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Tafazoli A, Cronin-Wood K. Pediatric Oncology Hospice: A Comprehensive Review. Am J Hosp Palliat Care 2024:10499091241227609. [PMID: 38225192 DOI: 10.1177/10499091241227609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
Pediatric hospice is a new terminology in current medical literature. Implementation of pediatric hospice care in oncology setting is a vast but subspecialized field of research and practice. However, it is accompanied by substantial uncertainties, shortages and unexplored sections. The lack of globally established definitions, principles, and guidelines in this field has adversely impacted the quality of end-of-life experiences for children with hospice needs worldwide. To address this gap, we conducted a comprehensive review of scientific literature, extracting and compiling the available but sparse data on pediatric oncology hospice from the PubMed database. Our systematic approach led to development of a well-organized structure introducing the foundational elements, highlighting complications, and uncovering hidden gaps in this critical area. This structured framework comprises nine major categories including general ideology, population specifications, role of parents and family, psychosocial issues, financial complications, service locations, involved specialties, regulations, and quality improvement. This platform can serve as a valuable resource in establishing a scientifically reliable foundation for future experiments and practices in pediatric oncology hospice.
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Affiliation(s)
- Ali Tafazoli
- Healthcare administration program, St Lawrence College, Kingston Campus, ON, Canada
- Hospice Kingston, Queen's University, Kingston, ON, Canada
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
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Friedel M, Aujoulat I, Brichard B, Fonteyne C, Renard M, Degryse JM. The Quality of Life of Children Facing Life-Limiting Conditions and That of Their Parents in Belgium: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1167. [PMID: 37508664 PMCID: PMC10378398 DOI: 10.3390/children10071167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Paediatric palliative care (PPC) aims to improve children's quality of life, but this outcome is rarely measured in clinical care. PPC is provided in Belgium through six transmural paediatric liaison teams (PLTs) ensuring continuity of care for children with life-limiting or life-threatening conditions (LLC/LTC). This study aims to measure the quality of life (QoL) of children with LLC/LTC followed-up by PLTs and the QoL of their parents. METHODS During interviews, an original socio demographic questionnaire, the Children palliative outcome scale-version 2 (CPOS-2), the Fragebogen für Kinder und Jugendliche zur Erfassung der gesundheitsbezogenen Lebensqualität (KINDL) and the Quality of life in life-threatening Illness-Family caregiver (QOLLTI-F) were filled in by PLT members. Statistics were used to investigate significant differences between scores. Results were discussed and interpreted with six PLTs. RESULTS 73 children aged 1-18 were included in the study. Especially for items focusing on emotional items, children reported their QoL as higher than their parents did. The QoL scores were not significantly associated with the child's condition's severity. CONCLUSIONS This study provides, for the first time, an overview of the QoL of children and parents followed-up by PLTs in Belgium.
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Affiliation(s)
- Marie Friedel
- Department of Life Sciences and Medicine (DLSM), Faculty of Sciences, Technology and Medicine (FSTM), University of Luxembourg, 4365 Esch-sur-Alzette, Luxembourg
- Institute of Health and Society (IRSS), Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Isabelle Aujoulat
- Faculty of Public Health, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Bénédicte Brichard
- Interface Pédiatrique, Department of Paediatric Oncology and Haematology, Cliniques Universitaires St Luc, 1200 Brussels, Belgium
| | - Christine Fonteyne
- Globul'home, Hôpital Universitaire des Enfants Reine Fabiola, 1020 Brussels, Belgium
| | - Marleen Renard
- Kites, Department of Paediatric Oncology and Haematology, Universitair Ziekenhuis Leuven, 3000 Leuven, Belgium
| | - Jean-Marie Degryse
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
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Fraser LK, Gibson-Smith D, Jarvis S, Papworth A, Neefjes V, Hills M, Doran T, Taylor J. Polypharmacy in Children and Young People With Life-limiting Conditions From 2000 to 2015: A Repeated Cross-sectional Study in England. J Pain Symptom Manage 2022; 64:213-221.e1. [PMID: 35675847 DOI: 10.1016/j.jpainsymman.2022.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/06/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022]
Abstract
CONTEXT Polypharmacy is often appropriate for children with life-limiting conditions but is associated with an increase in hospitalizations and inappropriate prescribing, and can affect the quality of life of children and their families as they manage complex medication schedules. Despite this, little is known about polypharmacy in this population. OBJECTIVE To describe the prevalence and patterns of polypharmacy in children with a life-limiting condition in a nationally representative cohort in England. METHODS Observational study of children (age 0-19 years) with a life-limiting condition in a national database from 2000 to 2015. Common definitions of polypharmacy were used to determine polypharmacy prevalence in each year based on unique medications and regular medications. Hierarchical regression analyses were used to explore factors associated with polypharmacy. RESULTS Data on 15,829 individuals were included. Each year 27%-39% of children were prescribed ≥5 unique medications and 8%-12% were prescribed ≥10. Children with a respiratory (OR 7.6, 95%CI 6.4-9.0), neurological (OR 2.8, 95%CI 2.4-3.2), or metabolic (OR 2.2, 95%CI 1.7-2.8) condition were more likely than those with a congenital condition to experience polypharmacy. Increasing age, being diagnosed with a LLC under one year of age, having >1 life-limiting or chronic condition or living in areas of higher deprivation were also associated with higher prevalence of polypharmacy. CONCLUSION Children with life-limiting conditions have a high prevalence of polypharmacy and some children are at greater risk than others. More research is needed to understand and address the factors that lead to problematic polypharmacy in this population.
