Pain Management in the Pediatric Palliative Care Population

Thomas, Russel W.; Phillips, Marcia; Hamilton, Rebekah

doi:10.1111/jnu.12389

Cited by 13 publications

(8 citation statements)

References 37 publications

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“…Therefore, care should be taken in the development of EMR in PPC documentation of symptoms to ensure the specific requirements in PPC [57]. In this context, scales specific to the paediatric population must be used for the external assessment of pain, such as the paediatric pain questionnaire [58].…”

Section: Discussionmentioning

confidence: 99%

Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians

et al. 2021

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Background: Electronic medical records (EMRs) offer a promising approach to mapping and documenting the complex information gathered in paediatric palliative care (PPC). However, if they are not well developed, poorly implemented EMRs have unintended consequences that may cause harm to patients. One approach to preventing such harm is the involvement of users in the participatory design to ensure user acceptance and patient safety. Therefore, the aim of this study is to evaluate the acceptance of a novel patient chart module (PCM) as part of an EMR from the perspective of potential users in PPC and to involve these professionals in the design process. Methods: A qualitative observational study with N = 16 PPC professionals (n = 10 nurses, n = 6 physicians) was conducted, including concurrent think aloud (CTA) and semi-structured interviews. A structured content analysis based on the Unified Theory of Acceptance and Use of Technology was applied. Results: The results can be summarized in terms of general observations, performance expectancy, effort expectancy and facilitating conditions, all of which are likely to have a positive influence on acceptance of the PCM from the user perspective in the context of PPC. Conclusions: The involvement of users in the development of EMRs is important for meeting the requirements in PPC. Further software adaptations are necessary to implement these requirements.

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Section: Discussionmentioning

confidence: 99%

Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians

et al. 2021

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“…Pain, from the disease or interventions, is the most common symptom experienced by critically ill children in PICU (27,28). Other commonly experienced symptoms are nausea, dyspnea and delirium.…”

Section: Pain and Symptom Managementmentioning

confidence: 99%

Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit

et al. 2022

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Palliative care (PC) is an integral component of optimal critical care (CC) practice for pediatric patients facing life-threatening illness. PC acts as an additional resource for patients and families as they navigate through critical illness. Although PC encompasses end of life care, it is most effective when integrated early alongside disease-directed and curative therapies. PC primarily focuses on improving quality of life for patients and families by anticipating, preventing and treating suffering throughout the continuum of illness. This includes addressing symptom distress and facilitating communication. Effective communication is vital to elicit value-based goals of care, and to guide parents through patient-focused and potentially difficult decision-making process which includes advanced care planning. A multidisciplinary approach is most favorable when providing support to both patient and family, whether it is from the psychosocial, practical, emotional, spiritual or cultural aspects. PC also ensures coordination and continuity of care across different care settings. Support for family carries on after death with grief and bereavement support. This narrative review aims to appraise the current evidence of integration of PC into pediatric CC and its impact on patient- and family-centered outcomes. We will also summarize the impact of integration of good PC into pediatric CC, including effective communication with families, advanced care planning, withholding or withdrawal of life sustaining measures and bereavement support. Finally, we will provide a framework on how best to integrate PC in PICU. These findings will provide insights on how PC can improve the quality of care of a critically ill child.

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“…Although the primary goal of pediatric palliative care is to improve pain in children, hospitalized children still experience severe unrelieved pain (Wolfe et al, 2015). Although pain may decrease after a referral to palliative care, researchers have identified that between 31% and 60% of hospitalized children receiving palliative care still struggle with significant pain (Bogetz, Schroeder, et al, 2014; Shaw, 2012; Thomas et al, 2018). The advances and success of medical science and medical care have resulted in a growing number of children living with long-term and/or life-limiting chronic conditions.…”

Section: Introductionmentioning

confidence: 99%

Reiki Therapy for Very Young Hospitalized Children Receiving Palliative Care

Thrane

Williams

Grossoehme

et al. 2022

Journal of Pediatric Hematology/Oncology Nursing

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Background: Approximately half of children receiving palliative care are under age five; however, there are a few studies exploring palliative care interventions for this population. The purpose of this study was to evaluate the effects of Reiki on pain, stress, heart, and respiratory rates, oxygenation, and quality of life (QoL) in hospitalized young children receiving palliative care services. Methods: In this single-group pilot study, hospitalized children receiving palliative care who were aged 1–5 years received two Reiki sessions per week for 3 weeks. Physiologic measures were assessed pre/post each session, and parent report measures of pain and QOL were collected at baseline, 3 weeks, and 6 weeks. The parent rating of Reiki's perceived efficacy and their own symptoms were also measured. Results: Sixteen families consented. Children had a mean age of 26 months and included nine boys and seven girls. Results were not significant but there were medium-to-large clinical effect sizes for children's QoL, stress, oxygenation, heart, and respiratory rates. Parents’ physical and mental health scores decreased over time. Children exhibited signs of relaxation such as quiet sleep post-Reiki versus active awake pre-Reiki session. Conclusion: Reiki is a noninvasive relaxing therapy that is useful for hospitalized young children receiving palliative care. The children reacted positively in both action and outcome measures. Multisite studies with larger sample sizes are needed to be able to generate enough scientific evidence to fully recommend Reiki as an adjunct for pain management.

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Pain Management in the Pediatric Palliative Care Population

Abstract: A better understanding of current research on pain in the pediatric palliative care population can improve patient care and lead to better research in this specialty field.

Cited by 13 publications

References 37 publications

Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians

Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians

Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit

Reiki Therapy for Very Young Hospitalized Children Receiving Palliative Care

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