Paediatric palliative screening scale as a useful tool for clinicians’ assessment of palliative care needs of pediatric patients: a retrospective cohort study

Abstract Background Although the importance of palliative care in pediatric patients has been emphasized, many health care providers have difficulty determining when patients should be referred to the palliative care team. The Paediatric Palliative Screening Scale (PaPaS) was developed as a tool for screening pediatric patients for palliative care needs. The study aimed to evaluate the PaPaS as a reliable tool for primary care clinicians unfamiliar with palliative care. Methods This was a retrospective cohort study of patients referred to the pediatric palliative care teams in two tertiary hospitals in the Republic of Korea between July 2018 and October 2019. Results The primary clinical and pediatric palliative care teams assessed the PaPaS scores of 109 patients, and both teams reported a good agreement for the sum of the PaPaS score. Furthermore, the PaPaS scores correlated with those obtained using the Lansky performance scale. Although the mean PaPaS score was higher in the pediatric palliative care team, the scores were higher than the cut-off score for referral in both groups. Conclusion The PaPaS can be a useful tool for primary care clinicians to assess the palliative care needs of patients and their families.

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Experience of nurses who work with children with palliative care needs: A mixed-method systematic review

Palliative & Supportive Care ◽

10.1017/s1478951519000956 ◽

2019 ◽

Vol 18 (4) ◽

pp. 473-485 ◽

Cited By ~ 1

Author(s):

Maha Atout

Keyword(s):

Palliative Care ◽

Nursing Education ◽

Pediatric Palliative Care ◽

Staffing Level ◽

Invasive Treatment ◽

Care Needs ◽

Care Education ◽

Palliative Care Education ◽

Palliative Care Needs ◽

Online Web

AbstractObjectiveThe importance of palliative care education for nurses has been recognized worldwide. The study aims to explore the experiences of nurses working with children with palliative care needs and to identify any related educational needs.MethodsThe electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period 2000–2015.ResultsFinding revealed that working with children with palliative care needs is an emotionally struggling job for nurses, especially when they try to manage the transition of pediatric patients from curative to palliative care. Staffing level and time constraints comprise a major obstacle in pediatric palliative care. Focusing on invasive treatment and technology in spite of the feelings that it will not improve patients' health status intensifies the feeling of guilt and helplessness for nurses. Finally, nurses asserted the importance of receiving pediatric palliative care education, especially how to communicate with children with palliative care needs and their families.Significance of resultsFurther research is recommended with regard to nurses' experience in communication with children with palliative care needs. Nursing education in pediatric palliative care is significantly important, especially how to communicate with children with palliative care needs and their families.

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Mortality among referrals to a community-based intermediate care team

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2017-001364 ◽

2017 ◽

Vol 9 (3) ◽

pp. 263-266

Author(s):

Bharath Lakkappa ◽

Sanjay Shah ◽

Stephen Rogers ◽

Leanne Helen Holman

Keyword(s):

Palliative Care ◽

Care Team ◽

Intermediate Care ◽

Care Needs ◽

Community Based ◽

Care Services ◽

Palliative Care Teams ◽

Care Models ◽

End Stage ◽

Palliative Care Needs

ObjectivesIntermediate care services have been introduced to help mitigate unnecessary hospital demand and premature placement in long-term residential care. Many patients are elderly and/or with complex comorbidities, but little consideration has been given to the palliative care needs of patients referred to intermediate care services. The objective of this study is to determine the proportion of patients referred to a community-based intermediate care team who died during care and up to 24 months after discharge and so to help inform the development of supportive and palliative care in this setting.MethodsA retrospective cohort study of all 4770 adult patients referred to Northamptonshire Intermediate Care Team (ICT) between 11 April 2010 and 10 April 2011.ResultsOf 4770 patients referred, 60% were 75 years or older and 32% were 85 years of age or older. 4.0% of patients died during their ICT stay and 11% within 30 days of discharge. At the end of 12 months, 25% of the patients had died, increasing to 32% before the end of the second year. About 34% of all deaths occurred during the ICT stay or within 30 days of discharge, and a further 46% by the end of the first year. Male gender and higher age were associated with greater likelihood of death.ConclusionsIt is important for ICT clinicians to consider immediate and longer-term palliative care needs among patients referred to ICTs. Care models involving ICTs and palliative care teams working together could enable more people with end-stage non-cancer illnesses to die at home.

