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Constantinou G, Cook EJ, Tolliday E, Randhawa G. 'A team around the child' professionals' experiences of unmet needs, access and expectations in children's palliative care services, a phenomenological study in the UK. J Child Health Care 2023:13674935221147716. [PMID: 36946427 DOI: 10.1177/13674935221147716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
This study aims to understand the experiences of professionals involved in caring for families of children with life-limiting illnesses to ascertain unmet needs, access issues and expectations of services.A phenomenological approach comprising semi-structured interviews with professionals from various services was used. Interviews that happened between July and November 2018 were audio-recorded, transcribed verbatim and thematically analysed based on descriptive phenomenology.In total, 29 interviews were conducted. Findings showed how essential collaborative working was for becoming a team around the child. Barriers to this include complex working relationships, overprotectiveness of families, roles and responsibilities and use of independent care records. The pressures of waiting times and the impact of staffing shortages affected the experiences of providing care. The reality of meeting families' expectations was shaped by family networking, online research and previous services resistance, which was influential in more challenging interactions. Expectations of care were also impacted by misunderstandings and anxieties surrounding access to services. Overall, professionals were concerned about families being used as a bottomless caring resource and stressed the need for short breaks to alleviate parents.Interventions that educate families and professionals on these services and how they can benefit the child and family would be well received.
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Affiliation(s)
- Georgina Constantinou
- Institute for Health Research, 5195University of Bedfordshire, UK
- Centre for Maternal and Child Health Research, School of Health Sciences, 4895City University of London, London, UK
| | - Erica J Cook
- Department of Psychology, 5195University of Bedfordshire, UK
| | | | - Gurch Randhawa
- Institute for Health Research, 5195University of Bedfordshire, UK
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Lohman D, Callaway M, Pardy S, Mwangi-Powell F, Foley KM. Six Key Approaches in Open Society Foundations' Support for Global Palliative Care Development. J Pain Symptom Manage 2023; 65:47-57. [PMID: 36064160 DOI: 10.1016/j.jpainsymman.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/15/2022] [Accepted: 08/25/2022] [Indexed: 02/03/2023]
Abstract
CONTEXT Between 1998 and 2021, the Open Society Foundations (OSF) network invested around US$50 million in supporting the emerging field of palliative care worldwide, funding different approaches and interventions to advance its objective of putting palliative care on the global public health agenda. OBJECTIVE To describe six approaches that were instrumental to the successes of Open Society Foundations' support in building the global field of palliative care. A robust discussion of lessons learnt is unfortunately not possible because Open Society Foundations did not commission a rigorous evaluation of the impacts of its investments. METHODS This article describes these six approaches: Investing in versatile palliative care leaders at national and regional level; investing in palliative care champions within the OSF network; proactively engaging the World Health Organization (WHO) in efforts to promote palliative care; developing tools and skills to improve palliative care financing; using a human rights-based approach; and supporting self-advocacy by people with palliative care needs. RESULTS Deep, long-term investments in national and regional champions from the palliative care community and OSF's own network built palliative care leaders with well-rounded skills, knowledge and opportunities to develop their own networks. The active engagement and involvement of the WHO in efforts to advance palliative care enhanced the credibility of palliative care as a discipline as well its champions, whereas the human rights approach resulted in more diverse strategies to overcome barriers to palliative care. The focus on palliative care financing and self-advocacy showed significant promise for impact. DISCUSSION The approaches and strategies described helped a nascent palliative care field develop into a health service that is increasingly integrated into public health systems. Other funders and national governments can build on OSF's long term support for the palliative care field and support further integration of palliative care within public health to increase access.