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Affiliation(s)
- Lorna K Fraser
- Department of Health Sciences (L.K.F., D.G-S., S.J. A.P., J.T.), University of York, York, UK; Martin House Research Centre (L.K.F., D.G-S., S.J., A.P., J.T.), University of York, York, UK.
| | - Deborah Gibson-Smith
- Department of Health Sciences (L.K.F., D.G-S., S.J. A.P., J.T.), University of York, York, UK; Martin House Research Centre (L.K.F., D.G-S., S.J., A.P., J.T.), University of York, York, UK
| | - Stuart Jarvis
- Department of Health Sciences (L.K.F., D.G-S., S.J. A.P., J.T.), University of York, York, UK; Martin House Research Centre (L.K.F., D.G-S., S.J., A.P., J.T.), University of York, York, UK
| | - Andrew Papworth
- Department of Health Sciences (L.K.F., D.G-S., S.J. A.P., J.T.), University of York, York, UK; Martin House Research Centre (L.K.F., D.G-S., S.J., A.P., J.T.), University of York, York, UK
| | | | - Michelle Hills
- Martin House Hospice (M.H.), Wetherby, UK; Leeds Teaching Hospitals NHS Trust (M.H.), Leeds, UK
| | - Tim Doran
- University Hospitals of Leicester NHS Trust (V.N., T.D.), UK
| | - Johanna Taylor
- Department of Health Sciences (L.K.F., D.G-S., S.J. A.P., J.T.), University of York, York, UK; Martin House Research Centre (L.K.F., D.G-S., S.J., A.P., J.T.), University of York, York, UK
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Feinstein JA, Feudtner C, Valuck RJ, Fairclough DL, Holstein JA, Samay S, Kempe A. Identifying Important Clinical Symptoms in Children With Severe Neurological Impairment Using Parent-Reported Outcomes of Symptoms. JAMA Pediatr 2020; 174:1114-1117. [PMID: 33044500 PMCID: PMC7551220 DOI: 10.1001/jamapediatrics.2020.2987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This cross-sectional study evaluates whether the Parent-Reported Outcomes of Symptoms system identifies more symptoms than clinicians do among children with severe neurological impairment.
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Affiliation(s)
- James A. Feinstein
- Adult and Child Consortium for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado, Children’s Hospital Colorado, Aurora
| | - Chris Feudtner
- Division of General Pediatrics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Robert J. Valuck
- Skaggs School of Pharmacy & Pharmaceutical Sciences, University of Colorado, Aurora
| | - Diane L. Fairclough
- Adult and Child Consortium for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado, Children’s Hospital Colorado, Aurora
| | | | - Sadaf Samay
- Research Informatics, Analytics Resource Center, Children’s Hospital Colorado, Aurora
| | - Allison Kempe
- Adult and Child Consortium for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado, Children’s Hospital Colorado, Aurora
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Passone CGB, Grisi SJ, Farhat SC, Manna TD, Pastorino AC, Alveno RA, Miranda CVS, Waetge AR, Cordon MN, Odone-Filho V, Tannuri U, Carvalho WB, Carneiro-Sampaio M, Silva CA. COMPLEXITY OF PEDIATRIC CHRONIC DISEASE: CROSS-SECTIONAL STUDY WITH 16,237 PATIENTS FOLLOWED BY MULTIPLE MEDICAL SPECIALTIES. ACTA ACUST UNITED AC 2019; 38:e2018101. [PMID: 31778404 PMCID: PMC6909259 DOI: 10.1590/1984-0462/2020/38/2018101] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/30/2018] [Indexed: 12/15/2022]
Abstract
Objective: To assess demographic data and characteristics of children and adolescents with pediatric chronic diseases (PCD), according to the number of specialties/patient. Methods: We performed a cross-sectional study with 16,237 PCD patients at outpatient clinics in one year. Data were analyzed by an electronic data system, according to the number of physician appointments for PCD. This study assessed: demographic data, follow-up characteristics, types of medical specialty, diagnosis (International Statistical Classification of Diseases and Related Health Problems - ICD-10), number of day hospital clinic visits, and acute complications. Results: Patients followed by ≥3 specialties simultaneously showed a significantly higher duration of follow-up compared to those followed by ≤2 specialties [2.1 (0.4-16.4) vs. 1.4 (0.1-16.2) years; p<0.001] and a higher number of appointments in all specialties. The most prevalent medical areas in patients