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De Rosa R, Siano MA, Colucci A, De Anseris AGE, Siani P, Vajro P, Savarese G, Mandato C. Perceptions and Expectations of Youth Regarding the Respect for Their Rights in the Hospital. CHILDREN (BASEL, SWITZERLAND) 2024; 11:222. [PMID: 38397334 PMCID: PMC10887615 DOI: 10.3390/children11020222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Information obtained from children themselves regarding the characteristics of the ideal hospital that ensure well-being during a hospital stay is scarce. Here, we report the opinions, perceptions, and expectations of 700 children and adolescents about their experiences, assessed through a mixed-method research approach with age-appropriate questionnaires, three open-ended questions, and an analysis of optional pictorial and textual narratives. Most children indicated that, while they acknowledged the expertise of hospital staff, they also noted several shortcomings, e.g., insufficiently understandable medical information as well as emotional and cognitive support. The continuity of schooling and the right to suffer as little as possible were also critical issues. Adolescents valued in particular the quality of care and services provided, the hospital's adherence to equality and non-discrimination rights, and protection systems but negatively perceived several aspects related to play and participation. Significant differences in the co-occurrences of the most frequently used text terms with the keywords "hospital" and "child/adolescent" between age groups highlight variations in the way patients perceive and articulate their experiences within the hospital setting depending on the cognitive processes linked to age. In drawings, prevailing attention was placed on the physical context of the hospital room, with figures expressing mostly negative emotions. Specifically, in this regard, the main emotion in children was sadness, and, in adolescents, it was fear. Overall, these insights are pivotal in the context of our research objectives as they shed light on the nuanced preferences, needs, and perspectives of children and adolescents during their hospital stays. Recognizing the identified shortcomings, we propose recommendations emphasizing the improvement of medical communication clarity, enhancement of emotional and cognitive support, and the improvement of programs to avoid instructional gaps during hospital stays. Addressing these specific needs is critical for a more comprehensive approach to pediatric healthcare provision.
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Affiliation(s)
- Roberta De Rosa
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Maria Anna Siano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | | | - Paolo Siani
- Pediatrics, AORN Santobono-Pausilipon Children’s Hospital, 80122 Naples, Italy;
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Giulia Savarese
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Psychology Section, University of Salerno, 84081 Salerno, Italy;
| | - Claudia Mandato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
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Sisk BA, Harvey K, Friedrich AB, Antes AL, Yaeger LH, Mack JW, DuBois J. Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review. Pediatr Blood Cancer 2022; 69:e29405. [PMID: 34662485 PMCID: PMC8875310 DOI: 10.1002/pbc.29405] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/03/2023]
Abstract
Multiple factors can facilitate or impede the fulfillment of communication functions in pediatric cancer. In this systematic review, we evaluated 109 studies from the preceding 20 years that presented qualitative or quantitative evidence of barriers or facilitators to communication in pediatric cancer. Using a multilevel framework developed in our prior study, we then analyzed and categorized the levels of barriers and facilitators identified in included studies. The vast majority of studies focused on individual-level barriers, rather than team, organization/system, collaborating hospital, community, or policy-level barriers. Future studies should explore the full range of factors that affect communication.
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Affiliation(s)
- Bryan A. Sisk
- Department of Pediatrics, Division of Hematology/Oncology, Washington University School of Medicine, St. Louis, Missouri.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Kieandra Harvey
- Brown School of Social Work, Washington University School of Medicine, St. Louis, Missouri
| | - Annie B. Friedrich
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, St. Louis, Missouri
| | - Alison L. Antes
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Lauren H Yaeger
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer W. Mack
- Pediatric Oncology and Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts; and Division of Pediatric Hematology/Oncology, Boston Children’s Hospital, Boston, Massachusetts
| | - James DuBois
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Pacurari N, De Clercq E, Dragomir M, Colita A, Wangmo T, Elger BS. Challenges of paediatric palliative care in Romania: a focus groups study. BMC Palliat Care 2021; 20:178. [PMID: 34794399 PMCID: PMC8598931 DOI: 10.1186/s12904-021-00871-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The availability of palliative care facilities for children vary considerably among the European member states. In Romania, a country where health expenditure is among the lowest in Europe, palliative care has been mainly provided by charitable organizations. Despite the high number of children needing palliative care, there is scant literature and research available on paediatric palliative care in Romania. The study explores the viewpoints of various paediatric oncology providers with regard to paediatric palliative care provision in Romania. METHODS Four mixed focus groups were conducted at four university-affiliated paediatric oncology centres located in three distinct Romanian regions (Bucuresti-llfov, Nord-Est and Nord-Vest). The focus groups were analyzed using thematic coding. RESULTS For many healthcare professionals, emotional burden inherent to the profession; unhealthy work-life balance and understaffing were among the biggest barriers to the successful integration of pediatric palliative care. The lack of staff was attributed to a shortage of financial resources, and to the persisting cultural stigma surrounding palliative care and oncology. Also political turmoil was identified as an important obstacle to palliative care implementation. CONCLUSION Significant barriers persist limiting the broader implementation of pediatric palliative care in Romania. In order to render palliative care in pediatric oncology more sustainable, more attention should be paid to the mental health care of healthcare professionals working in this field, to the development of mobile palliative care services and to the emigration of skilled medical staff.
