Primary palliative care: Skills for all clinicians

Sreedhar, Sue; Kraft, Colleen A.; Friebert, Sarah

doi:10.1016/j.cppeds.2020.100814

Cited by 14 publications

(10 citation statements)

References 32 publications

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“…Sreedhar SS et al, 2020 (22) Primary palliative care: Skills for all clinicians Sinaliza que no CPP a criança é vista como pessoa, que deve participar da construção do seu plano de cuidado avançado e sugere instrumentos para a construção deste plano.…”

Section: Resultsunclassified

“…Sreedhar et al reforçaram que os CPP enfatizam o reconhecimento da criança, que nos menores de 18 anos, o assentimento deveria ser obtido. Sugerem a aplicação de instrumentos como o Voicing My Choices para adolescentes e My Wishes para os mais jovens, para a construção deste plano(22). Esta visão do CPP, que muda o entendimento da criança enquanto pessoa, é estruturante para a transformação do cuidado em saúde, que se faz necessária, e possibilita a real mudança de papel da criança, de uma posição passiva para outra, de fato ativa e central.…”

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O protagonismo da criança em cuidados paliativos para a efetivação da sua segurança

Valete

Ferreira

Bruno

2022

Cad. Ibero Am. Direito Sanit.

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Objetivo: contribuir com o debate sobre o protagonismo da criança no seu processo de cuidado em saúde, alertando sobre o papel importante dessa participação no Cuidado Paliativo Pediátrico (CPP) e consequentemente, na sua própria segurança. Metodologia: revisão narrativa, a partir do levantamento bibliográfico nas bases de dados MEDLINE (via PubMed) e SciELO, nos últimos 10 anos, acrescida da experiência das autoras e captação secundária. Resultados: foram incluídos 14 artigos na síntese narrativa. A análise desses artigos em relação a segurança do paciente em CPP revelou a dificuldade da abordagem dos CPP na prática, além de lacunas na formação dos profissionais, a importância do cuidado centrado no paciente, das decisões compartilhadas, da comunicação apropriada e do uso seguro de opioides. Em relação a participação da criança como protagonista do seu cuidado, foi observado o desejo da criança em participar efetivamente da tomada de decisão, o reconhecimento da sua autonomia e a avaliação objetiva da sua competência para tal. Conclusão: muitos aspectos do CPP coadunam com a segurança do paciente, como a comunicação apropriada e a participação da criança como protagonista do seu processo de cuidado. A autonomia da criança enquanto paciente encontra-se num processo crescente de reconhecimento. Não obstante haja um arcabouço normativo acerca deste tema, a perspectiva observada em muitos artigos ainda é do cuidado centrado na família e para impulsionar a mudança necessária, é fundamental que se invista em todos os níveis de educação em saúde e em pesquisa.

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Section: Resultsunclassified

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O protagonismo da criança em cuidados paliativos para a efetivação da sua segurança

Valete

Ferreira

Bruno

2022

Cad. Ibero Am. Direito Sanit.

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“…The stories reflected how the HCPs view PPC as a specific field of health care that requires particular professional sensitivity, including good communication, collaboration and planning. Thus, the HCPs in this study demonstrated knowledge about the core qualities needed to succeed in PPC [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Stories of paediatric palliative care: a qualitative study exploring health care professionals’ understanding of the concept

et al. 2022

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Background By sharing patient stories, health care professionals (HCPs) may communicate their attitudes, values and beliefs about caring and treatment. Previous qualitative research has shown that HCPs usually associate paediatric palliative care (PPC) with death or dying and that they find the concept challenging to understand and difficult to implement. Attending to HCPs’ stories may provide a richer account of their understanding of PPC. Thus, the aim of this study was to explore PPC stories narrated by HCPs to gain increased insight into their understanding of what PPC entails. Methods This qualitative study collected data from four focus group interviews with 21 HCPs from different units in two Norwegian hospitals. Stories told by the HCPs to illustrate their comprehension of PPC were analysed following thematic analysis procedures. Results Four themes were identified illustrating what PPC meant to the participants: creating spaces for normality, providing tailored support for the family, careful preparations for saying goodbye and experiencing dilemmas and distress. The stories centred on family care, particularly relating to dramatic or affective situations when the death of a child was imminent. Conclusion The stories reflect how the HCPs view PPC as a specific field of health care that requires particular professional sensitivity, including good communication, collaboration and planning. Thus, the HCPs in this study demonstrated knowledge about the core qualities needed to succeed in PPC. However, similar to previous research, the stories illustrate that how HCPs speak about PPC is strongly associated with end-of-life care, and by that the HCPs do not capture the breadth of the PPC concept. The findings highlight the importance of increasing knowledge about the meaning and content of PPC among HCPs in order to maintain quality of life for all children with life-limiting or life-threatening conditions throughout their illness trajectory.

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“…It is widely accepted that pediatric palliative care improves outcomes for patients and families, [1][2][3] and has been declared by the World Health Organization (WHO) to be a moral duty of hospital systems. 3 However, integration of these services into the fast-paced environment of acute care continues to be met with both system and process barriers, 4,5 and can be described as inconsistent and often incomplete.…”

Section: Problem Descriptionmentioning

confidence: 99%

Evaluation of a Quality Improvement Intervention to Improve Pediatric Palliative Care Consultation Processes

Stoyell

Jordan

Derouin

et al. 2021

Am J Hosp Palliat Care

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Background: A critical aspect of pediatric palliative care consultations is the assessment and documentation of patient and family needs. While these assessments usually include a focus on physical pain, there is less standardization of assessments of other physical symptoms and psychosocial, emotional, or spiritual needs. Aims: To improve the breadth of assessment of psychosocial and emotional needs, screen for symptoms other than pain among pediatric patients utilizing palliative care services, and to increase documentation of assessment data from 30%-40% to 80% through practice changes implemented in 2 Plan-Do-Study-Act (PDSA) cycles. Methods: This quality improvement project involved implementing provider education and adapting the palliative care consultation template in the electronic health record to improve breadth and consistency of assessment and documentation during consultations by the interdisciplinary pediatric palliative care team. Two PDSA cycles were performed. Chi squared tests and statistical control charts were used for data analysis. Results: There was statistically significant improvement in the inclusion of documentation of a pediatric palliative care social work note from baseline (32%) to Cycle 2 (57%). Physical symptom screening declined slightly, but not significantly (p = .32) and socio-emotional discussions also declined but not significantly (p = .05). Conclusions: Screening for physical symptoms and discussions with patients and families about psychosocial/emotional needs during the initial palliative care consultations are extremely important in providing effective, holistic, patient-centered care. There is a need for development of pediatric-centric guidelines and quality measures to evaluate pediatric palliative care programs; further research is indicated to determine methods for evaluating compliance with these guidelines.

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Primary palliative care: Skills for all clinicians

Cited by 14 publications

References 32 publications

O protagonismo da criança em cuidados paliativos para a efetivação da sua segurança

O protagonismo da criança em cuidados paliativos para a efetivação da sua segurança

Stories of paediatric palliative care: a qualitative study exploring health care professionals’ understanding of the concept

Evaluation of a Quality Improvement Intervention to Improve Pediatric Palliative Care Consultation Processes

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