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Dombrecht L, Chambaere K, Beernaert K, Roets E, De Vilder De Keyser M, De Smet G, Roelens K, Cools F. Components of Perinatal Palliative Care: An Integrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:482. [PMID: 36980040 PMCID: PMC10047326 DOI: 10.3390/children10030482] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/17/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023]
Abstract
When a severe diagnosis is made before or after birth, perinatal palliative care (PPC) can be provided to support the infant, parents and involved healthcare providers. An integrative and systematic overview of effectiveness and working components of existing PPC programs was needed. An integrative search was conducted in MEDLINE, Embase, CENTRAL, CINAHL, PsycInfo and Web of Science. Study designs examining the effect of PPC compared to regular care, and (empirical) articles describing the components of care included in existing PPC initiatives were included. Three independent authors reviewed titles, abstracts and full texts against eligibility criteria. PRISMA guidelines were followed; 21.893 records were identified; 69 publications met inclusion criteria. Twelve publications (17.4%) discussed the effect of a PPC program. Other publications concerned the description of PPC programs, most often by means of a program description (22/69; 31.9%), guidelines (14/769; 20.3%) or case study (10/69; 14.5%). Outcome measures envisioned four main target categories: care coordination, parents and family members, care for the fetus/neonate and healthcare providers. No trials exist to date. Analysis of working components revealed components related to changes directed to the policy of the hospital wards and components involving actual care being provided within the PPC program, directed to the fetus or infant, the family, involved healthcare providers or external actors. PPC is a growing research field where evidence consists mainly of descriptive studies and guidelines. The extensive list of possible PPC components can serve as a checklist for developing future initiatives worldwide. PPC includes several important actors: the fetus/infant and their family and included healthcare providers on both maternity and neonatal wards. This leads to a large variety of possible care components. However, while some studies show proof of concept, an evidence base to determine which components are actually effective is lacking.
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Affiliation(s)
- Laure Dombrecht
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, 1090 Brussels, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, 1090 Brussels, Belgium
| | - Kim Beernaert
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, 1090 Brussels, Belgium
| | - Ellen Roets
- Department of Obstetrics, Women’s Clinic, University Hospital Ghent, 9000 Ghent, Belgium
| | | | - Gaëlle De Smet
- Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Kristien Roelens
- Department of Obstetrics, Women’s Clinic, University Hospital Ghent, 9000 Ghent, Belgium
| | - Filip Cools
- Department of Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium
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2
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Buskmiller C, Ho S, Chen M, Gants S, Crowe E, Lopez S. Patient-centered perinatal palliative care: family birth plans, outcomes, and resource utilization in a diverse cohort. Am J Obstet Gynecol MFM 2022; 4:100725. [PMID: 35995365 DOI: 10.1016/j.ajogmf.2022.100725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/28/2022] [Accepted: 08/15/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Perinatal palliative care is an emerging concept in fetal medicine that offers quality-of-life options and anticipatory grief management for families of fetuses with complex conditions. Few perinatal palliative care outcomes are detailed in peer-reviewed literature. OBJECTIVE This study aimed to describe outcomes of perinatal palliative care at the Fetal Center of the University of Texas Health Science Center at Houston and Women's Center at Children's Memorial Hermann Hospital. STUDY DESIGN This was a retrospective cohort of families receiving perinatal palliative care for life-limiting fetal diagnosis, such as trisomy 13 or 18 and some major structural anomalies between 2016 and 2020. The primary outcome was whether delivery events matched families' birth plans, including fetal/neonatal clinical course matching expectations described by consultant notes. Secondary outcomes included maternal safety outcomes, use of perinatal interventions, delivery outcomes, and resource utilization outcomes. RESULTS Of 187 perinatal palliative care consults, delivery events matched families' plans and clinicians' expectations in 89% of cases (165/185); 39% (73/187) of families requested some perinatal interventions, 64% of whom planned postnatal comfort care even while choosing antenatal interventions. Demographics and median income were similar between families who chose some interventions and those who chose comfort care. Patients choosing any interventions had more mismatches between their plans and delivery events (19% vs 2%; P<.001), were more likely to change their plans (24% vs 6%; P=.001), and unsurprisingly used more healthcare resources. They were also more likely to have intraamniotic infection or postpartum hemorrhage (9% vs 22%; P=.02), but this was associated with mode of delivery and not choice of interventions. CONCLUSION Most families' perinatal experiences matched birth plans and expectations in this perinatal palliative care program. Families who desired interventions used more healthcare resources, but often did so with plans for postnatal comfort care, demonstrating insight into neonatal prognosis but achieving value-consistent goals, such as meeting a live neonate. Perinatal palliative care was safe for maternal patients and equitable across racial, ethnic, and income groups. Perinatal palliative care and some perinatal interventions are options for care of the whole family in complex fetal medicine cases.
