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Alotaibi Q, Siden H. An agenda to develop Pediatric Palliative care programs to serve children with life-threatening and life-limiting conditions in the Gulf Cooperation Council countries. Palliat Care Soc Pract 2023; 17:26323524231201868. [PMID: 37790797 PMCID: PMC10542219 DOI: 10.1177/26323524231201868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
Medical advances have increased the number of children living with life-threatening/life-limiting illnesses worldwide, including in Gulf Cooperation Council (GCC) countries. Pediatric palliative care (PPC) is a relatively young subspecialty that cares for children with life-threatening/life-limiting illnesses and their families. PPC aims to alleviate physical, psychological, and social distress in children with life-threatening/life-limiting illnesses and their families and improve their quality of life. PPC is an essential service that should be implemented in all nations, as it is a human right. Moreover, a core value of PPC services is to alleviate children's suffering, irrespective of cure availability. Hence, the global consensus on palliative services must be universal and include developing countries with limited resources. While PPC services are growing internationally, the GCC countries have yet to implement these valuable services in the region. This work aims to define the local base information important to facilitating the PPC program. We explored and identified the information vital for establishing a successful program, which was then categorized and mapped into subgroups. In doing so, we outline a roadmap to facilitate the smooth introduction of PPC in GCC countries to benefit the lives of children with life-limiting illnesses.
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Affiliation(s)
- Qutaibah Alotaibi
- Pediatrics Department, Al Adan Hospital, Al Ahmadi Health District, Kuwait
| | - Harold Siden
- Canuck Place Children’s Hospice, BC Children’s Hospital, University of British Columbia, Vancouver, BC, Canada
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García-Quintero X, Claros-Hulbert A, Tello-Cajiao ME, Bolaños-Lopez JE, Cuervo-Suárez MI, Durán MGG, Gómez-García W, McNeil M, Baker JN. Using EmPalPed-An Educational Toolkit on Essential Messages in Palliative Care and Pain Management in Children-As a Strategy to Promote Pediatric Palliative Care. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060838. [PMID: 35740775 PMCID: PMC9221893 DOI: 10.3390/children9060838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/23/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022]
Abstract
Background: Most children needing palliative care (PC) live in low- and middle-income countries. In Colombia, pediatric palliative care (PPC) knowledge among healthcare professionals (HCPs) is lacking as PPC is not included in the educational curricula of healthcare programs. Therefore, specific training that improves knowledge of HCPs and access to PC for children and their families is needed. To address this gap, we organized and conducted the Essential Messages in Palliative Care and Pain Management in Children (EmPalPed), an educational toolkit to increase awareness and promote essential knowledge in PPC for low- and middle-income countries. Methodology: The EmPalPed toolkit consisted of a 5-h virtual workshop with small working groups of HCPs caring for children with life-threatening conditions such as cancer. The toolkit was organized along five key domains: (1) PC as it relates to the concept of quality of life (QoL), (2) effective communication, (3) addressing pain management as a top priority, (4) providing end-of-life care, and (5) access to high-quality PC as a fundamental human right. The workshop activities included different educational strategies and tools (e.g., a pocket guide for pain assessment and management, a PPC booklet, a quick guide for communicating bad news, role playing, and discussions of clinical cases). Results: A total of 145 HCPs from 22 centers were trained. The post-test analysis for HCPs showed that attitude and knowledge about communication (p < 0.001), pain assessment (p < 0.001), first-line opioid of choice in children (p < 0.001), and palliative sedation (p < 0.001) had positive and statistically significant changes from the pre-test analysis. Discussion: This study supported the notion that the EmPalPed educational toolkit is an effective mechanism for raising awareness regarding PPC as well as providing training in many of the key aspects of PPC. The EmPalPed training approach should be studied beyond this setting, and the impact should be measured longitudinally.
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Affiliation(s)
- Ximena García-Quintero
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali 760032, Colombia;
- Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS #260, Memphis, TN 38105, USA; (J.N.B.); (M.M.)