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“They Shouldn’t Be Coming to the ED, Should They?”: A Descriptive Service Evaluation of Why Patients With Palliative Care Needs Present to the Emergency Department

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909116676774 ◽

2017 ◽

Vol 34 (10) ◽

pp. 984-990 ◽

Cited By ~ 9

Author(s):

Emilie Green ◽

Sarah Ward ◽

Will Brierley ◽

Ben Riley ◽

Henna Sattar ◽

...

Keyword(s):

Emergency Department ◽

Palliative Care ◽

A Priori ◽

Service Evaluation ◽

Palliative Care Team ◽

Care Team ◽

Care Needs ◽

Direct Admission ◽

Palliative Care Needs ◽

Single Center Observational Study

Background: Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. Methods: This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period. Demographic and clinical data were collected from electronic health records. Results: A total of 105 patients made 112 presentations to the ED. The 2 most common presenting complaints were shortness of breath (35%) and pain (28%). Eighty-three percent of presentations required care in the ED according to a priori defined criteria. They either underwent urgent investigation or received immediate interventions that could not be delivered in another setting, were referred by a health-care professional, or were admitted. Conclusions: Findings challenge the misconception that patients known to a palliative care team should be cared for outside the ED. The importance and necessity of the ED for patients in their last years of life has been highlighted, specifically in terms of managing acute, unpredictable crises. Future service provision should not be based solely on a patient’s presenting complaint. Further qualitative research exploring patient perspective is required in order to explore the decision-making process that leads patients with palliative care needs to the ED.

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Integrated Palliative Care Outcome Scale (iPOS) as a Tool to Identify Complex Palliative Care Needs - First Results of iPOS-assessment in a Palliative Care Team

10.26226/morressier.5c76c8bce2ea5a72376126a7 ◽

2019 ◽

Author(s):

Carmen Roch

Keyword(s):

Palliative Care ◽

Palliative Care Team ◽

Care Team ◽

Care Needs ◽

Palliative Care Outcome Scale ◽

First Results ◽

Palliative Care Needs ◽

Care Outcome

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The development of an instrument that can identify children with palliative care needs: the Paediatric Palliative Screening Scale (PaPaS Scale): a qualitative study approach

BMC Palliative Care ◽

10.1186/1472-684x-12-20 ◽

2013 ◽

Vol 12 (1) ◽

Cited By ~ 19

Author(s):

Eva Bergstraesser ◽

Richard D Hain ◽

José L Pereira

Keyword(s):

Palliative Care ◽

Qualitative Study ◽

Care Needs ◽

Study Approach ◽

Palliative Care Needs ◽

Screening Scale

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Factors Associated With Knowledge and Comfort Providing Palliative Care: A Survey of Pediatricians in Mexico

Journal of Palliative Care ◽

10.1177/0825859719827021 ◽

2019 ◽

Vol 34 (2) ◽

pp. 132-138 ◽

Cited By ~ 3

Author(s):

Gregorio Zuniga-Villanueva ◽

Jose Luis Ramirez-GarciaLuna ◽

Kevin Weingarten

Keyword(s):

