Open
Abstract
Objectives The COVID-19 pandemic has impacted mental health at a population level. Families of children with health vulnerabilities have been disproportionately affected by pandemic-related policies and service disruptions as they substantially rely on the health and social care system. We elicited the impact of the COVID-19 pandemic on children with health and disability-related vulnerabilities, their families, and their health care providers (HCPs). Methods Children with diverse health vulnerabilities (cardiac transplantation, respiratory conditions, sickle cell disease, autism spectrum disorder, mental health issues, and nearing the end of life due to a range of underlying causes), as well as their parents and HCPs, participated in semi-structured interviews. Data were analyzed using qualitative content analysis in determining themes related to impact and recommendations for practice improvement. Results A total of 262 participants (30 children, 76 parents, 156 HCPs) were interviewed. Children described loneliness and isolation; parents described feeling burnt out; and HCPs described strain and a sense of moral distress. Themes reflected mental health impacts on children, families, and HCPs, with insufficient resources to support mental health; organizational and policy influences that shaped service delivery; and recommendations to enhance service delivery. Conclusion Children with health vulnerabilities, their families and HCPs incurred profound mental health impacts due to pandemic-imposed public health restrictions and care shifts. Recommendations include the development and application of targeted pandemic information and mental health supports. These findings amplify the need for capacity building, including proactive strategies and mitigative planning in the event of a future pandemic.
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Affiliation(s)
- David B Nicholas
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Rosslynn T Zulla
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Olivia Conlon
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | | | - Simon Urschel
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Adam Rapoport
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Emily's House Children's Hospice, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sherri Lynne Katz
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Aisha Bruce
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Lori J West
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Mark Belletrutti
- British Columbia Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emma Cullen
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada.,Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
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8
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The COVID-19 Pandemic: Early Ripple Effects in Pediatric Palliative Care. CHILDREN 2022; 9:children9050642. [PMID: 35626819 PMCID: PMC9139250 DOI: 10.3390/children9050642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/21/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
Abstract
Palliative care, which aims to provide comprehensive, interdisciplinary, holistic care to children, adolescents and adults with life-threatening, and ultimately life-limiting conditions, is a discipline that has emerged as an integral component of healthcare systems throughout the world. Although the value of life-affirming palliative care (PC) has been shown across many domains, funding and acceptance of palliative care teams have been variable: some hospital systems have free-standing, dedicated interdisciplinary teams while, in many instances, palliative care services are provided “pro bono” by individuals with a special interest in the discipline, who provide PC in addition to other responsibilities. In this article, we hope to highlight some of the observations on the early effects of the COVID–19 pandemic on the provision of PC in children.
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9
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Beight LJ, Helton G, Avery M, Dussel V, Wolfe J. Parent and Adolescent Perspectives on the Impact of COVID on the Care of Seriously Ill Children. J Pain Symptom Manage 2022; 63:52-60. [PMID: 34333095 PMCID: PMC8319041 DOI: 10.1016/j.jpainsymman.2021.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/07/2021] [Accepted: 07/19/2021] [Indexed: 12/12/2022]
Abstract
CONTEXT Few studies have explored the impact of the Coronavirus Pandemic (COVID-19) on the care of seriously ill children which may be especially affected due to the child's vulnerability, complexity of care, and high reliance on hospital-based care. OBJECTIVE To explore parental and adolescent perspectives on the impact of COVID-19 on care of seriously children. METHODS We recruited a convenience sample of families of seriously ill children between September and December 2020. The study involved a semi-structured interview through Zoom followed by an online sociodemographic survey. Interviews were transcribed and coded using the constant comparison method. The sample intended to represent diversity in child age and diagnoses, and family sociodemographic characteristics. RESULTS Sixty-four families were approached; 29 enrolled (response rate 45%), including 30 parents and three AYAs. Most parents and AYAs identified as white (62%). Some families reported new financial hardships, with 17.2% having difficulty paying bills after March 2020 compared to 6.9% before. Emerging themes from interviews included additional roles parents managed due to cancelled services or shifting to telehealth, increased isolation, high emotional distress due increased in-home demands, uncertainty, and visitor restrictions in medical facilities, and benefits and challenges to telehealth. One positive outcome was the use of a hybrid care model whereby families choose telehealth appointments and in-person services, when necessary. CONCLUSION Families caring for seriously ill children during COVID-19 face increased challenges. Health systems should consider long-term telehealth/in-person hybrid care models that have potential to improve access to and satisfaction with care.
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Affiliation(s)
- Leah J Beight
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA
| | - Gabrielle Helton
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA
| | - Madeline Avery
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA
| | - Veronica Dussel
- Pediatric Palliative Care (V.D.), Dana-Farber Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA; Center for Research and Implementation in Palliative Care (CII-CP) (V.D.), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires Argentina
| | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA; Department of Pediatrics (J.W.), Boston Children's Hospital. Boston, MA, USA.
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