scholarly journals Advancing Pediatric Palliative Care In a Low-Middle Income Country: An  Implementation Study, A challenging but not impossible task

2020 ◽  
Author(s):  
Ximena Garcia-Quintero ◽  
Luis Gabriel Parra-Lara ◽  
Angelica Claros-Hulbert ◽  
Maria Isabel Cuervo-Suarez ◽  
Wendy Gomez-Garcia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Pediatric Population ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Care Program ◽  
University Hospital ◽  
Pediatric Palliative Care ◽  
Middle Income ◽  
The Impact

Abstract Background: The abyss of access to pediatric palliative care and pain management in Latin America remains to be an unaddressed global health issue. Efforts to improve the development level of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Cares (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program “Taking Care of You ” (TCY) , in a tertiary care university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis to evaluate the impact of the program and service delivery was conducted. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of outpatients increased by 80% every trimester between 2017-2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a program, and how the referral times, coordination of care, communication with other hospital services were improved. Providing compassionate/holistic care to children with Life-limiting and threatening diseases, and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.

scholarly journals Advancing Pediatric Palliative Care In a Low-Middle Income Country: An  Implementation Study, A challenging but not impossible task

2020 ◽  
Author(s):  
Ximena Garcia-Quintero ◽  
Luis Gabriel Parra-Lara ◽  
Angelica Claros-Hulbert ◽  
Maria Isabel Cuervo-Suarez ◽  
Wendy Gomez-Garcia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Pediatric Population ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Care Program ◽  
University Hospital ◽  
Pediatric Palliative Care ◽  
Middle Income ◽  
The Impact

Abstract Background: The disparities in access to pediatric palliative care and pain management in Latin America remains an unaddressed global health issue. Efforts to improve the development of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Care (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program, “Taking Care of You ” (TCY) , in a tertiary care, university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis was carried out to evaluate the impact of the program and service delivery. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of ambulatory patients increased by 80% every trimester between 2017-2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a PPC program and how the referral times, coordination of care, communication with other hospital services were improved while providing compassionate/holistic care to children with life-limiting and threatening diseases and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.

scholarly journals Advancing Pediatric Palliative Care In A Low-Middle Income Country: A Descriptive Analysis of the Implementation, A challenging But Not Impossible Task

2020 ◽  
Author(s):  
Ximena Garcia-Quintero ◽  
Luis Gabriel Parra-Lara ◽  
Angelica Claros-Hulbert ◽  
Maria Isabel Cuervo-Suarez ◽  
Wendy Gomez-Garcia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Pediatric Population ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Care Program ◽  
University Hospital ◽  
Pediatric Palliative Care ◽  
Middle Income ◽  
The Impact

Abstract Background: The abyss of access to palliative care and pain management in Latin America remains to be an unaddressed global health issue. Efforts to improve the development level of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Cares (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program “Taking Care of You” (TCY), in a tertiary care university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis to evaluate the impact of the program and service delivery was conducted. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of outpatients increased by 80% every trimester between 2017-2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a program, and how the referral times, coordination of care, communication with other hospital services were improved. Providing compassionate/holistic care to children with Life-limiting and threatening diseases, and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.

scholarly journals Advancing pediatric palliative care in a low-middle income country: an implementation study, a challenging but not impossible task

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ximena Garcia-Quintero ◽  
Luis Gabriel Parra-Lara ◽  
Angelica Claros-Hulbert ◽  
Maria Isabel Cuervo-Suarez ◽  
Wendy Gomez-Garcia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Pediatric Population ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Care Program ◽  
University Hospital ◽  
Pediatric Palliative Care ◽  
Middle Income ◽  
The Impact

Abstract Background The disparities in access to pediatric palliative care and pain management in Latin America remains an unaddressed global health issue. Efforts to improve the development of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Care (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program, “Taking Care of You” (TCY), in a tertiary care, university hospital in Cali, Colombia. Methods A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis was carried out to evaluate the impact of the program and service delivery. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of ambulatory patients increased by 80% every trimester between 2017 and 2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a PPC program and how the referral times, coordination of care, communication with other hospital services were improved while providing compassionate/holistic care to children with life-limiting and threatening diseases and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.

The Impact of Integrated Multidisciplinary Palliative Care Program on Symptoms in Patients at the Palliative Care Ward—An Audit and a Protocol of Prospective Controlled Investigation

2017 ◽  
Vol 32 (3-4) ◽  
pp. 87-88 ◽  
Author(s):  
Andreas Jülich ◽  
Thomas Spreu ◽  
Britta Buchhold ◽  
Taras Usichenko
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Symptom Control ◽  
Sample Size Calculation ◽  
Care Program ◽  
Symptom Assessment ◽  
University Hospital ◽  
Retrospective Audit ◽  
Edmonton Symptom Assessment Scale ◽  
The Impact

An integrated multidisciplinary palliative care (IMPC) program is a promising tool to improve symptom control in patients at the end of life. The aim was to study the feasibility of the IMPC program in patients at the palliative care (PC) ward. A retrospective audit, using the extended Edmonton Symptom Assessment Scale (ESAS), was conducted on the PC ward of the university hospital. Consecutive patients who were admitted for the IMPC program during 1 year were considered. One hundred forty-eight cases (93% with underlying cancer) were analyzed. The intensity of pain levels, nausea, vomiting, shortness of breath, and sleep disorders decreased at least by 50% ( P < .0001) during the 13 (median) days of IMPC. Integrated multidisciplinary PC program was associated with symptom improvements in patients at the PC ward. The information generated supports sample size calculation for a prospective controlled trial.