Palliative Care ◽

Basic Knowledge ◽

Pediatric Palliative Care ◽

Care Needs ◽

Care Education ◽

Palliative Care Education ◽

Oncologic Patients ◽

Main Barrier ◽

Palliative Care Needs ◽

And Training

Background: Lack of education and training in palliative care has been described to be one of the most important barriers to pediatric palliative care implementation. Objective: To examine what factors determine the degree of knowledge and level of comfort Mexican pediatricians have providing pediatric palliative care. Methods: A questionnaire that assessed palliative care concepts was developed and applied online to Mexican pediatricians, both generalists and specialists. Results: A total of 242 pediatricians responded. The majority had not received palliative care education (92.6%) and felt uncomfortable discussing palliative needs with patients and families (92.1%). The mean score of the questionnaire was 6.8 (±1.4) of 10 correct answers. Knowledge in palliative care was associated with exposure to oncologic patients ( P = .01) and previous palliative care education ( P = .02) but inversely related to the pediatrician’s age ( P = .01). Comfort addressing patient’s palliative care needs was associated with knowledge in palliative care ( P < .01), exposure to oncologic patients ( P = .03), and previous education in palliative care ( P = .02). Conclusions: Although Mexican pediatricians have basic knowledge of palliative care concepts, they do not feel comfortable addressing palliative care needs, suggesting that the main barrier for implementing palliative care is not the lack of knowledge but rather feeling uncomfortable when addressing these issues with patients and families. Educational programs should incorporate strategies that could help physicians develop comfort in approaching palliative care patients.

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Preparing a young palliative care unit for the COVID-19 pandemic in a teaching hospital in Ghana

Palliative & Supportive Care ◽

10.1017/s1478951520000498 ◽

2020 ◽

Vol 18 (4) ◽

pp. 400-402

Author(s):

Rasheed Ofosu-Poku ◽

Gladys Anyane ◽

Anita Eseenam Agbeko ◽

Alberta Delali Dzaka ◽

Michael Owusu-Ansah ◽

...

Keyword(s):

Public Health ◽

Palliative Care ◽

Teaching Hospital ◽

Critically Ill Patients ◽

Preventive Measures ◽

Healthcare Services ◽

Palliative Care Team ◽

Care Needs ◽

The Public ◽

Palliative Care Needs

AbstractThe emergence of the Coronavirus Disease 2019 (COVID-19) pandemic has necessitated an interim restructuring of the healthcare system in accordance with public health preventive measures to mitigate spread of the virus while providing essential healthcare services to the public. This article discusses how the Palliative Care Team of the Komfo Anokye Teaching Hospital in Ghana has modified its services in accordance with public health guidelines. It also suggests a strategy to deal with palliative care needs of critically ill patients with COVID-19 and their families.

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Identification of palliative care needs among people with dementia and its association with acute hospital care and community service use at the end-of-life: A retrospective cohort study using linked primary, community and secondary care data

Palliative Medicine ◽

10.1177/02692163211019897 ◽

2021 ◽

pp. 026921632110198

Author(s):

Javiera Leniz ◽

Irene J Higginson ◽

Deokhee Yi ◽

Zia Ul-Haq ◽

Amanda Lucas ◽

...

Keyword(s):

Primary Care ◽

Palliative Care ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hospital Admissions ◽

Care Practice ◽

Care Needs ◽

People With Dementia ◽

Palliative Care Needs

Background: Hospital admissions among people dying with dementia are common. It is not known whether identification of palliative care needs could help prevent unnecessary admissions. Aim: To examine the proportion of people with dementia identified as having palliative care needs in their last year of life, and the association between identification of needs and primary, community and hospital services in the last 90 days. Design: Retrospective cohort study using Discover, an administrative and clinical dataset from 365 primary care practices in London with deterministic individual-level data linkage to community and hospital records. Setting/participants: People diagnosed with dementia and registered with a general practitioner in North West London (UK) who died between 2016 and 2019. The primary outcome was multiple non-elective hospital admissions in the last 90 days of life. Secondary outcomes included contacts with primary and community care providers. We examined the association between identification of palliative care needs with outcomes. Results: Among 5804 decedents with dementia, 1953 (33.6%) were identified as having palliative care needs, including 1141 (19.7%) identified before the last 90 days of life. Identification of palliative care needs before the last 90 days was associated with a lower risk of multiple hospital admissions (Relative Risk 0.70, 95% CI 0.58–0.85) and more contacts with the primary care practice, community nurses and palliative care teams in the last 90 days. Conclusions: Further investigation of the mechanisms underlying the association between identification of palliative care needs and reduced hospital admissions could help reduce reliance on acute care for this population.

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