Pain therapy, pediatric palliative care and end-of-life care: training, experience, and reactions of pediatric residents in Italy

2014 ◽  
Vol 173 (9) ◽  
pp. 1201-1207 ◽  
Author(s):  
Francesca Rusalen ◽  
Anna Ferrante ◽  
Chiara Pò ◽  
Michele Salata ◽  
Caterina Agosto ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Pain Therapy ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Training Experience ◽  
Pediatric Residents ◽  
Care Training

scholarly journals Development of a Pediatric Palliative Care Curriculum and Dissemination Model: Education in Palliative and End-of-Life Care (EPEC) Pediatrics

2019 ◽  
Vol 58 (4) ◽  
pp. 707-720.e3 ◽  
Author(s):  
Stefan J. Friedrichsdorf ◽  
Stacy Remke ◽  
Joshua Hauser ◽  
Laurie Foster ◽  
Andrea Postier ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Pediatric Palliative Care ◽  
Life Care

End-of-Life Care for Children Enrolled in a Community-Based Pediatric Palliative Care Program

2014 ◽  
Vol 17 (5) ◽  
pp. 589-591 ◽  
Author(s):  
Lisa M. Niswander ◽  
Philene Cromwell ◽  
Jeanne Chirico ◽  
Alyssa Gupton ◽  
David N. Korones
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Program ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Palliative Care Program ◽  
Community Based

Predictors of Specialized Pediatric Palliative Care Involvement and Impact on Patterns of End-of-Life Care in Children With Cancer

2018 ◽  
Vol 36 (8) ◽  
pp. 801-807 ◽  
Author(s):  
Kimberley Widger ◽  
Rinku Sutradhar ◽  
Adam Rapoport ◽  
Christina Vadeboncoeur ◽  
Shayna Zelcer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
End Of Life ◽  
End Of Life Care ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Children With Cancer ◽  
The Impact

Purpose The impact of specialized pediatric palliative care (SPPC) teams on patterns of end-of-life care is unknown. We sought to determine (1) which children with cancer access SPPC and (2) the impact of accessing SPPC on the risk of experiencing high-intensity end-of-life care (intensive care unit admission, mechanical ventilation, or in-hospital death). Methods Using a provincial childhood cancer registry, we assembled a retrospective cohort of Ontario children with cancer who died between 2000 and 2012 and received care through pediatric institutions with an SPPC team. Patients were linked to population-based administrative data capturing inpatient, outpatient, and emergency visits. Children were classified as having SPPC, general palliative care, or no palliative care on the basis of SPPC clinical databases, physician billing codes, or inpatient diagnosis codes. Results Of the 572 children, 166 (29%) received care from an SPPC team for at least 30 days before death, and 100 (17.5%) received general palliative care. SPPC involvement was significantly less likely for children with hematologic cancers (OR, 0.3; 95% CI, 0.3 to 0.4), living in the lowest income areas (OR, 0.4; 95% CI, 0.2 to 0.8), and living further from the treatment center (OR, 0.5; 95% CI, 0.4 to 0.5). SPPC was associated with a five-fold decrease in odds of intensive care unit admission (OR, 0.2; 95% CI, 0.1 to 0.4), whereas general palliative care had no impact. Similar associations were seen with all secondary indicators. Conclusion When available, SPPC, but not general palliative care, is associated with lower intensity care at the end of life for children with cancer. However, access remains uneven. These results provide the strongest evidence to date supporting the creation of SPPC teams.

scholarly journals Opinion and Special Article: Next Steps in Palliative Care Education for Neurology Residents

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012911
Author(s):  
Tara Cook ◽  
Robert Arnold ◽  
Kwonho Jeong ◽  
Julie Childers
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
End Of Life Decisions ◽  
Neurologic Diseases ◽  
Residency Programs ◽  
Palliative Care Education ◽  
Care Training

Many neurologic diseases are life limiting and markedly impair patients' quality of life. Growing recommendations in the field recommend that neurologists have primary skills in palliative medicine that will allow them to manage symptoms and discuss end of life decisions with patients and families. Previous work has shown that formal palliative care training in neurology residencies is very limited. In this paper we briefly describe a national survey of neurology residents where we assess both the quantity and quality of the teaching they receive in end-of-life care as compared to a common and an uncommon neurologic condition. Based on the gaps we identified, as well as previous studies and recommendations in neuropalliative care, we provide nine recommendations to help neurology residency programs improve their teaching of primary neuropalliative care skills.