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Affiliation(s)
- Diederik Lohman
- Former Senior Advisor to Open Society Foundations' Public Health Program (D.L.), New York, USA.
| | - Mary Callaway
- Former director of the International Palliative Care Initiative (M.C.), New York, USA
| | - Sara Pardy
- Former Senior Administrative Specialist to Open Society Foundations' Public Health Program (S.P.), New York, USA
| | - Faith Mwangi-Powell
- Former Senior Program Officer Advocacy and Financing in the International Palliative Care Initiative; current CEO Girls Not Brides (F.M.P.), London, UK
| | - Kathleen M Foley
- Former medical director of the International Palliative Care Initiative (K.M.F.), New York, USA
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Kennedy M, Loftus M, Lafferty T, Hilliard C, Reaper-Reynolds S, O'Donnell C. Reimagining a children's palliative care educational programme for registered nurses in response to the COVID-19 pandemic. NURSE EDUCATION TODAY 2022; 119:105569. [PMID: 36155211 PMCID: PMC9487166 DOI: 10.1016/j.nedt.2022.105569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 09/01/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Children with life-limiting conditions are a unique population with multiple health and social care needs. Key literature indicates the need for education to support registered nurses providing care, including palliative care, to these children. In response to the COVID-19 pandemic, a palliative care programme was converted to an online programme, adopting a blended approach between national and regional facilitators. OBJECTIVES To assess nurses' satisfaction with a re-designed palliative care programme centred around the care of children with life-limiting conditions, including their perceptions of the online format. DESIGN AND METHODS A descriptive correlational design and online survey was used to explore the participants' perception of the content and online delivery of the Care of the Child with a Life-Limiting Condition programme. Nine sessions, comprised of five national and four regional webinars, were delivered. RESULTS Attendees registered (n = 169) from throughout the Republic of Ireland, with 130 attending all webinars. Attendees stated online delivery of education increased their accessibility to highly qualified experts. The short, concise nature of sessions was well received. Online delivery and recorded sessions contributed to convenience with the ability to access and process information in attendees' own time being welcomed. However, the negative impact of losing face-to-face interactions was noted, including the opportunity to build relationships with colleagues caring for children with life-limiting conditions. CONCLUSIONS Results suggest that the redesigned online programme contributed to participants' knowledge, encouraged participation and increased accessibility. An e-Learning model enables specialised education to be more equitable and accessible, ensuring regional areas are not disadvantaged due to geographical remoteness from tertiary educational centres. However, the lack of face-to-face contact was acknowledged as a hindrance to socialisation and networking. When developing future programmes, focus should be put on creating opportunities for networking and social development to compensate for the lack of face-to-face contact.
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Affiliation(s)
- Martina Kennedy
- School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Mairéad Loftus
- Centre of Nurse & Midwifery Education Mayo/Roscommon, Castlebar, Co. Mayo, Ireland
| | - Tricia Lafferty
- Centre of Nursing & Midwifery Education Donegal, Letterkenny, Co. Donegal, Ireland
| | - Carol Hilliard
- Children's Health Ireland (CHI) at Crumlin, Crumlin, Dublin 12, Ireland
| | | | - Carmel O'Donnell
- Centre of Children's Nurse Education, Children's Health Irealand (CHI), Crumlin, Dublin 12, Ireland
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Connor EO, Corcoran Y. Caring for a child with a life limiting condition: The experiences of nurses in an intellectual disability service provider. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:938-953. [PMID: 34227424 PMCID: PMC9607955 DOI: 10.1177/17446295211018588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 06/13/2023]
Abstract
This study elicited the experiences of nurses caring for children with life-limiting conditions and their family, within a community based intellectual disability service. A qualitative descriptive research approach was adopted where purposeful sampling recruited 10 participants. Data was collected using one to one semi-structured interviews and was subsequently analysed using qualitative thematic content analysis. The findings identified a range of complexities unique to the care of children with life-limiting conditions in the intellectual disability setting. From the findings, it is clear that this is a population of highly skilled nurses who work in a challenging and complex area of practice. Further supports are required in order to meet the practice needs and support the emotional needs of this population of nurses. In doing so, high quality practice within the area will be promoted, thereby ensuring high quality care for the children and families within the disability service.
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Affiliation(s)
- Eilis O Connor
- Eilis O Connor, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland.
