Paediatric end-of-life care – symptoms and problems: parent assessment

ObjectiveSymptoms and problems (S&P) are under-reported in children in end-of-life care.To target future interventions, the primary aim was to examine S&P in children in end-of-life care.MethodsAll parents, who lost a child under the age of 18 years due to life-limiting diagnoses in the period 2012–2014 in Denmark, were invited to complete a self-administered questionnaire in 2017. In all, 152 (38%) children were represented by 136 mothers and 57 fathers. In the present study, parents’ assessments of S&P during the last month of life were restricted to children aged 3–18 years. Data were analyses by means of descriptive statistics.ResultsChildren ≥3 years at the time of death were represented by 71 parents (48 mothers and 23 fathers) representing 56 out of the 152 children. Physical fatigue (93%), sleepiness (90%), poor appetite (87%), pain (84%) and nausea (84%) were the five most frequent symptoms reported by the parents. In all, 65% of the parents reported that satisfactory pain relief was obtained and 64% of the parents reported that the healthcare services to a large extent reacted quickly, when the child and/or family needed help. However, 46% of the parents experienced ‘mess-ups’ or sloppy services in the primary ward and 27% experienced that the children suffered from fear of death.ConclusionAccording to the parents, children with life-limiting diagnosis are highly symptomatic and have substantial problems during end-of-life care. Our findings indicate that systematic screening of S&P in children should be considered.

Encouraging enough? A Case Study on Parental Feedback on New Assessment in Finnish Basic Education

This is a qualitative case study of the parental feedback about participatory assessment done during the first year (2016) of the implementation of the reformed Finnish basic education curriculum. It covered grades 1-6 and was a first time to have a broader, tri-angulated teacher-student-parent assessment on learning and schooling. Consequently, parents were selected from those grades, being of various ethnic backgrounds. This case study was conducted in a Southern Finland basic education school. Resulting trends were obvious: parents regarded this kind of participatory assessment meaningful. Second, the newer the whole schooling and curricula update was for parents, the better was the participatory feedback. As a result of this study, it is clear that while the discussion and longitudinal studies on learning and assessment are still on-going, there is no rush to return into an old system and heavy, centralized assessment instruction patterns. On the contrary, this study showed beneficial elements and development triggers towards even more collaborative and encouraging assessment.

Parent assessment of medical student skills in ambulatory pediatrics

Background: Partnership with parents is a vital part of pediatric medical education, yet few studies have examined parent attitudes towards learners in pediatric settings. Methods: Questionnaires were used to determine parent and student assessment of professional and clinical skills (primary outcome) and parent attitudes towards 3rd year medical students (secondary outcome) at the University of Alberta. Chi Square, Kendall’s Tau and Kappa coefficients were calculated to compare parent and student responses in 8 areas: communication, respect, knowledge, listening, history taking, physical examination, supervision, and overall satisfaction. Results: Overall satisfaction with medical student involvement by parents was high: 56.7% of all parents ranked the encounter as ‘excellent’. Areas of lesser satisfaction included physician supervision of students. Compared to the parent assessment, students tended to underrate many of their skills, including communication, history taking and physical exam. There was no relationship between parent demographics and their attitude to rating any of the students’ skills. Conclusions: Parents were satisfied with medical student involvement in the care of their children. Areas identified for improvement included increased supervision of students in both history taking and physical examination. This is one of the largest studies examining parent attitudes towards pediatric students. The results may enhance undergraduate curriculum development and teaching in pediatric ambulatory clinics and strengthen the ongoing partnership between the community and teaching clinics.