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Affiliation(s)
- Nadia Pacurari
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, CH, Switzerland
| | - Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, CH, Switzerland.
| | - Monica Dragomir
- Department of Pediatric Oncology, The Institute of Oncology, Prof. Dr. Alexandru Trestioreanu, Bucharest, Romania
| | - Anca Colita
- Department of Pediatric Hemato-Oncology & Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, CH, Switzerland
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, CH, Switzerland
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Souza RLAD, Mutti CF, Santos RPD, Oliveira DCD, Okido ACC, Jantsch LB, Neves ET. Hospitalization perceived by children and adolescents undergoing cancer treatment. ACTA ACUST UNITED AC 2021; 42:e20200122. [PMID: 34037109 DOI: 10.1590/1983-1447.2021.20200122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/05/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To know the perception of children and adolescents undergoing cancer treatment about hospitalization. METHODS Qualitative research conducted with 13 children and adolescents hospitalized for cancer treatment at a referral hospital in southern Brazil. Semi-structured interviews mediated by the drawing technique were conducted from May to November 2018. Data was submitted to inductive thematic analysis based on the theoretical framework of Brazil's National Humanization Policy. RESULTS Disturbances were detected in the professionals' communication with the hospitalized children and adolescents. The participants felt socially isolated and highlighted the importance of recreational activities during hospitalization. CONCLUSION Infant cancer is complex and needs multidisciplinary care during the treatment, enabling the organization of healthy and welcoming spaces that favor humanization of care.
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Affiliation(s)
- Raíra Lopes Amaral de Souza
- Universidade Federal de Santa Maria (UFSM), Programa de Pós-graduação em Enfermagem. Santa Maria, Rio Grande do Sul, Brasil
| | - Cintia Flôres Mutti
- Universidade Federal de Santa Maria (UFSM), Colégio Politécnico, Programa de Pós-graduação em Enfermagem. Santa Maria, Rio Grande do Sul, Brasil
| | | | | | | | - Leonardo Bigolin Jantsch
- Universidade Federal de Santa Maria (UFSM), Departamento de Ciências da Saúde. Palmeira das Missões, Rio Grande do Sul, Brasil
| | - Eliane Tatsch Neves
- Universidade Federal de Santa Maria (UFSM), Programa de Pós-graduação em Enfermagem. Santa Maria, Rio Grande do Sul, Brasil
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Ahmadnia S, Ghalibaf AK, Kamkar S, Mohamadzadeh Z, Ghalibafian M. Survivor and parent engagement in childhood cancer treatment in Iran. Ecancermedicalscience 2021; 15:1220. [PMID: 34158824 PMCID: PMC8183647 DOI: 10.3332/ecancer.2021.1220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Indexed: 02/01/2023] Open
Abstract
In Iran (with a population of 83 million), 19,973 children were diagnosed with cancer from 2009 to 2019 (MAHAK Charity). This study was part of the International Society of Paediatric Oncology, Paediatric Oncology in Developing Countries Committee, ‘Patient, Family and Stakeholder Engagement Task Force’ engagement study in ten low- and middle-income countries in 2019. We documented childhood cancer survivors and parents’ experiences and quality of engagement, including perceptions and expectations, during their cancer treatment journey in Iran. Fourteen in-depth interviews and three focus group discussions were conducted by three Iranian qualitative researchers with 29 participants: recent adolescent/young adult survivors (12–20 years), long-term survivors (21–30 years) and parents [36–61 years (six mothers and four fathers)] from diverse socio-economic and ethnic backgrounds. Data were recorded, transcribed and analysed, and then translated from Farsi into English. Participants’ expectations included inter alia improved communication and information flow among the key stakeholders including doctors, nurses, parents and patients. A need for improved patterns of doctor–patient relationships and communication, more effective psychosocial support and the importance of peer support groups (for survivors and parents) were reported. Participants identified areas of satisfaction and dissatisfaction regarding their actual engagement and decision-making. The dominance of a medical-only approach instead of multidisciplinary approach in care, the shortage of psychosocial support, the lack of an integrated system for providing information and delivering a package of printed material about the treatment journey and the absence of patient navigator in childhood cancer care systems were among obstacles for successful engagement of patients and parents throughout their cancer journey.
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Affiliation(s)
| | | | - Saba Kamkar
- MAHAK Charity-Society to Support Children Suffering from Cancer, Tehran 1956993461, Iran
| | - Zahra Mohamadzadeh
- MAHAK Charity-Society to Support Children Suffering from Cancer, Tehran 1956993461, Iran
| | - Mithra Ghalibafian
- MAHAK Paediatric Cancer Treatment and Research Centre (MPCTRC), Tehran 1956993461, Iran
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Zanon BP, Cremonese L, Ribeiro AC, Padoin SMDM, Paula CCD. Communication of bad news in pediatrics: integrative review. Rev Bras Enferm 2020; 73 Suppl 4:e20190059. [PMID: 32785469 DOI: 10.1590/0034-7167-2019-0059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/30/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to identify the scientific evidence of the elements of communication in the process of communicating bad news in pediatrics. METHODS integrative review searched in the LILACS, PubMed and WoS databases. Primary studies in Portuguese, Spanish or English were included. RESULTS the evidence from the 40 studies were organized according to the elements of communication: sender (family and/or professional), receiver (family and/or child), message (bad or difficult news about diagnosis/prognosis; empathetically, honestly, objective, hopeful and available), channel (materials, quality, quantity and pace), context and effects (social and emotional changes), noise (feelings and language) and failures (silencing and misleading information). CONCLUSIONS there is a need to prepare the institution and team, as well as the family and the child, in order to promote co-responsibility in this process, to minimize suffering and communication noise and to avoid failures, recognizing the child's right to know their condition.
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Affiliation(s)
- Bruna Pase Zanon
- Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Luiza Cremonese
- Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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