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Lohman D, Cleary J, Connor S, De Lima L, Downing J, Marston J, Morris C, Pardy S, Pettus K. Advancing Global Palliative Care Over Two Decades: Health System Integration, Access to Essential Medicines, and Pediatrics. J Pain Symptom Manage 2022; 64:58-69. [PMID: 35263621 DOI: 10.1016/j.jpainsymman.2022.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/25/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
CONTEXT Between 2000 and 2020 Open Society Foundations was one of very few funders that supported global palliative care development and advocacy. OBJECTIVES To describe progress made in three priority areas-the integration of palliative care into public health systems, access to controlled medicines, and pediatric palliative care-during those 20 years. METHODS Activities and developments between 2000 and 2020 on global integration of palliative care into health systems, access to and availability of controlled medicines, and pediatric palliative care are described and analyzed. RESULTS Major progress has been made in each area. Whereas in 2000, integration of palliative care into public healthcare systems was on the agenda in just a few pioneering countries, by 2020 a global consensus had emerged that palliative care should be integral to all health systems including in universal health coverage and countries were increasingly taking steps to integrate it into national health systems. While limited availability of these medicines was barely recognized as a public health or drug control issue in 2000, it had become an important priority in global drug policy debates by 2020 and numerous countries had taken steps to improve access to these medicines. Pediatric palliative care, available mostly in a small number of wealthy countries in the 1990s, has seen rapid growth, especially in low- and middle-income countries, and now has a solid foothold in all world regions. CONCLUSION Despite this progress, significant challenges remain as funding for palliative care advocacy is limited, the overdose crisis in the US has recently had a chilling effect on efforts to improve availability of opioid analgesics, and economic crises related to the COVID-19 pandemic create uncertainty over the future of universal health coverage.
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Affiliation(s)
- Diederik Lohman
- Open Society Foundations (D.L., S.P.), New York, New York, USA.
| | - James Cleary
- Walther Global Palliative Care and Supportive Oncology, IUSCC, Indianapolis (J.C.), Indiana, USA
| | - Stephen Connor
- Worldwide Hospice Palliative Care Alliance (S.C., C.M.), London, UK
| | - Liliana De Lima
- International Association for Hospice and Palliative Care, Houston (L.D., K.P.), Texas, USA
| | - Julia Downing
- International Children's Palliative Care Network, Makerere University (J.D.), London/ Kampala, UK/ Uganda
| | - Joan Marston
- PatchSA Palliative Treatment for Children South Africa (J.M.), Bloemfontein, South Africa
| | - Claire Morris
- Worldwide Hospice Palliative Care Alliance (S.C., C.M.), London, UK
| | - Sara Pardy
- Open Society Foundations (D.L., S.P.), New York, New York, USA
| | - Katherine Pettus
- International Association for Hospice and Palliative Care, Houston (L.D., K.P.), Texas, USA
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Benini F, Papadatou D, Bernadá M, Craig F, De Zen L, Downing J, Drake R, Friedrichsdorf S, Garros D, Giacomelli L, Lacerda A, Lazzarin P, Marceglia S, Marston J, Muckaden MA, Papa S, Parravicini E, Pellegatta F, Wolfe J. International Standards for Pediatric Palliative Care: From IMPaCCT to GO-PPaCS. J Pain Symptom Manage 2022; 63:e529-e543. [PMID: 35031506 DOI: 10.1016/j.jpainsymman.2021.12.031] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Since the publication of the IMPaCCT project in 2007, much effort has been made to develop new approaches to pediatric palliative care (PPC). Fifteen years later, it is time to redefine the standards in PPC. OBJECTIVES An international group of experts in PPC has revised the standards in PPC through the GO-PPaCS project (Global Overview - PPC Standards). The goal was to update the PPC standards considering the specificity of different settings, resources, and emerging challenges. The present document is intended to reach all people directly or indirectly involved in PPC. METHODS A literature review in MEDLINE was conducted to expand on the fundamental points and current standards on PPC and to cover an international setting. The literature search (updated on the 15th of April 2021) was carried out using different combinations of keywords and focusing on papers published in English over the past 5 years (2016-2020), but older articles were considered when relevant. The consensus on the fundamental points, standards of care and paper contents was reached by open discussion. RESULTS Fundamental points were defined regarding the definition of PPC, eligibility criteria and the magnitude of the need for PPC, while standards were redefined for the following six areas: 1) clinical, developmental, psychological, social, ethical and spiritual needs; 2) end-of-life care; 3) care models and settings of care; 4) PPC in humanitarian emergencies; 5) care tools; and 6) education and training for healthcare providers. CONCLUSION The present document, developed with the contribution of an international group of experts from different countries, experiences and models of care, provides fundamental points and standards for a wider implementation of PPC worldwide.
