Palliative nursing care for children and adolescents with cancer

Abstract

Pediatric palliative care aims to enhance life and decrease suffering of children and adolescents living with life-threatening conditions and their loved ones. Oncology nurses are instrumental in providing palliative care to pediatric oncology populations. This paper describes pediatric palliative care and provides an overview of literature related to the physical, psychological, social, and spiritual domains of palliative nursing care for children and adolescents with cancer. Nurses can provide optimal palliative care by accounting for children's understanding of death, encouraging early initiation of palliative care services, and improving utilization of pediatric palliative care in cancer settings. Specific roles of registered nurses and advanced practice nurses in pediatric palliative care will be addressed. Recommendations for future research are made to further advance the science of pediatric palliative care and decrease suffering for children and teens with cancer.

Perspectives on the Role of Nurses in Contemporary Palliative Care Practice: The Middle East as Example for the Developing World

“…Further, all of us managing cancer patients need to be honest about prognosis and treatment limitations, because patients can make better decisions when they know what's going on-even if the reality is difficu to hear [6]. Nowadays, experienced nurses need to take reign of leadership roles in nursing practice, teaching, research and service [5]. Nursing research must also be a priority.…”

“…Nursing research must also be a priority. ONS members have conducted a multitude of prospective descriptive studies, but now longitudinal and intervention research is needed to address deleterious symptoms, emotions, and grief and death-related fears at diagnosis and throughout the illness trajectory [5]; as it is essential for nurses to recognize patient and family experiences of illness, death and dying [4]. Now, as before, palliative care nurses have the obligation to provide meaningful service and play a pivotal role in the multidisciplinary care for cancer patients and their families.…”

“…Although palliative care teams may not be readily available in every cancer centre, let alone in the community, nurses across practice levels are in ideal positions to provide basic palliative care services to cancer patients and their families; as nurses have the capacity to appraise the patient's physical discomfort level, presence of emotional pain, communication channels, and care settings [5].…”

Pain Management in the Pediatric Palliative Care Population

“…Most diseases such as cancer, acute liver failure, or spinal muscular atrophy have pain as a symptom (Field & Behrman, ; Strassels et al., ). However, pain is often hard to manage especially with the pediatric population (Foster, Bell, Harris, & Gilmer, ; Strassels et al., ). Pain is difficult to manage because of many factors such as age, patients’ ability to communicate, and patients’ ability to comprehend their symptoms.…”

“…Pain is difficult to manage because of many factors such as age, patients’ ability to communicate, and patients’ ability to comprehend their symptoms. Pain can be incapacitating and has a number of effects on children and their families, such as decreasing physical movement, interrupting sleep cycles, increasing stress, and increasing medical bills (Foster et al., ). The primary goals of pain management are consistent control of pain and, ideally, complete pain relief.…”