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Affiliation(s)
- Cara Buskmiller
- Departments of Obstetrics, Gynecology and Reproductive Sciences (Drs Buskmiller and Ho, Ms Chen, Dr Gants, and Ms Crowe).
| | - Stephanie Ho
- Departments of Obstetrics, Gynecology and Reproductive Sciences (Drs Buskmiller and Ho, Ms Chen, Dr Gants, and Ms Crowe)
| | - Michelle Chen
- Departments of Obstetrics, Gynecology and Reproductive Sciences (Drs Buskmiller and Ho, Ms Chen, Dr Gants, and Ms Crowe)
| | - Shavonia Gants
- Departments of Obstetrics, Gynecology and Reproductive Sciences (Drs Buskmiller and Ho, Ms Chen, Dr Gants, and Ms Crowe)
| | - Ellen Crowe
- Departments of Obstetrics, Gynecology and Reproductive Sciences (Drs Buskmiller and Ho, Ms Chen, Dr Gants, and Ms Crowe)
| | - Suzanne Lopez
- Pediatrics (Dr Lopez), The University of Texas Health Science Center at Houston, Houston, TX
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Lord S, Williams R, Pollard L, Ives-Baine L, Wilson C, Goodman K, Rapoport A. Reimagining Perinatal Palliative Care: A Broader Role for Support in the Face of Uncertainty. J Palliat Care 2022; 37:476-479. [PMID: 35657323 PMCID: PMC9465549 DOI: 10.1177/08258597221098496] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Perinatal medicine is confronted by a growing number of complex fetal conditions that can be diagnosed prenatally. The evolution of potentially life-prolonging interventions for the baby before and after birth contributes to prognostic uncertainty. For clinicians who counsel families in these circumstances, determining which ones might benefit from early palliative care referral can be challenging. We assert that all women carrying a fetus diagnosed with a life-threatening condition for which comfort-focused care at birth is one ethically reasonable option ought to be offered palliative care support prenatally, regardless of the chosen plan of care. Early palliative care support can contribute to informed decision making, enhance psychological and grief support, and provide opportunities for care planning that includes ways to respect and honor the life of the fetus or baby, however long it may be.
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Affiliation(s)
- Sarah Lord
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Canada.,Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Rebecca Williams
- Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada
| | - Lindsay Pollard
- Department of Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Canada
| | - Lori Ives-Baine
- Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada
| | | | - Kira Goodman
- Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada
| | - Adam Rapoport
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Canada.,Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada.,Emily's House Children's Hospice, Toronto, Canada
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4
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Kadivar M, Mardani-Hamooleh M, Kouhnavard M, Sayarifard A. Nurses' attitudes toward caring for terminally ill neonates and their families in Iran: a cross-sectional study. J Med Ethics Hist Med 2021; 14:4. [PMID: 34849213 PMCID: PMC8595070 DOI: 10.18502/jmehm.v14i4.5651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 02/01/2021] [Indexed: 11/24/2022] Open
Abstract
Providing care for terminally ill neonates is an important issue in NICUs. This research aimed to determine nurses’ attitudes toward providing care for terminally ill neonates and their families. A total of 138 nurses working in neonatal intensive care units (NICUs) affiliated to Tehran University of Medical Sciences participated in this cross-sectional study via convenience sampling in 2019. The Data collection tool was the Frommelt attitudes toward caring for terminally ill persons and their families scale. The nurses in this study had the most positive attitudes toward the items “nursing care should include the family of the terminally ill patient, too” (4.2 ± 0.6) and “the care provider can prepare the patient or his/her family for death” (4.1 ± 0.7). The nurses had the least positive attitude toward the item “the time spent on caring for terminally ill patients creates a sense of frustration in me” (1.06 ± 1). The mean score of the attitudes of NICU nurses toward caring for terminally ill neonates and their families indicates the necessity of improving this attitude.
