scholarly journals Evaluating the Need for Integrated Pediatric Palliative Care Services in a Pediatric Oncology Setting: A Retrospective Audit

2021 ◽  
Vol 27 ◽  
pp. 286-290
Author(s):  
Vasudeva Bhat K ◽  
Krithika S Rao ◽  
Kalasekhar Vijayasekharan ◽  
Archana Mevalegire Venkatagiri ◽  
S Ashwini ◽  
...  

Objectives: Early integrated palliative care has shown to improve the quality of life in patients with cancer. During the past decade, pediatric palliative care has become an established area of medical expertise, however due to scant information available regarding the triggers for referral and referral practice very few children receive a formal palliative care consult. Materials and Methods: A retrospective audit of medical case records of pediatric oncology patients over a period of 1 year from September 30, 2019, to September 30, 2020, was conducted. Demographic details, diagnosis, staging, clinical parameters, reason for referral, and palliative care plan were captured in a predesigned pro forma. Results: Among 126 children with cancer, 27 (21.4%) patients were referred to palliative care. Majority 21 (77%) referrals were inpatient consults. Symptom management 17 (44.7%) was the most common trigger for referral followed by referrals for psychosocial support 12 (14.4%). Children with solid tumors 16 (59%) were more often referred than hematological malignancies. Among those needing end of life care, 8 (88.8%) out of 9 families preferred home than hospital. Conclusion: Low incidence of palliative care referral and presence of symptoms as a trigger for palliative care referral suggests gaps in the integrated approach. The study findings prompt a review of palliative care referral criteria and referral practice in a pediatric oncology setting.

2016 ◽  
Vol 22 (3) ◽  
pp. 266 ◽  
Author(s):  
Naveen Salins ◽  
Arunangshu Ghoshal ◽  
Anuja Damani ◽  
Jayita Deodhar ◽  
MaryAnn Muckaden

Author(s):  
Aye Tinzar Myint ◽  
Sariyamon Tiraphat ◽  
Isareethika Jayasvasti ◽  
Seo Ah Hong ◽  
Vijj Kasemsup

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients’ willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant’s socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill.


Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 127
Author(s):  
Su Hyun Bae ◽  
Yeo Hyang Kim

Few Korean hospitals had experience in pediatric palliative care. Since the beginning of the national palliative care project, interest in pediatric palliative care has gradually increased, but the establishment of professional palliative care is still inadequate due to a lack of indicators. This study aimed to find considerations in the process of initiating palliative care services. The general and clinical characteristics of 181 patients aged less than 24 years who were registered at the pediatric palliative care center from January 2019 to August 2021 were evaluated. Life-limiting condition group 1 had the largest number of patients. The primary need for palliative care was psychological and emotional support, followed by information sharing and help in communication with the medical staff in decision-making processes. Seventy-two patients were technologically dependent, with one to four technical supports for each patient. The registration of patients with cancer increased with time, and the time from disease diagnosis to consultation for pediatric palliative care service was significantly reduced. In conclusion, before starting pediatric palliative care, it is necessary to understand the needs of patients and their families and to cooperate with medical staff.


Children ◽  
2018 ◽  
Vol 5 (7) ◽  
pp. 97 ◽  
Author(s):  
Wei Chin ◽  
Tiina Jaaniste ◽  
Susan Trethewie

Siblings of children with life limiting conditions (LLC) are an important part of the broader family system and require consideration in the holistic care of the family. There can be considerable variation in the functioning and adjustment of these siblings. The current paper explores the resilience paradigm, particularly in the context of siblings of children with LLC and serious medical conditions. The potential impact of children living with a seriously ill brother or sister will be overviewed, and a range of functional outcomes considered. Factors contributing to sibling resilience are detailed, including individual, family, and broader external and social factors. Given the limited research with siblings of children with LLC, literature has also been drawn from the siblings of children with serious and/or chronic medical conditions. Implications for clinical practice and future research are considered. Pediatric palliative care services may be well placed to contribute to this body of research as they have commonly extended relationships with the families of children with LLC, which span across the child’s disease trajectory.


2018 ◽  
Vol 17 (2) ◽  
pp. 172-185 ◽  
Author(s):  
Pippa Blackburn ◽  
Caroline Bulsara

AbstractObjectiveAlthough the needs of the bereaved have been identified widely in the literature, how these needs translate into meaningful, appropriate, and client-centered programs needs further exploration. The application of receptivity to support is a critical factor in participation by the bereaved in palliative care bereavement programs. Receptivity is a complex multifactorial phenomenon influenced by internal and external factors that ultimately influences engagement in psychosocial support in bereavement. This study explored factors that influence receptivity to bereavement support from palliative care services in rural, regional, and remote Western Australia.MethodThe study comprised a qualitative descriptive research design using semistructured interviews with 24 bereaved individuals, nine palliative care health professionals, and four Aboriginal Health Professionals. Participants were recruited via palliative care services in country Western Australia. Interviews were transcribed verbatim and thematically analyzed.ResultFindings revealed that a range of individual, social, and geographical factors influence receptivity to bereavement support and can impact on utilization of bereavement support services.Significance of resultsReceptivity provides a frame of reference to enhance understanding of factors influencing engagement in psychosocial support in bereavement. Receptivity promotes a shift of service provider perspectives of effective supportive care to consumer-centric reasons for engagement.


2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-080
Author(s):  
Loyda Amor N. Cajucom ◽  
Rita C. Ramos ◽  
Raymund Kernell B. Mañago ◽  
Raya Kathreen T. Fuentes ◽  
Primo G. Garcia ◽  
...  

Background: Around 200,000 pediatric clients are diagnosed with cancer each year globally. Majority (84%) of cancer cases are found in developing countries with 20% average survival rate (Ferlay et al, 2012). Two-thirds of pediatric oncology clients in the Philippines are diagnosed at advanced stages (Lecciones, 2015). Abandonment of treatment is high at 80%. Only about 10%–20% of clients attain long-term survival despite availability of multidisciplinary management. These outcomes reflect the gap in service delivery for pediatric oncology clients (Ferlay et al, 2012). Therefore, to improve accessibility to healthcare, it is necessary to determine the perceived palliative care needs of clients, their caregivers, and healthcare providers. Objective: To identify the availability of palliative care services in the country, identify barriers in service delivery, and determine the palliative care needs of pediatric oncology clients, their caregivers, and healthcare providers. Methods: The descriptive, cross-sectional study design involved a situational analysis by mapping 2 Philippine palliative centers. Focus group discussions (FGD) and interviews with healthcare professionals were conducted to determine the extent of services, geographical coverage, and perceived palliative care needs. The needs assessment tool by WHO (2004) was adopted to identify the palliative care needs of pediatric oncology clients as perceived by caregivers. Results: From a total of 181 primary caregivers, the identified main problems in caring was the economical (95.6%) aspect. Financial support (92%) was the most pressing need. Caregivers would like to learn more about general cancer care (39%) and nutrition counseling (24%). The most common palliative care needs as perceived by caregivers included accessibility to cancer facility (27%), free cancer medications (12.7%), and financial assistance (14.9%). The common barriers in rendering care were financial constraints (66%), behavioral changes (12.7%), and travel limitations (6%). The common themes found during the FGDs and interviews were: (1) inadequate human and structural health resources; (2) need to focus on psychosocial care; (3) addressing economic constraints; and (4) need to increase cancer awareness among caregivers. Conclusion: The findings of the study documented the need for the development of structured programs for pediatric palliative care in the Philippines.


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