- Correspondence: ; Tel.: +1-(954)-290-1804
| | - Angélica Claros-Hulbert
- Faculty of Health Sciences, Universidad de la Sabana, Chia 250001, Colombia;
- Palliative Care Department, Instituto Nacional de Cancerología, Bogotá 111511, Colombia
| | | | - Jhon Edwar Bolaños-Lopez
- Dirección de Investigación y Desarrollo, Centro de Biociencias, Seguros SURA Colombia, Medellín 050021, Colombia;
| | - María Isabel Cuervo-Suárez
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali 760032, Colombia;
- Faculty of Health Sciences Department, Clinical Medical Science, Universidad Icesi, Cali 760031, Colombia
| | - Martha Gabriela García Durán
- Psycho-Oncology Service, Hospital Pediátrico de Sinaloa “Dr. Rigoberto Aguilar Pico”, Culiacán 80200, Sinaloa, Mexico;
| | - Wendy Gómez-García
- Dr. Robert Reid Cabral Children’s Hospital, Santo Domingo 10107, Dominican Republic;
| | - Michael McNeil
- Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS #260, Memphis, TN 38105, USA; (J.N.B.); (M.M.)
| | - Justin N. Baker
- Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS #260, Memphis, TN 38105, USA; (J.N.B.); (M.M.)
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Verberne LM, Kars MC, Schepers SA, Schouten-van Meeteren AYN, Grootenhuis MA, van Delden JJM. Barriers and facilitators to the implementation of a paediatric palliative care team. BMC Palliat Care 2018; 17:23. [PMID: 29433576 PMCID: PMC5810030 DOI: 10.1186/s12904-018-0274-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/22/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Over the last decade, paediatric palliative care teams (PPCTs) have been introduced to support children with life-limiting diseases and their families and to ensure continuity, coordination and quality of paediatric palliative care (PPC). However, implementing a PPCT into an organisation is a challenge. The objective of this study was to identify barriers and facilitators reported by healthcare professionals (HCPs) in primary, secondary or tertiary care for implementing a newly initiated multidisciplinary PPCT to bridge the gap between hospital and home. METHODS The Measurement Instrument for Determinants of Innovations (MIDI) was used to assess responses of 71 HCPs providing PPC to one or more of the 129 children included in a pilot study of a PPCT based at a university children's hospital. The MIDI (29 items) assessed barriers and facilitators to implementing the PPCT by using a 5-point scale (completely disagree to completely agree) and additional open-ended questions. Items to which ≥20% of participants responded with 'totally disagree/disagree' and ≥80% responded with 'agree/totally agree' were considered as barriers and facilitators, respectively. A general inductive approach was used for open-ended questions. RESULTS Reported barriers to implementing a PPCT were related to the HCP's own organisation (e.g., no working arrangements related to use of the intervention [PPCT] registered, other organisational changes such as merger going on). Reported facilitators were mainly related to the intervention (correctness, simplicity, observability and relevancy) and the user scale (positive outcome expectations, patient satisfaction) and only once to the organisation scale (information accessibility). Additionally, HCPs expressed the need for clarity about tasks of the PPCT and reported having made a transition from feeling threatened by the PPCT to satisfaction about the PPCT. CONCLUSION Positive experiences with the PPCT are a major facilitator for implementing a PPCT. Tailored organisational strategies such as working arrangements by management, concrete information about the PPCT itself and the type of support provided by the PPCT should be clearly communicated to involved HCPs to increase awareness about benefits of the PPCT and ensure a successful implementation. New PPCTs need protection and resources in their initial year to develop into experienced and qualified PPCTs.
