Pediatric Palliative Care Pilot Curriculum

Barnett, Matthew; Maurer, Scott H.; Wood, Gordoń

doi:10.1177/1049909115590965

Cited by 11 publications

(4 citation statements)

References 16 publications

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“…Como tratante tiendo a sentirme culpable por la muerte de mis pacientes, lo que puede influir en mis decisiones de tratamiento 17 (21,8)…”

Section: Discussionunclassified

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Percepción de facilitadores y barreras para la derivación a cuidados paliativos pediátricos

Ceballos-Yáñez,

Astudillo P.,

Eugenin-Soto

2023

Andes pediatr

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La percepción de facilitadores y barreras para la derivación a cuidados paliativos pediátricos (CPP) es un fenómeno estudiado ampliamente, con escasa información en Latinoamérica. Objetivo: Adaptar una encuesta sobre la percepción de facilitadores y barreras para la derivación y evaluación a CPP. Sujetos y Método: Encuesta electrónica con adaptación cultural con traducción-retrotraducción en pediatras y subespecialista pediátricos de 3 centros terciarios de Santiago. La encuesta consta de 4 secciones y 51 preguntas, que corresponden a datos sociodemográficos (incluyendo autopercepción de espiritualidad y religiosidad), formación y práctica clínica del encuestado en CPP, y facilitadores y barreras para la derivación a CPP. Resultados: 146 pediatras fueron invitados y se obtuvieron 78 encuestas (Tasa de respuesta: 53,4%). La mediana de edad fue 42 años y 11,5 años de ejercicio profesional. La mayoría correspondió a pediatras sin formación de subespecialidad (n = 34; 43,6%). Veintitrés (29,5%) de los encuestados recibió formación en CPP, percibida como insuficiente en 17 (74%) de ellos, tampoco hay diferencias en formación de CPP al comparar pediatras con o sin formación de subespecialidad. El 95% de los encuestados estuvo de acuerdo con la percepción de beneficio de derivación temprana de CPP a pacientes con patologías amenazantes para la vida, independiente de su diagnóstico, aunque solo un 47,7% declaró haber realizado una derivación a un equipo de CPP. La relación emocional con los pacientes y sus familias fue percibida como barrera en los tratantes pediátricos en subespecialistas susceptibles a CPP comparados a los que no (20% vs. 50%; p = 0,03) Conclusión: Se detectó déficit importante en la formación en CPP. No se evidenciaron diferencias de facilitadores y barreras entre pediatras y subespecialidades susceptibles a CPP. Las especialidades no habituadas a pacientes susceptibles de CPP podrían ver afectadas sus decisiones por factores emocionales.

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“…Como tratante tiendo a sentirme culpable por la muerte de mis pacientes, lo que puede influir en mis decisiones de tratamiento 17 (21,8)…”

Section: Discussionunclassified

“…En ese contexto, es urgente incorporar los CPP en la formación de residentes para reducir la brecha de conocimiento. Se han descrito experiencias en Estados Unidos que muestran un incremento de la seguridad del residente para enfrentar casos relacionados con clases electivas o con guías de referencia 20,21 .…”

Section: Discussionunclassified

Percepción de facilitadores y barreras para la derivación a cuidados paliativos pediátricos

Ceballos-Yáñez,

Astudillo P.,

Eugenin-Soto

2023

Andes pediatr

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“…[ 25 ] In spite of the American Academy of Pediatrics' emphasis on the need for basic competence in palliative care, only 39% of professionals have the necessary knowledge. [ 60 ] Since knowledge and attitude of doctors as the patient's first gate of palliative care is very important,[ 53 ] its integration into the medical and nursing curriculum is highly recommended. [ 25 27 32 45 ] Currently, one of the biggest obstacles is the lack of professors that can be problematic in the future.…”

Section: Discussionmentioning

confidence: 99%

Palliative care for children with cancer in the Middle East: A comparative study

Mojen

Rassouli

Eshghi

et al. 2017

Indian J Palliat Care

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Introduction:High incidence rates of childhood cancer and the consequent deaths in the Middle East is one of the major reasons for the need for palliative care in these countries. Using the experiences and innovations of the other countries can provide a pattern for the countries of the region and lead to the development of palliative care in children. Therefore, the aim of this study is to compare the status of pediatric palliative care in Egypt, Lebanon, Jordan, Turkey, and Iran.Materials and Methods:This is a comparative study in which the information related to pediatric palliative care system in the target countries (from 2000 to 2016) has been collected, summarized, and classified by searching in databases, such as “PubMed, Scopus, Google scholar, Ovid, and science direct.”Results:Palliative care in children in the Middle East is still in its early stages and there are many obstacles to its development, namely, lack of professional knowledge, inadequate support of policy-makers, and lack of access to opioids and financial resources. Despite these challenges, providing services at the community level, support of nongovernmental organizations (NGOs), using trained specialists and multi-disciplinary approach is an opportunity in some countries.Conclusion:Considering the necessity of the development of pediatric palliative care in the region, solutions such as training the human resources, integrating palliative care programs into the curriculum of the related fields, establishing facilitating policies in prescription and accessibility of opioids, providing the necessary support by policy-makers, doing research on assessment of palliative care quality, as well as NGOs' participation and public education are suggested.

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“…Most of these curricula exclude specific instruction in pain control and focus on opioid abuse rather than on appropriate dosing and management of opioids to treat pain. Few published interventions specifically address pain management in children,14–18 and most require attendance at real-time lectures or workshops. The ongoing opioid epidemic may further limit attention to, and education of trainees in, treating pain 19,20.…”

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confidence: 99%

Development and Validation of Pediatric Opioid Analgesia Self-Instruction System (PedOASIS): An Opioid Knowledge Tool for Pediatric Clinicians

MacDonell-Yilmaz

Anderson²,

Hirway

et al. 2021

Journal of Pediatric Hematology/Oncology

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Background: Acute pain is common in children and young adults with cancer and sickle cell disease. Current training curricula fail to adequately impart skills for pain management. We sought to develop and validate an education and assessment tool to address the safe effective use of opioids for pain management by pediatrics trainees. Methods:The first version of the tool contained 10 case-based, multiple-choice questions. It was pilot tested within a medium-sized pediatric residency program using preintervention and postintervention surveys to assess residents' knowledge and comfort related to prescribing opioids. Content validation was performed through an expert panel of physicians. Internal reliability was tested by administering the tool to learners and practitioners with varying levels of training.Results: Comfort with choosing and converting between opioids increased significantly in pilot testing (P = 0.005). Mean objective knowledge scores increased from 51% to 85.9% (P < 0.001). The revised tool showed internal reliability within each group (Cronbach alpha 0.71 to 0.78) and significant differences in mean scores between groups (F ratio = 9.45, P = 0.0002).Conclusions: This tool demonstrates validity and internal reliability. Its use was associated with short-term educational gains and it garnered overall favorable feedback from users. Further testing is needed to assess the duration of these gains.

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Pediatric Palliative Care Pilot Curriculum

Abstract: This longitudinal curriculum, designed specifically for pediatric residents, was built into an existing training program and proved to be popular, feasible, and effective at improving comfort with basic palliative care principles.

Cited by 11 publications

References 16 publications

Percepción de facilitadores y barreras para la derivación a cuidados paliativos pediátricos

Percepción de facilitadores y barreras para la derivación a cuidados paliativos pediátricos

Palliative care for children with cancer in the Middle East: A comparative study

Development and Validation of Pediatric Opioid Analgesia Self-Instruction System (PedOASIS): An Opioid Knowledge Tool for Pediatric Clinicians

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