Pediatric Palliative Care in the United States of America

Author(s):  
Stacy F. Orloff
2018 ◽  
Vol 17 (03) ◽  
pp. 269-275 ◽  
Author(s):  
Samuel M. Kase ◽  
Elisha D. Waldman ◽  
Andrea S. Weintraub

AbstractObjectiveCompassion fatigue (CF) is secondary traumatic distress experienced by providers from contact with patients' suffering. Burnout (BO) is job-related distress resulting from uncontrollable workplace factors that manifest in career dissatisfaction. Compassion satisfaction (CS) is emotional fulfillment derived from caring for others. The literature on BO in healthcare providers is extensive, whereas CF and CS have not been comprehensively studied. Because of ongoing exposure to patient and family distress, pediatric palliative care (PPC) providers may be at particular risk for CF. We conducted a cross-sectional pilot study of CF, BO, and CS among PPC providers across the United States.MethodThe Compassion Fatigue and Satisfaction Self-Test for Helpers and a questionnaire of professional and personal characteristics were distributed electronically and anonymously to PPC physicians and nurses. Logistic and linear regression models for CF, BO, and CS as a function of potential risk factors were constructed.ResultsThe survey response rate was 39%, primarily consisting of female, Caucasian providers. The prevalence of CF, BO, and CS was 18%, 12%, and 25%, respectively. Distress about a “clinical situation,” physical exhaustion, and personal loss were identified as significant determinants of CF. Distress about “coworkers,” emotional depletion, social isolation, and “recent involvement in a clinical situation in which life-prolonging activities were not introduced” were significant determinants of BO. Physical exhaustion, personal history of trauma, “recent involvement in a clinical situation in which life-prolonging activities were not introduced,” and not discussing distressing issues were significant predictors of lower CS scores.Significance of resultsCF and BO directly influence the well-being and professional performance of PPC providers. To provide effective compassionate care to patients, PPC providers must be attentive to predictors of these phenomena. Further work is needed to explore additional causes of CF, BO, and CS in PPC providers as well as potential interventions.


Author(s):  
Greg Schneider

Hospice and palliative care volunteering in the United States of America (USA) has changed dramatically since its inception in the late 1960s. Inspired by physician Dame Cicely Saunders, the modern hospice movement officially began in the USA in 1971 with Florence Wald founding the first hospice, Hospice, Inc., a non-profit in New Haven, Connecticut. Then in 1983, the US Congress established the Medicare Hospice Benefit, whose Conditions of Participation (CoPs) mandated that volunteers must provide administrative or direct patient care in an amount that, at a minimum, equals 5 per cent of the total patient care hours expended by all paid hospice employees and contract staff. Hence, every hospice programme must have a volunteer programme in order to receive reimbursement for services rendered. The primary forces currently shaping hospice and palliative care volunteering have been regulations, care quality, skill requirements, liability concerns, and changing business objectives in a highly competitive environment.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Siobhán O’Keefe, ◽  
Aline B. Maddux ◽  
Kimberly S. Bennett ◽  
Jeanie Youngwerth ◽  
Angela S. Czaja

Author(s):  
Aimee K. Hildenbrand ◽  
Christina M. Amaro ◽  
Colette Gramszlo ◽  
Melissa A. Alderfer ◽  
Carly Levy ◽  
...  

2007 ◽  
Vol 16 (1) ◽  
pp. 42-43
Author(s):  
Ann Armstrong-Dailey ◽  
Jane Koppelman

2020 ◽  
pp. 237-246
Author(s):  
Elissa G. Miller

Opioid misuse, abuse, and diversion are serious concerns due to the risk of addiction and death from overdose. Rising addiction and overdose rates in the United States have led providers to establish a set of standard practices by which they assess patient risk and monitor closely while the patient is receiving opioid therapy for pain management. Pediatric patients and their families are not immune to the risks of opioids, and they should therefore be monitored closely in accordance with the adult standard of care. This chapter discusses universal precautions for opioid prescribing and makes recommendations for pediatric palliative care providers.


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