Integration of a palliative and terminal care center into a comprehensive pediatric oncology department
- 31 January 2008
- journal article
- other
- Published by Wiley in Pediatric Blood & Cancer
- Vol. 50 (5), 949-955
- https://doi.org/10.1002/pbc.21476
Abstract
Background The sharp division between curative cancer therapy and palliative care results in the late introduction of palliative care and a high incidence of suffering in children with cancer. We established a Palliative Care Unit (PCU) that is fully integrated with the Pediatric Hematology Oncology Department (PHOD). We wished to explore the impact of such integrative model on patterns of hospitalizations and exposure to palliative care of pediatric oncology patients. Procedures Retrospective search of medical records of patients admitted to the PHOD since PCU establishment in 1999, and of children who died from progressive disease between 1990 and 2005 was performed. Differences in clinical and prognostic variables between PCU and non-PCU patients, and differences in location of death before and after PCU establishment were evaluated. Results The majority (59%) of patients, who were hospitalized after the PCU establishment, were hospitalized in the PCU, including 49% of the good prognosis patients and 91% of the poor prognosis patients. Poor prognosis patients were hospitalized in the PCU earlier and with higher frequency compared to children with curable disease. After PCU opening there was a significant decline in the percentage of patients who died in the general pediatric ward, hematology-oncology ward, and at home from 40%, 26% and 28% to 4%, 8%, and 16%, respectively. Conclusions Our integrative model results in exposure of the majority of children with cancer to palliative care. For poor prognosis patients, palliative care is introduced early enough to allow gradual transition from symptom control after diagnosis to end of life care. Pediatr Blood Cancer 2008;50:949–955.This publication has 33 references indexed in Scilit:
- Site of Oncologic Specialty Care for Older Adolescents in UtahJournal of Clinical Oncology, 2007
- Hospice Referral Practices for Children With Cancer: A Survey of Pediatric OncologistsJournal of Clinical Oncology, 2006
- Early integration of pediatric palliative care: for some children, palliative care starts at diagnosisCurrent Opinion in Pediatrics, 2006
- When a child cannot be cured - reflections of health professionalsEuropean Journal of Cancer Care, 2005
- Status Quo of Palliative Care in Pediatric Oncology—A Nationwide Survey in GermanyJournal of Pain and Symptom Management, 2005
- Terminal care in paediatrics: where we are nowHeart, 2003
- Palliative Care: The World Health Organization's Global PerspectiveJournal of Pain and Symptom Management, 2002
- Defining Hospice and Palliative CareJournal of Pain & Palliative Care Pharmacotherapy, 2002
- The Measurement of Symptoms in Young Children With Cancer: The Validation of the Memorial Symptom Assessment Scale in Children Aged 7–12Journal of Pain and Symptom Management, 2002
- How Children Die in HospitalJournal of Pain and Symptom Management, 2000