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Title
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October 2019 List
Text
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October 2019 List
URL Address
<a href="https://academic.oup.com/pch/article/24/Supplement_2/e25/5506908" target="_blank" rel="noreferrer noopener">https://academic.oup.com/pch/article/24/Supplement_2/e25/5506908</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Who should discuss goals of care during acute deteriorations in patients with life threatening illnesses? A survey of clinicians from diverse pediatric specialties
Publisher
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Paediatrics and Child Health (Canada)
Date
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2019
Subject
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child; female; human; major clinical study; male; palliative therapy; controlled study; emergency ward; cancer patient; respiratory distress; conference abstract; decision making; human tissue; perception; clinician; spinal muscular atrophy; data analysis software; advanced cancer; brain disease; cancer resistance; deterioration; disease exacerbation; e-mail; hypoplastic left heart syndrome; leukemia; Likert scale; nonparametric test; pediatrician; vignette
Creator
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Cote A J; Gaucher N; Payot A
Description
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BACKGROUND: Discomfort exists discussing goals of care (GOC) with families of children with advanced life-threatening illnesses. There also exists important variability in the management of these patients. OBJECTIVE(S): This study seeks to explore the perceptions of pediatric specialists involved in the care of children with life-threatening illnesses with regards to GOC discussions and management during acute unexpected clinical deteriorations. DESIGN/METHODS: This single center survey study used 4 scenarios of children with advanced life-threatening illnesses, presenting to the emergency department (ED) with respiratory distress. Scenarios included patients with hypoplastic left heart syndrome (HLHS), static encephalopathy, spinal muscular atrophy (SMA), refractory leukemia. Questions following each vignette were identical. Physicians from the specialties most involved in these scenarios completed the survey by email or in person. Data analysis used SPSS v.20 (IBM Inc.). Related samples non-parametric tests compared participants' Likert scale answers to the different scenarios. RESULT(S): Between May 2015 and May 2016, 60 participants completed the study; 14 were excluded (>60% missing answers). Most (80.4%) participants reported an interest in pediatric palliative care; 71.7% had 0-3 formal trainings. Participants believed GOC were best discussed before an acute deterioration (Table 1). Acute deteriorations were not seen as an opportune moment to initiate discussions about GOC. However, validating GOC was necessary, given that not discussing GOC was unacceptable. Pediatric specialists were seen as the most suitable teams to initiate these discussions, while the ED's role was unclear. Several management options were less acceptable for the patient with static encephalopathy. CONCLUSION(S): Discussing GOC in the ED during exacerbations is complex, involving many stakeholders, who may not always be available to help in decision making processes. Advanced care planning with these families is essential to prepare them for acute heath events. (Table Presented).
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2019
Advanced Cancer
brain disease
Cancer Patient
cancer resistance
Child
Clinician
conference abstract
Controlled Study
Cote A J
Data Analysis Software
Decision Making
Deterioration
disease exacerbation
E-mail
Emergency Ward
Female
Gaucher N
Human
Human Tissue
Hypoplastic Left Heart Syndrome
Leukemia
Likert scale
Major Clinical Study
Male
nonparametric test
October 2019 List
Paediatrics and Child Health (Canada)
Palliative Therapy
Payot A
Pediatrician
Perception
respiratory distress
Spinal Muscular Atrophy
vignette
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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July 2019 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
July 2019 List
URL Address
<a href="http://doi.org/10.1016/j.annemergmed.2019.03.008" target="_blank" rel="noreferrer noopener">http://doi.o rg/10.1016/j.annemergmed.2019.03.008</a>
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Title
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Palliative Care in the Pediatric Emergency Department: Findings From a Qualitative Study
Publisher
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Annals of Emergency Medicine.