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Affiliation(s)
- Franca Benini
- Paediatric Palliative Care, Pain Service, Department of Women's and Children's Health, University of Padua, Padua, Italy.
| | - Danai Papadatou
- Professor of Clinical Psychology, Department of Mental Health and Behavioral Studies, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| | - Mercedes Bernadá
- Associated Professor of Pediatrics, School of Medicine, Universidad de la República, Pereira Rossell Hospital Center, Pediatric Palliative Care Team Director, Montevideo, Uruguay
| | - Finella Craig
- Consultant in Paediatric Palliative Medicine at the Louis Dundas Centre, Great Ormond Street Hospital for Children, London, UK
| | - Lucia De Zen
- Pediatric Palliative Care and Pain Service, Institute for Maternal and Child Health Burlo Garofolo, Trieste, Italy
| | - Julia Downing
- International Children's Palliative Care Network (ICPCN), Uganda/UK
| | - Ross Drake
- Pediatric Palliative Care and Pain Services, Starship Children's Health, Auckland District Health Board, Auckland, New Zealand
| | - Stefan Friedrichsdorf
- Professor in Pediatrics, Medical Director, Center of Pediatric Pain, Palliative and Integrative Medicine at UCSF Benioff Children's Hospitals in Oakland and San Francisco, California, USA
| | - Daniel Garros
- Department of Pediatrics, Division of Critical Care, University of Alberta, Edmonton, Alberta, Canada; Stollery Children's Hospital PICU, Edmonton, Alberta, Canada
| | | | - Ana Lacerda
- Department of Pediatrics, Portuguese Institute of Oncology, Lisbon Centre, Lisbon, Portugal
| | - Pierina Lazzarin
- Paediatric Palliative Care, Pain Service, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Sara Marceglia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Joan Marston
- Sunflower Children's Hospice, Bloemfontein, South Africa
| | | | | | | | | | - Joanne Wolfe
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute and Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
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Mitchell S, Slowther AM, Coad J, Bertaud S, Dale J. Facilitators and barriers to the delivery of palliative care to children with life-limiting and life-threatening conditions: a qualitative study of the experiences and perceptions of healthcare professionals. Arch Dis Child 2022; 107:59-64. [PMID: 33980510 DOI: 10.1136/archdischild-2021-321808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/01/2021] [Accepted: 04/19/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To understand healthcare system facilitators and barriers to the delivery of palliative care for children with life-limiting and life-threatening conditions and their family members. DESIGN Focus groups with children's palliative care professionals. Data were analysed using thematic analysis. SETTING Four regions of England (West Midlands, South West, Yorkshire and Humber, and London) from December 2017 to June 2018. PARTICIPANTS Healthcare professionals (doctors, nurses and allied healthcare professionals) working in children's palliative care services. FINDINGS A total of 71 healthcare professionals participated in the focus groups. Three overarching themes were identified which influenced whether and when children were referred to and started to receive palliative care: (1) the unspoken background of clinical uncertainty which often delayed palliative care; (2) the cultural 'collusion of immortality', where conversations about the possibility of dying can be avoided or deferred; and (3) the role of paediatric palliative care teams in 'illuminating the blind spot' of palliative care as well as providing hands-on care. CONCLUSIONS Palliative care is a holistic approach to care that focuses on quality of life for people living with life-limiting and life-threatening conditions that can be delivered alongside active treatment. There is a need to prioritise and integrate this into healthcare services for children more effectively if improvements in care are to be realised. While more specialist paediatric palliative care services are needed, the unspoken background of clinical uncertainty needs to be addressed together with the collusion of immortality within healthcare culture and organisations.