Describing the pediatric resident experience in caring for dying patients.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 51-51
Author(s):  
Puja J. Umaretiya ◽  
Arielle Spellun ◽  
Angela Marie Feraco
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Center ◽  
Tertiary Care ◽  
Life Care ◽  
Training Experience ◽  
Pediatric Residents ◽  
Pediatric Residency ◽  
Dying Patients ◽  
Dying Children

51 Background: Cancer remains the leading cause of childhood death beyond infancy. Though growing subspecialty palliative care provides expertise in caring for dying children, all pediatricians encounter dying patients and should feel adequately prepared to participate in their care. Clinicians who feel insufficiently trained in communication or end-of-life care are more likely to distance themselves from seriously ill patients and report higher levels of distress and burnout. Pediatric residents are often responsible for the frontline care of dying children in the hospital and yet, most pediatric residencies lack a formal end-of-life curriculum. Here, we aim to understand the experience of pediatric residents caring for dying patients. Methods: A thirty-four item survey instrument was administered to residents in a large pediatric residency program at a tertiary care center at Rising Junior Orientation and Rising Senior Orientation in spring 2018. All residents present completed the survey. Results: Seventy-six residents completed surveys including 46 rising juniors and 30 rising seniors. Only 19 residents (25%) reported receiving any training in caring for dying children; most of which was by noon/morning conferences or informal teaching. Nearly all (70/74; 95%) residents felt that their training in caring for dying children was not sufficient. A majority of residents reported minimal to no comfort with discussion of goals of care (73%) or resuscitation status (69%), managing pain (76%), anxiety (79%), and dyspnea (80%) at the end-of-life, performing a death exam (81%), and reaching out to families after the death of a child (85%). A majority of residents anticipate continuing to care for dying children after residency (50/76; 66%). Conclusions: Pediatric residents are uncomfortable with caring for dying patients and receive minimal training, suggesting that end-of-life care is a large gap in the pediatric residency training experience.

scholarly journals Cultural and religious considerations in pediatric palliative care

2012 ◽  
Vol 11 (1) ◽  
pp. 47-67 ◽  
Author(s):  
Lori Wiener ◽  
Denice Grady McConnell ◽  
Lauren Latella ◽  
Erica Ludi
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Pediatric Oncology ◽  
End Of Life Care ◽  
Death And Dying ◽  
Care Quality ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Improvement Project

AbstractObjective:A growing multicultural society presents healthcare providers with a difficult task of providing appropriate care for individuals who have different life experiences, beliefs, value systems, religions, languages, and notions of healthcare. This is especially vital when end-of-life care is needed during childhood. There is a dearth of literature addressing cultural considerations in the pediatric palliative care field. As members of a specific culture often do not ascribe to the same religious traditions, the purpose of this article was to explore and review how culture and religion informs and shapes pediatric palliative care.Method:Comprehensive literature searches were completed through an online search of nine databases for articles published between 1980 and 2011: PsychINFO, MEDLINE®, Journal of Citation Reports-Science Edition, Embase, Scopus, CINAHL®, Social Sciences Citation Index (SSCI), EBSCO, and Ovid. Key terms included: culture, transcultural, spiritual, international, ethnic, customs or religion AND end-of-life, palliative care, death, dying, cancer, or hospice, and children, pediatrics, or pediatric oncology. Reference lists in the retrieved articles were examined for additional studies that fit the inclusion criteria, and relevant articles were included for review. In addition, web-based searches of specific journals were conducted. These included, but were not limited to: Qualitative Health Research, Psycho-Oncology, Journal of Psychosocial Oncology, Journal of Pediatric Psychology, Journal of Pediatric Health Care, Journal of Pediatric Oncology Nursing, Omega, Social Work in Health Care, and Journal of Palliative Medicine.Results:Thirty-seven articles met eligibility criteria. From these, seven distinct themes emerged that have implications for pediatric palliative care. These include the role of culture in decision-making, faith and the involvement of clergy, communication (spoken and unspoken language), communicating to children about death (truth telling), the meaning of pain and suffering, the meaning of death and dying, and location of end-of-life care.Significance of results:The review of the literature provides insight into the influence of religion and how culture informs lifestyle and shapes the experiences of illness, pain, and end-of-life care. Recommendations for providing culturally sensitive end-of-life care are offered through the framework outlined in the Initiative for Pediatric Palliative Care Quality Improvement Project of 2002. Cultural traditions are dynamic, never static, and cannot be generalized to all families. Guidelines to aid in approaches to palliative care are provided, and providers are encouraged to define these important differences for each family under their care.

scholarly journals Trends in Pediatric Palliative Care Research (TPPCR) 2021; Issue #9: Commentary on Rapoport & Gupta

2021 ◽  
Author(s):  
Katherine Ketchum ◽  
- TPPCR
Keyword(s):  
Palliative Care ◽  
Children And Adolescents ◽  
End Of Life ◽  
End Of Life Care ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Care Research

This TPPCR commentary discusses the 2021 paper by Rapoport & Gupta, “Children and adolescents with hematologic cancers deserve better end-of-life care” published in Cancer.

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