scholarly journals First referral to an integrated onco-palliative care program: A retrospective analysis of its timing.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 167-167
Author(s):  
Claire Barth ◽  
Isabelle Colombet ◽  
Pascale Vinant
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
End Of Life ◽  
Retrospective Analysis ◽  
Hospice Care ◽  
Care Program ◽  
University Hospital ◽  
Cancer Type ◽  
Palliative Care Program ◽  
The Impact

167 Background: Despite being recommended early in the course of advanced cancer, palliative care (PC) referral remains often late. Taking into account limited PC resources, disease-specific referral criteria and models of care need to be explored. In a previous work, we showed that a weekly onco-palliative meeting (OPM) allowed earlier introduction of the PC team (PCT) and decreased aggressiveness of end-of-life (EOL) care1. We describe patient’s profile when first referred to this Integrated Onco-Palliative Care program (IOPC), the timing of the referral relatively to the course of his/her disease and the impact on the trajectory of EOL care. Methods: The IOPC of our University Hospital combined a weekly OPM, dedicated to patients with incurable diseases for whom goals and organization of care need to be discussed, and/or clinical evaluation with possible follow-up by the PCT. We retrospectively analysed all patients reported for the first time at OPM between 2011 and 2013. We calculated an index of precocity, defined as the ratio of time from the first referral to death and the time from the diagnosis of incurability to death, with values ranging from 0 (late referral) to 1 (early referral). Results: Of the 416 patients included, 57% presented with lung cancer, urinary carcinoma and sarcoma. At first referral to IOPC program, 76% were receiving chemotherapy, 63% were outpatients, 56% had a PS ≤ 2 and 46% had a serum albumin level > 35g/l. The median (1st-3rd quartile) index of precocity was 0.39 (0.16-0.72), ranging between 0.53 (0.20-0.79) (earliest, for lung cancer) to 0.16 (0.07-0.56) (latest, for prostate cancer). Among 367 decedents, 42 (13%) received chemotherapy within 14 days before death, 157 (43%) died in hospice care setting. Conclusions: Most patients first referred to IOPC were still under antitumoral treatment and had intermediate prognostic markers. However the time of referral between diagnosis of incurability and death is highly variable according to cancer type, and should probably be adapted while therapies progress.1 Colombet I, et al. Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients. BMJ Support Palliat Care. 2012;2(3):239–47

scholarly journals Knowledge in palliative care of nursing professionals at a Spanish hospital

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Elena Chover-Sierra ◽  
Antonio Martínez-Sabater ◽  
Yolanda Lapeña-Moñux
Keyword(s):  
Palliative Care ◽  
Basic Education ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Study Data ◽  
Care Hospital ◽  
Cross Sectional

Resume Objective: to determine the level of knowledge in palliative care of nursing staff at a Spanish tertiary care hospital. Method: descriptive, cross-sectional study. Data were collected about the results of the Spanish version of the Palliative Care Quiz for Nurses (PCQN), sociodemographic aspects, education level and experience in the field of palliative care. Univariate and bivariate descriptive analysis was applied. Statistical significance was set at p < 0.05 in all cases. Results: 159 professionals participated (mean age 39.51 years ± 10.25, with 13.96 years ± 10.79 of professional experience) 54.7% possessed experience in palliative care and 64.2% educational background (mainly basic education). The mean percentage of hits on the quiz was 54%, with statistically significant differences in function of the participants’ education and experience in palliative care. Conclusions: although the participants show sufficient knowledge on palliative care, they would benefit from a specific training program, in function of the mistaken concepts identified through the quiz, which showed to be a useful tool to diagnose professionals’ educational needs in palliative care.

scholarly journals A study on impact of iron deficiency on cognition and anthropometry in pediatrics and clinical pharmacist’s intercession to provide awareness about iron deficiency in tertiary care teaching hospital

2021 ◽  
Vol 8 (11) ◽  
pp. 1848
Author(s):  
Aishvarya V. ◽  
Roshine P. ◽  
Elayarani M. ◽  
Mahendravarman P. ◽  
Saravanan S.
Keyword(s):  
Iron Deficiency ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Indian Academy ◽  
Convincing Evidence ◽  
Physical Growth ◽  
Micronutrient Deficiencies ◽  
Single Digit ◽  
Cognitive Behaviour ◽  
The Impact

Background: Micronutrient deficiencies largely affect pediatric population worldwide. In India, pediatric category is more prone to iron deficiency, the most common micronutrient deficiency disorder which produces haematological as well as non-hematological disturbances. This study aimed to identify the impact of iron deficiency on cognitive function and anthropometric changes in pediatric populations.Methods: A hospital based, prospective observational study was conducted at Department of Pediatrics in Rajah Muthiah Medical College and Hospital, 127 participants were enrolled in this study. BKT kit of Intelligence, Electronic weighing machine, Stadiometer, BMI Calculator by CDC guidelines and patient’s haemoglobin values were used in this study.Results: Out of 127 patients, 66 patients had iron deficiency with anemia and remaining 61 had iron deficiency without anemia. Cognitive behaviour was assessed based on the norms and majority were under the category- dull average (52 patients) followed by average (45 patients) and other’s had single digit patients. Growth charts of Indian Academy of Pediatrics were used to assess anthropometric characteristics and majority were in the underweight category (61.4%) followed by average category (38.6 %).Conclusions: Low cognitive scores and underweight were found in participants with low haemoglobin levels. Hence, our study provides convincing evidence that iron plays a vital role in the cognition, motor and physical growth. Awareness about the importance of iron and the health issues associated with its deficiency was also provided to the participants.

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