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Popa MV, Mîndru DE, Hizanu (Dumitrache) M, Gurzu IL, Anton-Păduraru DT, Ștreangă V, Gurzu B, Guțu C, Elkan EM, Duceac LD. Stress Factors for the Paediatric and Adult Palliative Care Multidisciplinary Team and Workplace Wellbeing Solutions. Healthcare (Basel) 2024; 12:868. [PMID: 38727425 PMCID: PMC11083451 DOI: 10.3390/healthcare12090868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Palliative care is a challenging specialty, especially when it comes to caring for children with serious life-limiting conditions and supporting their families. Workers face significant challenges and experience major impacts on their wellbeing. We conducted a qualitative study to understand the sources of stress in the palliative care team, their work expectations, and how they can cope with the demands. METHODS We used an online questionnaire about the causes of stress, the impact of the COVID-19 pandemic and the ways in which support is needed in the workplace. RESULTS Of the 56 palliative care professionals who participated in the survey, 57.1% considered the main causes of stress to be high workload, difficult emotional burdens (55.4%) affecting their outlook on life (61.2%), the death of patients (46.4%), and communication with patients' families (26.8%). The COVID-19 pandemic increased stress levels for the majority of respondents (89.3%). The need for specialised training (53.6%), support groups, psychological counselling and adapted organisational policies was highlighted. CONCLUSIONS The study demonstrates the importance of understanding the needs of both paediatric and adult palliative care staff in order to provide optimal care and support their balance in this demanding area of the healthcare system.
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Affiliation(s)
- Maria Valentina Popa
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania; (M.V.P.); (M.H.)
| | - Dana Elena Mîndru
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Mihaela Hizanu (Dumitrache)
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania; (M.V.P.); (M.H.)
| | - Irina Luciana Gurzu
- Department of Preventive Medicine and Interdisciplinarity, Discipline of Occupational Health, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania;
| | - Dana Teodora Anton-Păduraru
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Violeta Ștreangă
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Bogdan Gurzu
- Department of Morfofunctional Sciences, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania;
| | - Cristian Guțu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ”Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
| | - Eva Maria Elkan
- Department of Morfofunctional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
| | - Letiția Doina Duceac
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
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Mauritz MD, von Both U, Dohna-Schwake C, Gille C, Hasan C, Huebner J, Hufnagel M, Knuf M, Liese JG, Renk H, Rudolph H, Schulze-Sturm U, Simon A, Stehling F, Tenenbaum T, Zernikow B. Clinical recommendations for the inpatient management of lower respiratory tract infections in children and adolescents with severe neurological impairment in Germany. Eur J Pediatr 2024; 183:987-999. [PMID: 38172444 PMCID: PMC10951000 DOI: 10.1007/s00431-023-05401-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
Children and adolescents with severe neurological impairment (SNI) require specialized care due to their complex medical needs. In particular, these patients are often affected by severe and recurrent lower respiratory tract infections (LRTIs). These infections, including viral and bacterial etiology, pose a significant risk to these patients, often resulting in respiratory insufficiency and long-term impairments. Using expert consensus, we developed clinical recommendations on the management of LRTIs in children and adolescents with SNI. These recommendations emphasize comprehensive multidisciplinary care and antibiotic stewardship. Initial treatment should involve symptomatic care, including hydration, antipyretics, oxygen therapy, and respiratory support. In bacterial LRTIs, antibiotic therapy is initiated based on the severity of the infection, with aminopenicillin plus a beta-lactamase inhibitor recommended for community-acquired LRTIs and piperacillin-tazobactam for patients with chronic lung disease or tracheostomy. Ongoing management includes regular evaluations, adjustments to antibiotic therapy based on pathogen identification, and optimization of supportive care. Implementation of these recommendations aims to improve the diagnosis and treatment of LRTIs in children and adolescents with SNI. What is Known: • Children and adolescents with severe neurological impairment are particularly affected by severe and recurrent lower respiratory tract infections (LRTIs). • The indication and choice of antibiotic therapy for bacterial LRTI is often difficult because there are no evidence-based treatment recommendations for this heterogeneous but vulnerable patient population; the frequent overuse of broad-spectrum or reserve antibiotics in this patient population increases selection pressure for multidrug-resistant pathogens. What is New: • The proposed recommendations provide a crucial framework for focused diagnostics and treatment of LRTIs in children and adolescents with severe neurological impairment. • Along with recommendations for comprehensive and multidisciplinary therapy and antibiotic stewardship, ethical and palliative care aspects are taken into account.