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
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article; child; female; human; major clinical study; male; palliative therapy; clinical evaluation; controlled study; critically ill patient; distress syndrome; emergency ward; genetic transcription; intensive care; patient care; pediatric emergency medicine; qualitative research; software; thematic analysis; theoretical study
Creator
An entity primarily responsible for making the resource
Cote A J; Payot A; Gaucher N
Description
An account of the resource
Study objective: Children with medical complexity represent a fragile population and account for the majority of patients followed in pediatric palliative care. Little is known in regard to the role of the emergency department (ED) in caring for the families of children with medical complexity. Method(s): Semistructured focus groups were held with health care professionals from pediatric emergency medicine, palliative care, complex care, and intensive care to explore their perspective on pediatric palliative care in the ED. Data were transcribed and analyzed with NVivo software, and thematic analysis and theoretic sampling were performed. Result(s): From January to October 2016, 58 participants were interviewed. Difficulties providing pediatric palliative care in the ED are related on the one hand to characteristics specific to the ED, such as its culture and its health care professionals' strong emotional responses when caring for children with medical complexity, and on the other hand to factors extrinsic to the ED; mainly, lack of continuity of care. For critically ill children with unknown goals of care and potential for end of life, professionals in the ED should evaluate the clinical situation, contact known health care teams, remain open to families' preferences, alleviate distressing symptoms, and create a caring environment. Communication between teams is targeted by health care professionals to facilitate and improve patient flow and care. Conclusion(s): Although perspectives differ in regard to how to provide care for pediatric palliative care patients in the ED, several barriers to providing high-quality emergency pediatric palliative care can be overcome. Copyright © 2019 American College of Emergency Physicians
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.annemergmed.2019.03.008" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2019.03.008</a>
2019
Annals of Emergency Medicine.
Article
Child
clinical evaluation
Controlled Study
Cote A J
Critically Ill Patient
Distress Syndrome
Emergency Ward
Female
Gaucher N
genetic transcription
Human
Intensive Care
July 2019 List
Major Clinical Study
Male
Palliative Therapy
Patient Care
Payot A
pediatric emergency medicine
Qualitative Research
Software
Thematic Analysis
theoretical study
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
October 2019 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
October 2019 List
URL Address
<a href="http://doi.org/10.1111/apa.14969" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/apa.14969</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Pediatric Palliative Care in Practice: Perspectives between Acute and Long-term Healthcare Teams
Publisher
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Acta Paediatrica
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
The topic of the resource
Pediatric palliative care; clinical ethics; continuity of care; quality of care
Creator
An entity primarily responsible for making the resource
Cote A J; Payot A; Gaucher N
Description
An account of the resource
AIM: To explore and compare acute and long-term care professionals' perspectives about pediatric palliative care. METHODS: Focus group interviews were conducted in 2016-2017 with professionals from acute (Emergency Department, Intensive Care Unit) and long-term care (Complex Care Service, Palliative Care) teams. RESULTS: Fifty-eight participants were enrolled. Palliative care definitions were similar throughout groups: to provide active care early in the illness, focusing on the child as a whole and supporting families. Each group perceived a different role in the patient's illness trajectory, reflecting their own culture of care. They demonstrated important differences in their approach to palliative care. Disagreements regarding when or how to discuss goals of care were expressed. Acute care professionals reported discomfort when having to introduce these discussions for the first time, while long-term care professionals perceived negative judgments about their patients' quality of life by acute care teams during health events. Personalized care, communication with families and continuity of care were thought to be key elements to improve care. CONCLUSION: Pediatric palliative care is well recognized throughout specialties, yet continuity of care is challenged by groups' roles and interventions in a patient's illness. A reflective and mutual clinical approach is needed to improve quality of care and professionals' satisfaction. This article is protected by copyright. All rights reserved.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/apa.14969" target="_blank" rel="noreferrer noopener">10.1111/apa.14969</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2019
Acta Paediatrica
Clinical Ethics
Continuity of care
Cote A J
Gaucher N
October 2019 List
Payot A
Pediatric Palliative Care
Quality Of Care