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The objectives of this study were (i) to assess the level of knowledge with respect to pain and symptom management among doctors in their first year after graduation and (ii) to measure the impact of a structured teaching programme on their level of knowledge. All 34 newly qualified junior house officers in one teaching hospital were offered a six-session teaching programme in pain and symptom management. A multiple-choice questionnaire was used to assess their level of knowledge at the beginning and at the end of a 6-month period over which the teaching sessions took place. Attendance at and satisfaction with the programme were high. There was a significant improvement in the level of knowledge at the end of the programme, with the greatest improvement in those who attended most sessions. The low scores recorded for the questionnaire administered before the teaching programme suggest that there is a critical need for improved education in palliative care amongst newly qualified doctors. We have shown that a simple in-service case-based teaching programme can meet this need effectively.

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Aims:To compare health status and health related quality of life of teenagers in mainstream school born before 29 weeks of gestation and classroom controls Methods: Of 218 survivors from three regional cohorts (Scotland, former Northern and Oxford regions) born in 1983-84, 174 (80%) were traced and assessed at age 15-16 years. Using the eight attributes of the Health Utilities Index Mark 3, vision, hearing, speech, emotion, pain, ambulation, hand use and cognition, the health status and derived utility score of the 145 teenagers in mainstream school and 107 classroom controls were measured using questionnaires to both parents and the teenagers themselves Results: Parents reported two or more attributes aVected in 30.8% index children compared with 18.2% controls (diVerence 12.6; 95%CI 1.9-23.3). On self report two or more attributes were aVected in 42.8% of index teenagers and 37.4% of controls (diVerence 5.4; 95%CI −6.8-17.6). Based on health states reported by parents, a utility score of <0.75 [1.00 = 'perfect health' and 0 = 'dead'] was derived for 25.7% of index teenagers compared with 8.2% of controls (diVerence 17.6, 95% CI 8.5-26.6). Based on self report, 19.6% of index teenagers and 11.2% of controls had a utility score of <0.75 (diVerence 8.4, 95%CI −0.6-17.3).Conclusions: Health related problems persist into adolescence in extremely preterm survivors who are in mainstream school. There are diVerences in proxy reports of health status by parents and the views of teenagers themselves. G182 EXPERIENCES OF PARENTS WITH LIFE-LIMITED CHILDREN: A QUALITATIVE STUDY E. Horak. Keech Cottage Children's Hospice, UKBackground: Life-limiting conditions other than cancer impose a huge, long-term burden on the family of the aVected child. These conditions usually require long term care, with the expectancy of sure but delayed fatal outcome. Although increasing attention is being focused on the psychosocial issues of families of children dying of cancer, few studies explore the problems of parents with children dying from nonmalignant but severely disabling life-limiting conditions. Aims: The study intends to explore the experiences and needs of families with children having life limiting illnesses. It attempts to identify parents' problems, to match care and support to the family's needs.Methods: As little is known about the views and experiences of these families, a qualitative study was performed, using in-depth interviews. Purposive sampling was used, selecting parents systematically from the list of a children's hospice. Triangulation and respondent validation techniques safeguarded the validity.Results: The overall emotional and behavioural patterns were similar to those described by Kubler-Ross. However, the sequence of the recognised stages was frequently diVerent, and several attitudes (such as anger, denial and bargaining) were prolonged and present at the same time.Unique attitudes were also seen. Emotional distancing, followed by guilt and frustration, were observed when a fatal illness was diagnosed perina...