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Affiliation(s)
- Sarah Mitchell
- Oncology and Metabolism, The University of Sheffield, Sheffield, UK .,Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Jane Coad
- University of Nottingham School of Health Sciences, Nottingham, UK
| | - Sophie Bertaud
- The Louis Dundas Centre for Children's Palliative Care, Great Ormond Street Hospital for Children, London, UK
| | - Jeremy Dale
- Warwick Medical School, University of Warwick, Coventry, UK
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House TR, Wightman A. Adding Life to Their Years: The Current State of Pediatric Palliative Care in CKD. KIDNEY360 2021; 2:1063-1071. [PMID: 35373080 PMCID: PMC8791371 DOI: 10.34067/kid.0000282021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/05/2021] [Indexed: 01/16/2023]
Abstract
AbstractDespite continued advances in medical treatment, pediatric CKD remains an unremitting, burdensome condition characterized by decreased quality of life and earlier death. These burdens underscore the need for integration of pediatric palliative care (PPC) into nephrology practice. PPC is an evolving field that strives to (1) relieve physical, psychologic, social, practical, and existential suffering; (2) improve quality of life; (3) facilitate decision making; and (4) assist with care coordination in children with life-threatening or life-shortening conditions. Integration of palliative care into routine care has already begun for adults with kidney disease and children with other chronic diseases; however, similar integration has not occurred in pediatric nephrology. This review serves to provide a comprehensive definition of PPC, highlight the unmet need in pediatric nephrology and current integration efforts, discuss the state of palliative care in adult nephrology and analogous chronic pediatric disease states, and introduce future opportunities for study.
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Zuniga-Villanueva G, Ramos-Guerrero JA, Osio-Saldaña M, Casas JA, Marston J, Okhuysen-Cawley R. Quality Indicators in Pediatric Palliative Care: Considerations for Latin America. CHILDREN (BASEL, SWITZERLAND) 2021; 8:250. [PMID: 33806896 PMCID: PMC8004984 DOI: 10.3390/children8030250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022]
Abstract
Pediatric palliative care is a growing field in which the currently available resources are still insufficient to meet the palliative care needs of children worldwide. Specifically, in Latin America, pediatric palliative care services have emerged unevenly and are still considered underdeveloped when compared to other regions of the world. A crucial step in developing pediatric palliative care (PPC) programs is delineating quality indicators; however, no consensus has been reached on the outcomes or how to measure the impact of PPC. Additionally, Latin America has unique sociocultural characteristics that impact the perception, acceptance, enrollment and implementation of palliative care services. To date, no defined set of quality indicators has been proposed for the region. This article explores the limitations of current available quality indicators and describes the Latin American context and how it affects PPC development. This information can help guide the creation of standards of care and quality indicators that meet local PPC needs while considering the sociocultural landscape of Latin America and its population.
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Affiliation(s)
- Gregorio Zuniga-Villanueva
- Department of Pediatrics, Tecnologico de Monterrey, Monterrey 64849, Mexico
- Division of Pediatric Palliative Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada
| | | | - Monica Osio-Saldaña
- Department of Global Studies, Universidad Nacional Autonoma de Mexico, Mexico City 04510, Mexico;
| | - Jessica A. Casas
- Department of Pediatric Palliative Care, Texas Children’s Hospital, Houston, TX 77030, USA; (J.A.C.); (R.O.-C.)
| | - Joan Marston
- Global Ambassador, International Children’s Palliative Care Network, Assagay 3624, South Africa;
| | - Regina Okhuysen-Cawley
- Department of Pediatric Palliative Care, Texas Children’s Hospital, Houston, TX 77030, USA; (J.A.C.); (R.O.-C.)
