Pediatric Palliative Care

Korones, David N.

doi:10.1542/pir.28-8-e46

Cited by 32 publications

(26 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To achieve this goal, needs of these children and their families need to be identified. Recent review articles examining the needs of affected families revealed six domains critical to high quality PPC: (1) support of the family, (2) communication with child and family, (3) ethics and decision-making, (4) relief of pain and other symptoms, (5) continuity of care, and (6) grief and bereavement support [11,17,26].…”

Section: Introductionmentioning

confidence: 99%

Palliative care for children and adolescents in Switzerland: a needs analysis across three diagnostic groups

2011

View full text Add to dashboard Cite

The objective of this qualitative study was to explore the perceptions and needs of families who care for a child with a life-limiting disease. Considering the heterogeneity of life-limiting diseases in childhood, three diagnostic groups were defined: (a) cancer, (b) neurological disorders, and (c) non-cancer/non-neurological conditions. Fifteen parents whose child had been treated in one of four children's hospitals and received palliative care or had died within the previous 2 years were interviewed. The main interview topics were: communication with professionals, need for support in care (at home or hospital), and bereavement support. Irrespective of the center of care, parents of children with diagnoses other than cancer reported a lack of support concerning practical issues of care and psychosocial aspects. Parents of children with cancer expressed difficulties related to coordination of care especially when care was provided at home. Bereaved parents emphasized their wish for bereavement support. Our findings demonstrate shortcomings in pediatric palliative care in Switzerland and outline basic needs of affected families including psychosocial support, coordination of care and bereavement support. Based on these findings we formulate some suggestions on how to initiate pediatric palliative care in a most efficient way and tailored to the needs of families in Switzerland.

show abstract

Section: Introductionmentioning

confidence: 99%

Palliative care for children and adolescents in Switzerland: a needs analysis across three diagnostic groups

2011

View full text Add to dashboard Cite

show abstract

“…To address the shortcomings of physician communication in this fi eld, it is essential to acknowledge that sharing bad news and discussion of diffi cult issues is not an innate, but a learned skill (Korones 2007) . Multistep communication tools can aid physician education in this arena.…”

Section: Communicationmentioning

confidence: 99%

“…For children who have moderate to severe pain, opioids are the primary pharmaceutical agent used for treatment (Korones 2007) . For children who have moderate to severe pain, opioids are the primary pharmaceutical agent used for treatment (Korones 2007) .…”

Section: Painmentioning

confidence: 99%

Pediatric CNS Tumors

2010

Pediatric Oncology

View full text Add to dashboard Cite

“…4 Families consider communication to be both very important and an area in which care providers could improve. 5 Poor communication may lead to conflict among providers and families. Pediatric graduate medical education does not offer significant training in end-of-life issues and the majority of house officers would like additional training, particularly in the area of communication.…”

Section: Dr Pleacher Has Disclosed No Financial Relationship Relevantmentioning

confidence: 99%

Factors Influencing Decisions to Withdraw Life Support

Pleacher¹

2010

AAP Grand Rounds

View full text Add to dashboard Cite

I nvestigators from two Chicago tertiary care centers sought to identify the factors that parents of children in pediatric intensive care units (PICU) would consider important if they were to consider withdrawing life-sustaining therapies. English-or Spanishspeaking parents older than 17 years with a child in the PICU for one to seven days were eligible. Semi-structured interviews were conducted with each of the parents.Parents were asked five questions including if they could "imagine a situation when you would consider asking the doctors" to withdraw life support. Four questions assessed whether their decision would be influenced by patient suffering, quality of life, physician estimate of prognosis, or financial burden.Seventy-four (63%) of the 117 parents approached agreed to participate (69 children) and 70 had usable interviews. The majority of children were critically ill with 45% mechanically ventilated and 26% on vasoactive medications. More than half (57%) of parents said that they could imagine a situation in which they would consider withdrawal of life-sustaining therapies. Parents reported that suffering (64%), poor quality of life (51%), and physician's assessment of prognosis (43%) would influence their decision. Only 7% would be influenced by financial considerations. Qualitative analysis identified six additional influential themes in the decision-making process including faith (whether to help accept withdrawal or reject it), passage of time (withdrawal could only be considered after some indeterminate time had passed), mistrust of physicians, reliance on intuition or a sense that one would know what would be appropriate when the time came, and general rejection of withdrawal of life support. Almost all parents (96%) stated that the parents should be the primary decision-makers and 52% felt that physicians were also key participants.The authors conclude that parents and pediatricians share common considerations, such as suffering and quality of life, when making a decision about withdrawal of life support. However, parents describe additional factors, including faith, time, and intuition, that are not always considered by pediatricians.

show abstract

Pediatric Palliative Care

Cited by 32 publications

References 10 publications

Palliative care for children and adolescents in Switzerland: a needs analysis across three diagnostic groups

Palliative care for children and adolescents in Switzerland: a needs analysis across three diagnostic groups

Pediatric CNS Tumors

Factors Influencing Decisions to Withdraw Life Support

Contact Info

Product

Resources

About