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Affiliation(s)
- Lisa M. Verberne
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO BOX 85500, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
| | - Marijke C. Kars
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO BOX 85500, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
| | - Sasja A. Schepers
- Psychosocial Department, Emma Children’s Hospital, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Lundlaan 6, 3584 AE Utrecht, The Netherlands
- Department of Psychology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105 USA
| | | | - Martha A. Grootenhuis
- Psychosocial Department, Emma Children’s Hospital, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Lundlaan 6, 3584 AE Utrecht, The Netherlands
| | - Johannes J. M. van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO BOX 85500, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
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Levine DR, Johnson LM, Snyder A, Wiser RK, Gibson D, Kane JR, Baker JN. Integrating Palliative Care in Pediatric Oncology: Evidence for an Evolving Paradigm for Comprehensive Cancer Care. J Natl Compr Canc Netw 2017; 14:741-8. [PMID: 27283167 DOI: 10.6004/jnccn.2016.0076] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 03/07/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The demonstrated benefit of integrating palliative care (PC) into cancer treatment has triggered an increased need for PC services. The trajectory of integrating PC in comprehensive cancer centers, particularly pediatric centers, is unknown. We describe our 8-year experience of initiating and establishing PC with the Quality of Life Service (QoLS) at St. Jude Children's Research Hospital. METHODS We retrospectively reviewed records of patients seen by the QoLS (n=615) from March 2007 to December 2014. Variables analyzed for each year, using descriptive statistics, included diagnostic groups, QoLS encounters, goals of care, duration of survival, and location of death. RESULTS Total QoLS patient encounters increased from 58 (2007) to 1,297 (2014), new consults increased from 17 (2007) to 115 (2014), and mean encounters per patient increased from 5.06 (2007) to 16.11 (2014). Goal of care at initial consultation shifted from primarily comfort to an increasing goal of cure. The median number of days from initial consult to death increased from 52 days (2008) to 223 days (2014). A trend toward increased outpatient location of death was noted with 42% outpatient deaths in 2007, increasing to a majority in each subsequent year (range, 51%-74%). Hospital-wide, patients receiving PC services before death increased from approximately 50% to nearly 100%. CONCLUSIONS Since its inception, the QoLS experienced a dramatic increase in referrals and encounters per patient, increased use by all clinical services, a trend toward earlier consultation and longer term follow-up, increasing outpatient location of death, and near-universal PC involvement at the end-of-life. The successful integration of PC in a comprehensive cancer center, and the resulting potential for improved care provision over time, can serve as a model for other programs on a broad scale.
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Affiliation(s)
- Deena R Levine
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Liza-Marie Johnson
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Angela Snyder
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Robert K Wiser
- University of Tennessee Health Science Center, Memphis, Tennessee
| | - Deborah Gibson
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Javier R Kane
- Department of Pediatric Hematology Oncology, McLane Children’s Scott and White Clinic, Texas A&M Health Science Center College of Medicine, Temple, Texas
| | - Justin N Baker
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, Tennessee
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Quinn C, McCarthy S, Devins M, O'Reilly M, Twomey M, Ling J. Prioritisation of future research topics in paediatric palliative care in Ireland: a Delphi study. Int J Palliat Nurs 2017; 23:88-97. [PMID: 28245162 DOI: 10.12968/ijpn.2017.23.2.88] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This paper reports the findings from a Delphi Study undertaken to identify the research priorities in children's palliative care in Ireland. Palliative care for children is a small and highly specialised field of healthcare that focuses on improving the quality of life of children living with, or dying from, a life-limiting condition. Ideally, support for children requiring palliative care begins at the time of diagnosis, which for many children with life-limiting conditions can be from birth. There is a notable overlap between the needs of children requiring palliative care and those with disabilities and other complex care needs, resulting in care being provided by a range of voluntary and statutory agencies. As a new specialty, there is a need to develop an evidence-based approach to providing children's palliative care. In order to do this in a systematic way, identification of the research priorities in children's palliative care within Ireland is required.