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Affiliation(s)
- Maliheh Kadivar
- Professor, Department of Pediatrics, Nursing and Midwifery Care Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Mardani-Hamooleh
- Associate Professor, Nursing Care Research Center, Department of Psychiatric Nursing, Iran University of Medical Sciences, Tehran, Iran
| | - Marjan Kouhnavard
- Researcher, Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Sayarifard
- Associate Professor, Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
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5
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Affiliation(s)
- Francesca Rusalen
- Woman's and Child's Department, Pediatric Pain and Palliative Care Service, University of Padua, Padua, Italy
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6
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Hendriks MJ, Abraham A. Perinatal loss and parental loneliness: Narratives of late termination of pregnancy. DEATH STUDIES 2021; 46:1490-1500. [PMID: 33750278 DOI: 10.1080/07481187.2021.1894511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Advances in perinatal medicine, present increasing numbers of women with difficult decisions about their pregnancy. We explored the views of 5 parents and 5 perinatal healthcare professionals regarding late termination of pregnancy following the principles of qualitative content analysis. Parents deciding on whether to (dis)continue pregnancy needed more time and decisional support. Decentralized care and lacking continuity between caregivers led to negative experiences. No standardized bereavement services were offered after leaving the hospital. Integrating principles of perinatal palliative care to care might help to offer further decisional support and to overcome the fragmentation of care.
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Affiliation(s)
- M J Hendriks
- Newborn Research, Department of Neonatology, Clinical Ethics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - A Abraham
- Dialog Ethics, Interdisciplinary Institute of Ethics in Health Care, Zurich, Switzerland
- Institute of Social Anthropology, University of Bern, Bern, Switzerland
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Boan Pion A, Baenziger J, Fauchère JC, Gubler D, Hendriks MJ. National Divergences in Perinatal Palliative Care Guidelines and Training in Tertiary NICUs. Front Pediatr 2021; 9:673545. [PMID: 34336737 PMCID: PMC8316587 DOI: 10.3389/fped.2021.673545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives: Despite established principles of perinatal palliative care (PnPC), implementation into practice has shown inconsistencies. The aim of this study was to assess PnPC services, examine healthcare professionals (HCPs) awareness and availability of PnPC guidelines, and describe HCPs satisfaction with PC and guidelines. Material and Methods: A nationwide survey was conducted in Swiss tertiary NICUs between April-November 2019. Data were examined by descriptive statistics and linear regression models. Results: Overall response rate was 54% (65% physicians; 49% nurses; 72% psychosocial staff). Half of professionals (50%) received education in PC during their medical/nursing school, whereas 36% indicated they obtained further training in PnPC at their center. PnPC guidelines were available in 4/9 centers, with 68% HCPs being aware of the guideline. Professionals who had access to a PnPC team (P = 0.001) or were part of the nursing (P = 0.003) or psychosocial staff (P = 0.001) were more likely aware of having a guideline. Twenty-eight percent indicated being satisfied with PC in their center. Professionals with guideline awareness (P = 0.025), further training (P = 0.001), and access to a PnPC team (P < 0.001) were more likely to be satisfied, whereas HCPs with a nursing background (P < 0.001) were more likely to be dissatisfied. A majority expressed the need for a PnPC guideline (80%) and further PC training (94%). Conclusion: This study reveals lacking PnPC guidelines and divergences regarding onsite opportunities for continued training across Swiss level III NICUs. Extending PnPC guidelines and training services to all centers can help bridge the barriers created by fragmented practice.