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Affiliation(s)
- Maximilian David Mauritz
- Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, 45711, Datteln, Germany.
- Department of Children's, Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine , Herdecke University, 58448, WittenWitten, Germany.
| | - Ulrich von Both
- Department of Infectious Diseases, Dr von Hauner Children's Hospital, LMU University Hospital, 80337, Munich, Germany
| | - Christian Dohna-Schwake
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care Medicine, and Pediatric Neurology, University Hospital Essen, 45147, Essen, Germany
| | - Christian Gille
- Department of Neonatology, Heidelberg University Children's Hospital, 69120, Heidelberg, Germany
| | - Carola Hasan
- Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, 45711, Datteln, Germany
- Department of Children's, Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine , Herdecke University, 58448, WittenWitten, Germany
| | - Johannes Huebner
- Department of Infectious Diseases, Dr von Hauner Children's Hospital, LMU University Hospital, 80337, Munich, Germany
| | - Markus Hufnagel
- Department of Paediatrics and Adolescent Medicine, Medical Faculty, University Medical Centre, University of Freiburg, 79106, Freiburg, Germany
| | - Markus Knuf
- Department for Pediatric and Adolescent Medicine, Worms Clinic, 67550, Worms, Germany
| | - Johannes G Liese
- Department of Paediatrics, Division of Paediatric Infectious Diseases, University Hospital of Wuerzburg, 97080, Würzburg, Germany
| | - Hanna Renk
- University Children's Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Henriette Rudolph
- Department of Pediatrics, Goethe University Frankfurt, 60590, Frankfurt am Main, Germany
| | - Ulf Schulze-Sturm
- University Children's Hospital, University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Arne Simon
- Pediatric Oncology and Hematology, University Hospital Homburg Saar, 66421, Homburg/Saar, Germany
| | - Florian Stehling
- Department of Pediatric Pulmonology and Sleep Medicine, University Children's Hospital Essen, 45147, Essen, Germany
| | - Tobias Tenenbaum
- Clinic for Child and Adolescent Medicine, Sana Klinikum Lichtenberg, Academic Teaching Hospital, Charité-Universitätsmedizin, 10365, Berlin, Germany
| | - Boris Zernikow
- Paediatric Palliative Care Centre, Children's and Adolescents' Hospital, 45711, Datteln, Germany
- Department of Children's, Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine , Herdecke University, 58448, WittenWitten, Germany
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Tatterton MJ, Fisher MJ, Storton H, Walker C. The role of children's hospices in perinatal palliative care and advance care planning: The results of a national British survey. J Nurs Scholarsh 2022. [DOI: 10.1111/jnu.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Michael J. Tatterton
- School of Nursing and Healthcare Leadership, Faculty of Health Studies University of Bradford Bradford UK
- Bluebell Wood Children's Hospice North Anston UK
- International Children's Palliative Care Network c/o Together for Short Lives Bristol UK
| | - Megan J. Fisher
- School of Nursing and Healthcare Leadership, Faculty of Health Studies University of Bradford Bradford UK
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Lyon ME, Wiener L. Special Issue: Psychosocial Considerations for Children and Adolescents Living with a Rare Disease. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1099. [PMID: 35884083 PMCID: PMC9322344 DOI: 10.3390/children9071099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022]
Abstract
This Special Issue of the journal Children constitutes an opportune moment to reflect on the psychosocial needs of children living with rare diseases and of their families [...].
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Affiliation(s)
- Maureen E. Lyon
- Children’s National Hospital, Center for Translational Research, Washington, DC 20010, USA
- School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Lori Wiener
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
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