scholarly journals Attracting Earlier Referrals to a Paediatric Palliative Care Service: The Vocabulary of Enhanced Supportive Care

2019 ◽  
Author(s):  
June Hemsley
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Paediatric Palliative Care

Affording opportunities to discuss deterioration in paediatric palliative care consultations: a conversation analytic study

2017 ◽  
Vol 10 (2) ◽  
pp. e13-e13 ◽  
Author(s):  
Stuart Ekberg ◽  
Susan Danby ◽  
Anthony Herbert ◽  
Natalie K Bradford ◽  
Patsy Yates
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Self Report ◽  
Palliative Care Specialist ◽  
Communicative Practices ◽  
Paediatric Palliative Care ◽  
Care Specialist ◽  
Self Report Data ◽  
Limiting Condition

ObjectiveDiscussing the potential deterioration of a child who has a life-limiting condition has recognised benefits for future care, but can be challenging in a clinical context where uncertain illness trajectories are common. Existing research is restricted to indirect forms of evidence such as self-report data from clinicians and families. This study directly explores how discussions about deterioration are managed within actual paediatric palliative care consultations.Methods9 consultations were video recorded in an Australian paediatric palliative care service. Each consultation involved the same paediatric palliative care specialist. Conversation analysis was used to identify and explore recurrent ways in which discussions about deterioration came to be realised.FindingsThe study identified two communicative practices used by a paediatric palliative care specialist that afforded opportunities to discuss deterioration: (1) soliciting the family's agenda for the consultation; (2) initiating and maintaining topics where discussing deterioration is a relevant possibility. Across these different practices, a common feature was indirect initiation of discussions about deterioration. This approach made such discussions possible, but without mandating or even suggesting that such discussion must occur.ConclusionsThese communicative practices balance the benefit of discussing deterioration against a recognised importance of allowing discussions to be directed by a child's family. This was achieved by creating opportunities for discussing deterioration, without making such discussions necessary.

Referral to a specialist paediatric palliative care service in oncology patients

2010 ◽  
Vol 56 (4) ◽  
pp. 677-680 ◽  
Author(s):  
Lorna K. Fraser ◽  
Michael Miller ◽  
Patricia A. McKinney ◽  
Roger C. Parslow ◽  
Richard G. Feltbower
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Oncology Patients ◽  
Paediatric Palliative Care

scholarly journals Finding a way with words: Delphi study to develop a discussion prompt list for paediatric palliative care

2019 ◽  
Vol 34 (3) ◽  
pp. 291-299 ◽  
Author(s):  
Stuart Ekberg ◽  
Anthony Herbert ◽  
Kristi Johns ◽  
Gabrielle Tarrant ◽  
Holly Sansone ◽  
...  
Keyword(s):  
Palliative Care ◽  
Delphi Study ◽  
Healthcare Professionals ◽  
Care Service ◽  
Family Members ◽  
Palliative Care Service ◽  
Future Research ◽  
Paediatric Palliative Care ◽  
Question Prompt List ◽  
Question Prompt

Background: Effective communication is a cornerstone of quality paediatric palliative care. Families report struggling, however, to know what to discuss, with whom, and when. Although question prompt lists exist for adult palliative care, they do not suit the unique circumstances of paediatric palliative care. Aim: To develop a prompt list suitable for paediatric palliative care. Design: Underpinned by Delphi methodology, a six-phase procedure was adopted: (1) drafting items based on the findings of a literature review, (2) condensing the list of items based on group discussion, (3) refining items based on a survey of expert healthcare professionals, (4) additional refining of items based on another survey of professionals, (5) further refining of items based on cognitive interviews with family members, and (6) final review by healthcare professional and family member groups. Participants: Three participant groups were involved during various phases: (1) members of an Australasian paediatric palliative care national reference group, (2) healthcare professionals associated with a local paediatric palliative care service, and (3) family members who were users of the same local service. Results: Through multi-phase consultation across participant groups, the draft question prompt list was refined progressively to 28 items, split across two booklets to allow end-of-life items to be provided separately, and reconceptualised as a discussion prompt list rather than a question prompt list. Conclusion: By involving representatives of major stakeholder groups, this study has facilitated the design of a prompt list suited to the circumstances of paediatric palliative care. Future research should trial the effectiveness of this resource.

Paediatric palliative care delivered by an adult palliative care service

2006 ◽  
Vol 20 (4) ◽  
pp. 433-437 ◽  
Author(s):  
Norma O’Leary ◽  
J Flynn ◽  
A MacCallion ◽  
E Walsh ◽  
Regina McQuillan
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Paediatric Palliative Care

Paediatric palliative care: the role of an adult palliative care service

1995 ◽  
Vol 9 (2) ◽  
pp. 166-167 ◽  
Author(s):  
Ilora Finlay ◽  
Regina McQuillan ◽  
David Webb
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Paediatric Palliative Care

scholarly journals Physician Shadowing for Development and Implementation of a Paediatric Palliative Care Service in Enugu, Nigeria

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 85s-85s
Author(s):  
T. Onyeka ◽  
I. Ugwu
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Care Program ◽  
Pediatric Palliative Care ◽  
Red Cross ◽  
Care Practice ◽  
Care Organization ◽  
Paediatric Palliative Care ◽  
Living With Cancer

Background: The challenges facing Nigerian children with cancer and other chronic life-limiting illnesses are enormous, with many of them not surviving due to lack of supportive services. About 80% of children living with cancer in developing countries have no access to proper cancer care and usually present to institutions like ours with very advanced disease. Cost of treatment in hospital is astronomical, with most families having to pay out-of-pocket but being unable to do so. Also, many pediatricians are discouraged when they feel they are not capable of making progress with the child's treatment and are left with feelings of hopelessness, giving patients and families the impression they have given up. The combination of these factors usually results in patients absconding from inpatient admission, defaulting from treatment and eventually dying at home. Aim: The current practice of palliative care in our institution is near-completely adult-based with little pediatric involvement despite the huge pediatric palliative care burden. We want to change the current narrative and build the pediatric palliative care practice in our institution, through the practice of 'shadowing'. Methods: We intend to accomplish this through the opportunity of the 2018 UICC African Cancer Fellowship, by visiting the Paedspal, a nongovernmental South African pediatric palliative care organization affiliated with the Red Cross War Memorial Children's Hospital and the Rondebosch Medical Centre, that offers inpatient, outpatient and hospices services. Results: Outcomes from this project will define the probability of a clinical observer program in effectively serving as a catalyst for the development and implementation of a pediatric palliative care program and as well as a facilitator for the mentoring experience. Conclusion: We posit that 'the shadowing experience' may be an effective strategy to building capacity in hospitals with no specialist pediatric palliative care physicians.

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