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Affiliation(s)
- Antonio Boan Pion
- Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Julia Baenziger
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jean-Claude Fauchère
- Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Deborah Gubler
- Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Pediatric Palliative Care, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Manya J Hendriks
- Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Clinical Ethics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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8
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Akyempon AN, Aladangady N. Neonatal and perinatal palliative care pathway: a tertiary neonatal unit approach. BMJ Paediatr Open 2021; 5:e000820. [PMID: 33537461 PMCID: PMC7852922 DOI: 10.1136/bmjpo-2020-000820] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/24/2020] [Accepted: 12/14/2020] [Indexed: 12/27/2022] Open
Abstract
A lack of well-structured guideline or care pathway results in inadequate, inconsistent and fragmented palliative care (PC) for babies and their families. The impact on the families could be emotionally and psychologically distressing. Not all neonatal units have specialist PC clinicians or teams, and such units will benefit from a well-planned perinatal PC pathway. In this article, we discuss a tertiary neonatal unit perinatal care pathway which provides guidance from the point of diagnosis and establishment of eligibility of a baby for PC through to care after death and bereavement support for families. Planning PC with families which encourages family-centred and individualised approach is also discussed.
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Affiliation(s)
- Abena N Akyempon
- Neonatology, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Narendra Aladangady
- Neonatology, Homerton University Hospital NHS Foundation Trust, London, UK.,Pediatrics, Centre for Paediatrics, Bart's and the London School of Medicine and Dentistry, London, UK
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9
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Locatelli C, Corvaglia L, Simonazzi G, Bisulli M, Paolini L, Faldella G. "Percorso Giacomo": An Italian Innovative Service of Perinatal Palliative Care. Front Pediatr 2020; 8:589559. [PMID: 33330283 PMCID: PMC7710893 DOI: 10.3389/fped.2020.589559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/20/2020] [Indexed: 11/21/2022] Open
Abstract
The perspective proposed by this article will focus on perinatal palliative care as a strategy for improving the quality of life of neonates with life-limiting conditions when extending the patient's life is no longer the goal of care. This manuscript reports the creation of an innovative program of perinatal palliative care called "Percorso Giacomo" (Giacomo's Pathway) at Sant'Orsola Hospital in Bologna, Italy in 2013. Key features include interdisciplinary collaboration between professionals from obstetrics, neonatology and other specialties aiming to reach the most detailed fetal and neonatal diagnosis and prognosis; communication and engagement with the family to discuss goals of care and prepare a birthing plan that follows the family's desires and expectations; and personalized care to achieve comfort for each newborn and support for families according to their social, cultural, and religious backgrounds.
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Affiliation(s)
- Chiara Locatelli
- Neonatal Intensive Care Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - Luigi Corvaglia
- Neonatal Intensive Care Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Giuliana Simonazzi
- Obstetric Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Maria Bisulli
- Obstetric Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | | | - Giacomo Faldella
- Neonatal Intensive Care Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
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10
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Weeks A, Saya S, Hodgson J. Continuing a pregnancy after diagnosis of a lethal fetal abnormality: Views and perspectives of Australian health professionals and parents. Aust N Z J Obstet Gynaecol 2020; 60:746-752. [PMID: 32323315 DOI: 10.1111/ajo.13157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 02/24/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Couples who receive a prenatal diagnosis of a fetal anomaly in Victoria, Australia, are generally offered a choice about whether or not to continue with the pregnancy. When a severe or 'lethal' abnormality is diagnosed, some couples decide to continue the pregnancy in the knowledge that their baby may die before or shortly after birth. Several Australian parents who published personal accounts of that experience describe a lack of clear clinical pathways, suggesting those who decide to continue a pregnancy following a diagnosis of a 'lethal fetal abnormality' (LFA) may not be receiving optimal care. AIMS This study aimed to provide empirical Australian evidence of views and experiences of care provision from health professionals (HPs) and parents. MATERIALS AND METHODS Two sequential phases of this qualitative study purposively recruited a range of key HPs and parents. Semi-structured interviews were thematically analysed. RESULTS Findings reveal that current care provision following prenatal diagnosis of an LFA is 'ad hoc' with both participant groups identifying disparities between parents' needs and available care. However, the goodwill and good intentions of all HPs involved was apparent. There was strong support from both groups for considering a model of perinatal palliative care (PPC) based on existing programs overseas. CONCLUSIONS Future care provision in this setting needs to be redefined. A formal PPC program could ensure better and more consistent experiences of support for parents as well as the HPs working in the field.