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Affiliation(s)
- Claire Quinn
- Lecturer, Programme Director, School of Nursing and Midwifery, NUI Galway
| | | | - Mary Devins
- Our Lady' Children's Hospital, Crumlin, Dublin
| | - Maeve O'Reilly
- Our Lady's Children's Hospital, Crumlin, Dublin and St Lukes Hospital, Rathgar, Dublin
| | - Marie Twomey
- Our Lady's Children's Hospital, Crumlin, Dublin and St Lukes Hospital, Rathgar, Dublin
| | - Julie Ling
- CEO European Association of Palliative Care
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Peng NH, Lee CH, Lee MC, Huang LC, Chang YC, DeSwarte-Wallace J. Effectiveness of Pediatric Palliative Care Education on Pediatric Clinicians. West J Nurs Res 2016; 39:1624-1638. [DOI: 10.1177/0193945916680615] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A lack of knowledge and skills in pediatric palliative care may create hesitation in caring for children with serious life-threatening conditions and their families. Our research examined the effectiveness of pediatric palliative care training for pediatric clinicians. A pretest–posttest study provided educational training in pediatric palliative care to pediatric clinicians and used a pretest and a posttest to assess outcomes. Fifty pediatric clinicians attended this research with 83.3% response rate. After training, participants reported significantly increased confidence in a variety of areas, including providing emotional support to clinicians, personal knowledge, skills, and communication; ethical and legal concerns; and providing emotional support to dying children and their families. Results showed a significant main effect of training on confidence levels ( p < .000). This suggests that education can effectively boost pediatric clinicians’ confidence regarding providing pediatric palliative care and therefore should regularly be provided to clinicians.
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Affiliation(s)
- Niang-Huei Peng
- College of Nursing, National Yang-Ming University, Taipei, Taiwan
| | | | - Min-Chun Lee
- Buddhist Tzu-Chi General Hospital, Taichung City, Taiwan
| | - Li-Chi Huang
- College of Nursing, China Medical University, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tmkang University, Taipei City, Taiwan
| | - Joetta DeSwarte-Wallace
- Miller Children’s Hospital Long Beach, CA, USA
- University of Southern California, Los Angeles, CA, USA
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Singh AL, Klick JC, McCracken CE, Hebbar KB. Evaluating Hospice and Palliative Medicine Education in Pediatric Training Programs. Am J Hosp Palliat Care 2016; 34:603-610. [PMID: 27122617 DOI: 10.1177/1049909116643747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hospice and Palliative Medicine (HPM) competencies are of growing importance in training general pediatricians and pediatric sub-specialists. The Accreditation Council for Graduate Medical Education (ACGME) emphasized pediatric trainees should understand the "impact of chronic disease, terminal conditions and death on patients and their families." Currently, very little is known regarding pediatric trainee education in HPM. METHODS We surveyed all 486 ACGME-accredited pediatric training program directors (PDs) - 200 in general pediatrics (GP), 57 in cardiology (CARD), 64 in critical care medicine (CCM), 69 in hematology-oncology (ONC) and 96 in neonatology (NICU). We collected training program's demographics, PD's attitudes and educational practices regarding HPM. RESULTS The complete response rate was 30% (148/486). Overall, 45% offer formal HPM curriculum and 39% offer a rotation in HPM for trainees. HPM teaching modalities commonly reported included conferences, consultations and bedside teaching. Eighty-one percent of all respondents felt that HPM curriculum would improve trainees' ability to care for patients. While most groups felt that a HPM rotation would enhance trainees' education [GP (96%), CARD (77%), CCM (82%) and ONC (95%)], NICU PDs were more divided (55%; p < 0.05 for all comparisons vs. NICU). CONCLUSION While most programs report perceived benefit from HPM training, there remains a paucity of opportunities for pediatric trainees. Passive teaching methods are frequently utilized in HPM curricula with minimal diversity in methods utilized to teach HPM. Opportunities to further emphasize HPM in general pediatric and pediatric sub-specialty training remains.
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Affiliation(s)
- Arun L Singh
- 1 Division of Pediatric Critical Care, Emory University School of Medicine, Atlanta, GA, USA.,2 Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,3 Children's Healthcare of Atlanta at Egleston, Atlanta, GA, USA
| | - Jeffrey C Klick
- 3 Children's Healthcare of Atlanta at Egleston, Atlanta, GA, USA
| | - Courtney E McCracken
- 2 Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Kiran B Hebbar
- 1 Division of Pediatric Critical Care, Emory University School of Medicine, Atlanta, GA, USA.,2 Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,3 Children's Healthcare of Atlanta at Egleston, Atlanta, GA, USA
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Miller EG, Frizzola MA, Levy C, Greenspan JS. Recent experience establishing a new pediatric palliative care team. J Pediatr 2015; 166:4-5. [PMID: 25527850 DOI: 10.1016/j.jpeds.2014.09.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Elissa G Miller
- Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.