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10
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Zhang M, Li X. Focuses and trends of the studies on pediatric palliative care:A bibliometric analysis from 2004 to 2018. Int J Nurs Sci 2021; 8:5-14. [PMID: 33575439 PMCID: PMC7859508 DOI: 10.1016/j.ijnss.2020.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/10/2020] [Accepted: 11/26/2020] [Indexed: 10/25/2022] Open
Abstract
Objectives To investigate the focuses and trends of the studies on pediatric palliative care (PPC) and provide directions for future research. Methods Relevant papers about PPC published from 2004 to 2018 were analyzed using bibliometric analysis methods, including co-word analysis, biclustering analysis, and strategic diagram analysis. The included papers were divided into three groups based on the publication time, including 2004-2008, 2009-2013, and 2014-2018. Results A total of 1132 papers were published between 2004 and 2018, and there were 293 papers published between 2004 and 2008, 396 between 2009 and 2013, and 443 between 2014 and 2018. There were 42 high-frequency MeSH terms/MeSH subheadings in papers published between 2004 and 2018, including 12 between 2004 and 2008, 13 between 2009 and 2013, and 17 between 2014 and 2018. Conclusion Studies on PPC were making progress, with the increasing number, expanding scope, and uneven global distribution. Integration palliative care into pediatrics, cancer treatments in pediatric oncology, education methods on PPC, and establishment of professional teams were the major themes during 2004-2008, then the themes changed into establishing interventions to enhance the quality of life of the patients and parents, building professional-family relationship, and investigating attitude of health personnel in PPC during 2009-2013 and subsequently turned into communication skills, end-of-life decision making, and guidelines making on PPC during 2014-2018. Underdeveloped and protential themes including effective approaches to deal with the ethical dilemmas, training programs on communication skills, family support and guideline making are worth studying in the future.
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Affiliation(s)
- Miao Zhang
- School of Nursing, China Medical University, Shenyang, Liaoning, China
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, Liaoning, China
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Schütze D, Engler F, Ploeger C, Ulrich LR, Hach M, Seipp H, Kuss K, Bösner S, Gerlach FM, van den Akker M, Erler A, Engler J. Specialised outpatient paediatric palliative care team-parent collaboration: narrative interviews with parents. BMJ Support Palliat Care 2021; 12:e664-e670. [PMID: 33402383 DOI: 10.1136/bmjspcare-2020-002576] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/14/2020] [Accepted: 12/12/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In Germany, children with life-limiting conditions and complex symptoms are eligible for specialised outpatient palliative care (SOPC). In the federal state of Hesse, SOPC for children (SOPPC) is delivered by teams with paediatric expertise. While burdened by the life-limiting condition of their child, parents must also fulfill their roles as main care providers and decision makers. Collaboration between parents and SOPPC teams is important, as the intermittent care and uncertainty it entails often lasts for several months or years. We explored parents' experiences and their demands of collaboration with SOPPC teams. METHODS We conducted nine narrative interviews with 13 parents of children and adolescents with life-limiting conditions and used a grounded theory approach to analyse interview data. RESULTS Parents stressed the importance of paediatric expertise, honesty, psychosocial support, an individualised approach, experience of self-efficacy and the need to be recognised as experts for their children. The narrative interviews showed that collaboration between parents and SOPPC teams was characterised by parents' need for specialised professional assistance and their simultaneous empowerment by SOPPC teams. CONCLUSIONS Parents' perceptions of what good collaboration with SOPPC teams entails are manifold. To meet these complex needs, SOPPC requires time and specialised expertise.