followed by ≥3 specialties were: Psychiatry (Odds Ratio - OR=8.0; confidence interval of 95% - 95%CI 6-10.7; p<0.001), Palliative/Pain Care (OR=7.4; 95%CI 5.7-9.7; p<0.001), Infectious Disease (OR=7.0; 95%CI 6.4-7.8; p<0.001) and Nutrology (OR=6.9; 95%CI 5.6-8.4; p<0.001). Logistic regressions demonstrated that PCD patients followed by ≥3 specialties were associated with high risk for: number of appointments/patient (OR=9.2; 95%CI 8.0-10.5; p<0.001), day hospital clinic visits (OR=4.8; 95%CI 3.8-5.9; p<0.001), emergency department visits (OR=3.2; 95%CI 2.9-3.5; p<0.001), hospitalizations (OR=3.0; 95%CI 2.7-3.3; p<0.001), intensive care admissions (OR=2.5; 95%CI 2.1-3.0; p<0.001), and deaths (OR=2.8; 95%CI 1.9-4.0; p<0.001). The diagnosis of asthma, obesity, chronic pain, and transplant was significantly higher in patients followed by ≥3 specialties. Conclusions: The present study showed that PCD patients who required simultaneous care from multiple medical specialties had complex and severe diseases, with specific diagnoses.
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Rico-Mena P, Palacios-Ceña D, Martino-Alba R, Chocarro-Gonzalez L, Güeita-Rodríguez J. The impact of home-based physical rehabilitation program on parents' experience with children in palliative care: a qualitative study. Eur J Phys Rehabil Med 2019; 55:494-504. [PMID: 30781934 DOI: 10.23736/s1973-9087.19.05474-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pediatric palliative care programs aim to improve the quality of life of children with severe life-threatening illnesses, and that of their families. Although rehabilitation and physical therapy provides a valuable tool for the control of symptoms, it has been poorly researched to date. Since the family represents such a fundamental support in these cases, it is important to deepen our understanding regarding the value of implementing rehabilitation programs from the parents' perspective. AIM The aim of this paper was to explore parents' experiences regarding the implementation of a physical rehabilitation program in pediatric palliative care. DESIGN A qualitative methodology was chosen. SETTING The unit of pediatric palliative care at the Hospital Niño Jesús (Madrid, Spain). POPULATION The inclusion criteria were: 1) parents of children, irrespective of their diagnosis; 2) integrated within the program of palliative care at the time of study; 3) aged between 0-18 years; 4) must be receiving Home-Based Rehabilitation Program by the Pediatric Palliative Care team. Fourteen parents were included. METHODS Purposeful sampling method was implemented. Data collection consisted of unstructured and semi-structured interviews. A thematic analysis was performed to interpret transcripts. Guidelines for conducting qualitative studies established by the Consolidated Criteria for Reporting Qualitative Research were followed. RESULTS Three main themes were identified: 1) the meaning of physical rehabilitation to parents; 2) physical rehabilitation as an opportunity for patients to stay in their home environment; and 3) home-based physical rehabilitation as part of the families' social environment. CONCLUSIONS The main needs of a home physical rehabilitation program are to decrease pain and suffering, together with improving family education and training. CLINICAL REHABILITATION IMPACT The experience of rehabilitation programs at home is essential in order to improve both the quality of life and the quality of care of affected children and parents.
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Affiliation(s)
- Patricia Rico-Mena
- Department of Physiotherapy, Podology and Dance, European University of Madrid, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Rey Juan Carlos University, Madrid, Spain - .,Group of Humanities and Qualitative Research in Health Science of Univesidad Rey Juan Carlos (Hum&QRinHS), Madrid, Spain
| | - Ricardo Martino-Alba
- Unit of Pediatric Palliative Care, Niño Jesús Pediatric University Hospital, Madrid, Spain
| | | | - Javier Güeita-Rodríguez
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.,Group of Humanities and Qualitative Research in Health Science of Univesidad Rey Juan Carlos (Hum&QRinHS), Madrid, Spain
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