| | - Meg A Frizzola
- Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Carly Levy
- Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Jay S Greenspan
- Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
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Frizzola M, Miller EG. Referrals to a new pediatric palliative care team: details of the first 12 months of operation. J Palliat Med 2014; 17:585-8. [PMID: 24576099 DOI: 10.1089/jpm.2013.0206] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although the field of pediatric palliative care (PPC) remains in its infancy, over the past decade it has grown in practice and scope. We report on patient referral patterns to a new PPC team at a free-standing children's hospital. OBJECTIVE Our aim is to provide a descriptive comparison of the patient population seen by our new program as compared to existing literature. METHODS We examined our database of patient referral and demographic data and compared our data with published reports. CONCLUSIONS Our team was operating beyond its predicted year-one volume with a patient population that mirrored larger, more established programs. In an era of growth and acceptance of PPC, hospitals that have undergone a strong needs assessment, significant educational effort, and have a strong prediction of patient volume should expect to be operating at projected capacity quickly.
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Affiliation(s)
- Meg Frizzola
- 1 Department of Anesthesia and Critical Care Medicine, Nemours/Alfred I. duPont Hospital for Children , Wilmington, Delaware
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Feudtner C, Womer J, Augustin R, Remke S, Wolfe J, Friebert S, Weissman D. Pediatric palliative care programs in children's hospitals: a cross-sectional national survey. Pediatrics 2013; 132:1063-70. [PMID: 24190689 DOI: 10.1542/peds.2013-1286] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pediatric palliative care (PPC) programs facilitate the provision of comprehensive care to seriously ill children. Over the past 10 years many such programs have been initiated by children's hospitals, but little is known about their number, staff composition, services offered, sources of support, or national distribution. METHODS In the summer of 2012, we surveyed 226 hospitals as identified by the National Association of Children's Hospitals and Related Institutions. The survey instrument gathered data about whether their institution had a PPC program, and for hospitals with programs, it asked for a wide range of information including staffing, patient age range, services provided, and financial support. RESULTS Of the 162 hospitals that provided data (71.7% response rate), 69% reported having a PPC program. The rate of new program creation peaked in 2008, with 12 new programs created that year, and 10 new programs in 2011. Most programs offer only inpatient services, and most only during the work week. The number of consults per year varied substantially across programs, and was positively associated with hospital bed size and number of funded staff members. PPC programs report a high level of dependence on hospital funding. CONCLUSIONS PPC programs are becoming common in children's hospitals throughout the United States yet with marked variation in how these programs are staffed, the level of funding for staff effort to provide PPC, and the number of consultations performed annually. Guidelines for PPC team composition, funding, and consultation standards may be warranted to ensure the highest quality of PPC.
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Affiliation(s)
- Chris Feudtner
- CHOP North, Room 1523, The Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 10194.
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Chong L, Khalid F. Paediatric palliative care in Malaysia: Survey of knowledge base and barriers to referral. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/1743291x13y.0000000074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
Over the past two decades, paediatric palliative care has emerged as both a primary approach and as its own medical subspecialty, the overall aim of which is to ease suffering for children with life-threatening illness and their families through a concurrent model of care. However, most discussions have been focused on the transition to palliative care when no realistic hope for cure exists. We believe that, because the course of cancer is so unpredictable, this idea is misleading. Indeed, palliative care is increasingly being recognized as being about not just how to cope with the process of dying, but also about how to engage in living when faced with a life-threatening illness. This article will examine our current understanding of several areas of palliative care, with the ultimate message that palliative care is simply a novel term for the total care of a child and family, an approach that should be applied consistently and concurrently regardless of disease status. By improving familiarity with palliative care and building relationships with palliative care specialists, the paediatric oncology clinician will ensure that the best care possible for children and families is provided, regardless of outcome.