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Affiliation(s)
- Dania Schütze
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Fabian Engler
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Cornelia Ploeger
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Lisa-R Ulrich
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany.,German Federal Rehabilitation Council (BAR e. V.), Frankfurt am Main, Germany
| | - Michaela Hach
- Professional Association of Specialized Outpatient Palliative Care in Hesse, Wiesbaden, Germany
| | - Hannah Seipp
- Department of General Practice and Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Katrin Kuss
- Department of General Practice and Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Stefan Bösner
- Department of General Practice and Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Ferdinand M Gerlach
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Marjan van den Akker
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Antje Erler
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jennifer Engler
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
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Downing J, Boucher S, Ambler J, Brand T, Sithole Z, Nkosi B, Meiring M, Gwyther E, Sithole L, Steel B, Daniels A. Inspiration, innovation and integration: highlights from the third ICPCN conference on children's palliative care, 30 May to 2 June 2018, Durban, South Africa. Ecancermedicalscience 2018; 12:870. [PMID: 30263061 PMCID: PMC6145521 DOI: 10.3332/ecancer.2018.870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Indexed: 12/19/2022] Open
Abstract
The International Children's Palliative Care Network (ICPCN) held its third international conference on children's palliative care in Durban, South Africa, from May 30 2018 to 2 June 2018. The conference-inspiration, innovation and integration-brought together 250 participants from 41 countries and was held in conjunction with local partners-Umduduzi Hospice Care for Children, Palliative Treatment for Children South Africa (Patch SA) and the Hospice and Palliative Care Association of South Africa. It built on national and global developments in palliative care such as its inclusion in Universal health coverage (UHC), the Lancet Commission report on pain and palliative care and the sustainable development goals (SDGs), and aimed to raise the profile of children's palliative care in KwaZulu-Natal (KZN) and nationally. Seven pre-conference workshops were held prior to the conference on topics such as pain and symptom management, children's palliative care within a humanitarian crisis, perinatal palliative care, research, developing programmes, ethical issues and difficult conversations in children's palliative care. Delegates were welcomed in true Durban style at the welcome reception hosted by the City of Durban and uShaka Marine World. The opening plenary included entertainment from the Open Air School and Hillcrest Primary School, and inspirational talks from the Member of the Executive Council (MEC) for Health, a representative of the World Health Organization (WHO), the Chief Executive of ICPCN and the Noble Peace Prize Nominee Dr MR Rajagopal from Pallium India. Plenary sessions were interspersed throughout the conference with 56 oral concurrent presentations and workshops, six 'Meet the expert sessions' 100 poster presentations and the South African Premier of the film 'Hippocratic: 18 Experiments in gently shaking the world'. There was a great feeling of networking and learning throughout the conference, with the conference being well evaluated, and an increase in the level of presentations and research from previous conferences demonstrating the steps that are being taken in children's palliative care globally.
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Affiliation(s)
- Julia Downing
- International Children's Palliative Care Network (ICPCN), New Bond House, Bond Street, Bristol, BS2 9GA, UK.,Makerere University, Kampala, Uganda
| | - Sue Boucher
- International Children's Palliative Care Network, Cluster Box 3050, Assagay, 3624, South Africa
| | - Julia Ambler
- Umduduzi Hospice Care for Children, Durban, South Africa
| | - Tracey Brand
- Umduduzi Hospice Care for Children, Durban, South Africa
| | - Zodwa Sithole
- Hospice and Palliative Care Association of South Africa, Cape Town 7700, South Africa
| | - Busi Nkosi
- International Children's Palliative Care Network, Cluster Box 3050, Assagay, 3624, South Africa
| | - Michelle Meiring
- Palliative Treatment for Children (Patch) South Africa, Cape Town, 7700 South Africa
| | - Elizabeth Gwyther
- Hospice and Palliative Care Association of South Africa, Cape Town 7700, South Africa
| | - Lorna Sithole
- International Children's Palliative Care Network, Cluster Box 3050, Assagay, 3624, South Africa
| | - Barbara Steel
- International Children's Palliative Care Network, Cluster Box 3050, Assagay, 3624, South Africa
| | - Alex Daniels
- International Children's Palliative Care Network, Cluster Box 3050, Assagay, 3624, South Africa
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Daniels A, Downing J. Increasing access to children's palliative care education through e-learning: a review of the ICPCN experience. Int J Palliat Nurs 2018; 24:351-358. [DOI: 10.12968/ijpn.2018.24.7.351] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alex Daniels
- Education Officer, International Children's Palliative Care Network, Durban, South Africa
| | - Julia Downing
- Chief Executive, International Children's Palliative Care Network, Kampala, Uganda and Kent, UK
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