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Affiliation(s)
- Alice Weeks
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Sibel Saya
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jan Hodgson
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Genetics Education and Health Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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11
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Bolognani M, Morelli PD, Scolari I, Dolci C, Fiorito V, Uez F, Graziani S, Stefani B, Zeni F, Gobber G, Bravi E, Tateo S, Soffiati M. Development of a Perinatal Palliative Care Model at a Level II Perinatal Center Supported by a Pediatric Palliative Care Network. Front Pediatr 2020; 8:574397. [PMID: 33520884 PMCID: PMC7845291 DOI: 10.3389/fped.2020.574397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022] Open
Abstract
Objective: To describe the model build up to take care of fetuses and newborns eligible to perinatal palliative care (PnPC) followed in an Italian II level perinatal center. Methods: Retrospective chart review of all fetuses and newborn infants eligible to PnPC admitted to level II perinatal center within a 4 years period. Results: Forty-five of 848 infants (0.5%) referred to II level NICU were eligible to PnPC. Twenty-seven percentage had fetal diagnosis. Twenty percentage were preterm infants at the limit of viability, 35% were newborns with life limiting or life threatening disease diagnosed in utero or at the postnatal ward, 45% were newborns not responding to intensive care intervention with high health care needs or medical complexity. Fifty-seven percentage of neonates admitted to NICU died before discharge, while 16 (35% of population considered) were discharged home. Median age at death was 4 days after birth, and delivery room death immediately after birth occurred in six patients (13%). Conclusions: Despite the paucity of our population and the high variability in disease trajectories the perinatal palliative care program build up in our region provides a reproducible method for a structured taking in charge of fetuses and neonates eligible to PnPC and their families, from the time of diagnosis to bereavement, in both outpatient and inpatient settings.
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Affiliation(s)
- Marco Bolognani
- Department of Neonatology, Santa Chiara Hospital, Trento, Italy.,Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | | | - Isabella Scolari
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Cristina Dolci
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | | | - Francesca Uez
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Silvia Graziani
- Department of Neonatology, Santa Chiara Hospital, Trento, Italy
| | - Barbara Stefani
- Department of Neonatology, Santa Chiara Hospital, Trento, Italy.,Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Francesca Zeni
- Department of Neonatology, Santa Chiara Hospital, Trento, Italy.,Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Gino Gobber
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Elena Bravi
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Saverio Tateo
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
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12
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Ghoshal A. Adapting and using the quality of dying and death questionnaire. Indian J Palliat Care 2020; 26:39-41. [PMID: 32132782 PMCID: PMC7017709 DOI: 10.4103/ijpc.ijpc_170_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/02/2019] [Indexed: 11/04/2022] Open
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13
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Benini F, Congedi S, Rusalen F, Cavicchiolo ME, Lago P. Barriers to Perinatal Palliative Care Consultation. Front Pediatr 2020; 8:590616. [PMID: 33072680 PMCID: PMC7536314 DOI: 10.3389/fped.2020.590616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 08/25/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Franca Benini
- Pediatric Pain and Palliative Care Service, Department of Women's and Children's Health, University Hospital Padua, Padua, Italy
| | - Sabrina Congedi
- Pediatric Pain and Palliative Care Service, Department of Women's and Children's Health, University Hospital Padua, Padua, Italy
| | - Francesca Rusalen
- Pediatric Pain and Palliative Care Service, Department of Women's and Children's Health, University Hospital Padua, Padua, Italy
| | - Maria Elena Cavicchiolo
- Woman's and Child's Department, Neonatal Intensive Care Unit, University of Padua, Padua, Italy
| | - Paola Lago
- Neonatal Intensive Care Unit, Treviso's Hospital, Treviso, Italy
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