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Affiliation(s)
- Elisha Waldman
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA 02215, USA
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Edlynn ES, Derrington S, Morgan H, Murray J, Ornelas B, Cucchiaro G. Developing a pediatric palliative care service in a large urban hospital: challenges, lessons, and successes. J Palliat Med 2012; 16:342-8. [PMID: 23249403 DOI: 10.1089/jpm.2012.0187] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND AIM We report the process of creating a new palliative care service at a large, urban children's hospital. Our aim was to provide a detailed guide to developing an inpatient consultation service, along with reporting on the challenges, lessons, and evaluation. METHODS We examined the hiring process of personnel and marketing strategies, a clinical database facilitated ongoing quality review and identified trends, and a survey project assessed provider satisfaction and how referring physicians used the palliative care service. RESULTS AND CONCLUSION The pilot phase of service delivery laid the groundwork for a more effective service by creating documentation templates and identifying relevant data to track growth and outcomes. It also allowed time to establish a clear delineation of team members and distinction of roles. The survey of referring physicians proved a useful evaluation starting point, but conclusions could not be generalized because of the low response rate. It may be necessary to reconsider the survey technique and to expand the sample to include patients and families. Future research is needed to measure the financial benefits of a well-staffed inpatient pediatric palliative care service.
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Affiliation(s)
- Emily S Edlynn
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
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Eagle S, Creel A, Alexandrov A. The Effect of Facilitated Peer Support Sessions on Burnout and Grief Management among Health Care Providers in Pediatric Intensive Care Units: A Pilot Study. J Palliat Med 2012; 15:1178-80. [DOI: 10.1089/jpm.2012.0231] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Samantha Eagle
- Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Amy Creel
- Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Anne Alexandrov
- Department of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
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Pelant D, McCaffrey T, Beckel J. Development and implementation of a pediatric palliative care program. J Pediatr Nurs 2012; 27:394-401. [PMID: 22703687 DOI: 10.1016/j.pedn.2011.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 05/25/2011] [Accepted: 06/02/2011] [Indexed: 10/17/2022]
Abstract
Palliative care, long-used in the adult setting, is new to the pediatric setting. Research indicates that palliative care reduces length of stay and use of aggressive end-of-life interventions, improves quality of life, and provides hope. It balances provision of coordinated care with building of family memories and preparation for the child's death with celebration of the child's life. We advocate implementation of pediatric palliative care in any hospital that cares for children. This article provides a model outlining critical steps and considerations for establishing a successful pediatric palliative care program.
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Knapp CA. Research in Pediatric Palliative Care: Closing the Gap Between What Is and Is Not Known. Am J Hosp Palliat Care 2009; 26:392-8. [DOI: 10.1177/1049909109345147] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Pediatric palliative care provides physical and psychosocial care to children with life-limiting illnesses and their families. Services are provided by physicians, nurses, volunteers, and other providers in a myriad of settings. Over the past 30 years, a portfolio of research has amassed on palliative care. Yet, much remains unknown, particularly about pediatric palliative care. This article is the first in a series and it provides a general overview of what is known and unknown about the provision and need for pediatric palliative care. Subsequent articles will focus on specific topics such as decision making and support care. The purpose of this series is to inform and promote discussion about research in pediatric palliative care.
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Affiliation(s)
- Caprice A. Knapp
- Departments of Epidemiology and Health Policy Research and the Institute for Child Health Policy, University of Florida, Gainesville, Florida,
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Hubble R, Trowbridge K, Hubbard C, Ahsens L, Ward-Smith P. Effectively using communication to enhance the provision of pediatric palliative care in an acute care setting. J Multidiscip Healthc 2008; 1:45-50. [PMID: 21197332 PMCID: PMC3004546 DOI: 10.2147/jmdh.s3854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The capability of effectively communicating is crucial when providing palliative care, especially when the patient is a child. Communication among healthcare professionals with the child and family members must be clear, concise, and consistent. Use of a communication tool provides documentation for conversations, treatment plans, and specific desires related to care. This paper describes communication theory, portrays the use of this theory to develop a communication tool, and illustrates the use of this tool by multidisciplinary members of a healthcare team to provide pediatric palliative care.
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Affiliation(s)
- Rosemary Hubble
- Children's Mercy Hospitals and Clinics, Kansas City, MO, USA
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Bibliography. PROGRESS IN PALLIATIVE CARE 2007. [DOI: 10.1179/096992607x236425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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