Browse Items · Pediatric Palliative Care Library

Mind the child: using interactive technology to improve child involvement in decision making about life-limiting illness.

2010

Was there a plan? End-of-life care for children with life-limiting conditions: a review of multi-service healthcare records

BACKGROUND: Planning for care at the end of life (EoL) is an essential component of support and care for families of children with life-limiting conditions. The purpose of this review was to compare documented EoL planning with published children's…

Tracking the route to sustainability: a service evaluation tool for an advance care planning model developed for community palliative care services.

AIMS AND OBJECTIVES: The study aim was to develop a service evaluation tool for an advance care planning model implemented in community palliative care., BACKGROUND: Internationally, advance care planning programmes usually measure success by…

Is an advance care planning model feasible in community palliative care? A multi-site action research approach.

AIM: This article reports a study to determine the feasibility of an advance care planning model developed with Australian community palliative care services., BACKGROUND: An effective advance care planning programme involves an organizational wide…

Integrating POLST into palliative care guidelines: a paradigm shift in advance care planning in oncology.

Because predicting and outlining guidance for all possible scenarios is difficult, advance directives are rarely sufficiently precise to dictate patient preferences in specific situations as a disease progresses. Nonetheless, advance care planning is…

Tags: 2006, Advance Care Planning, Advance Directives, Backlog, Bomba Patricia A, Decision Making, DNAR, Humans, Journal Article, Journal Of The National Comprehensive Cancer Network, Life Support Care/st [Standards], Medical Oncology, Neoplasms/px [psychology], Neoplasms/th [therapy], Palliative Care, Physician's Practice Patterns/og [Organization & Administration], Vermilyea D

Can't we improve on advance directives?.

2008

Tags: 2008, Advance Care Planning/st [Standards], Advance Directives, Annals Of Internal Medicine, Backlog, Brasic GM, Decision Making, DNAR, Documentation, Family, Hammes BJ, Humans, Journal Article, Medical Records, Palliative Care/st [standards], Patients/px [psychology]

Determinants of do-not-resuscitate orders in palliative home care.

OVERVIEW: Do-not-resuscitate (DNR) orders allow home care clients to communicate their own wishes over medical treatment decisions, helping to preserve their dignity and autonomy. To date, little is known about DNR orders in palliative home care.…

Documenting end of life decisions in residential aged care facilities in South Australia.

OBJECTIVE: This research examined the provision of palliative care for residents with a non-cancer diagnosis including the use of advance directives and advance care planning as part of palliative care policies in residential aged care facilities in…

Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients.

The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care…

The triad that matters: palliative medicine, code status, and health care costs.

INTRODUCTION: Delayed discussion of a patient's code status can lead to shortsighted care plans that increase hospital length of stay (LOS) and costs., METHODS: Retrospective study compared intensive care unit (ICU) patients who accepted verses…

Tags: 2010, 80 And Over, Aged, Backlog, Celso BG, Code status, Critical Illness/ec [Economics], Critical Illness/ep [Epidemiology], Direct Service Costs/sn [Statistics & Numerical Data], DNAR, DNAR Outcomes, Emergency Service, Equipment and Supplies, Female, Health Care Cost, Hospice, Hospital Costs/sn [Statistics & Numerical Data], Hospital/ec [Economics], Hospital/ut [Utilization], Humans, Intensive Care/ec [Economics], Intensive Care/ut [Utilization], Journal Article, Laboratories, Length of Stay/ec [Economics], Length of Stay/sn [Statistics & Numerical Data], Male, Meenrajan S, Middle Aged, Operative/ec [Economics], palliation, Palliative Care/ec [economics], Palliative Care/ut [Utilization], Patient Admission, Radiology Department, Respiratory Care Units/ec [Economics], Retrospective Studies, Surgical Procedures, The American Journal of Hospice & Palliative Care, United States/ep [Epidemiology]

Talking with parents about end-of-life decisions for their children

BACKGROUND AND OBJECTIVE: Retrospective studies show that most parents prefer to share in decisions to forgo life-sustaining treatment (LST) from their children. We do not yet know how physicians and parents communicate about these decisions and to…

Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives.

PURPOSE: Many seriously ill patients with cancer do not discuss prognosis or advance directives (ADs), which may lead to inappropriate and/or unwanted aggressive care at the end of life. Ten years ago, patients with cancer said they would not like to…

Barriers to conducting advance care discussions for children with life-threatening conditions.

BACKGROUND AND OBJECTIVE: Advance care discussions (ACD) occur infrequently or are initiated late in the course of illness. Although data exist regarding barriers to ACD among the care of adult patients, few pediatric data exist. The goal of this…

Care for dying patients.

1997

Tags: 1997, Advance Care Planning, Advance Directives, Backlog, Communication, Decision Making, DNAR, Emanuel EJ, Euthanasia, Family, Humans, Journal Article, Lancet, Palliative Care, Passive, Physician-patient Relations, Physicians, Terminal Care, Withholding Treatment

Intensive care unit palliative medicine: some issues-part II.

Tags: 2011, Backlog, DNAR, Enck RE, Health Care Rationing/ec [economics], Health Care Rationing/og [Organization & Administration], Humans, Intensive Care Units/ec [Economics], Intensive Care Units/og [Organization & Administration], Journal Article, Medical, Palliative Care/ec [economics], Palliative Care/og [Organization & Administration], Resuscitation Orders, Sociology, The American Journal of Hospice & Palliative Care

Planning for the end of children's lives--the lifetime framework.

AIM: This paper describes the development of 'a best practice framework', following review of a sample of notes of children known to the Lifetime Service, where the child has a non-malignant life limiting condition, to improve child and family…

Advanced care planning in children with life-limiting conditions – the Wishes Document

Parent resuscitation preferences for young people with severe developmental disabilities.

OBJECTIVE: To determine the relationship of providing explanatory information regarding resuscitation to DNR status for parents and guardians of young people who reside in a pediatric skilled nursing facility., DESIGN: Retrospective,…

Tags: 2006, Adolescent, Adult, Advance Care Planning/og [Organization & Administration], Advance Care Planning/organization & Administration, Analysis of Variance, Attitude To Health, Backlog, Child, Choice Behavior, Consent Forms, Developmental Disabilities/co [Complications], Developmental Disabilities/complications/therapy, Developmental Disabilities/th [Therapy], DNAR, Documentation, Female, Friedman SL, Health Education/og [Organization & Administration], Health Education/organization & administration, Humans, Journal Article, Journal Of The American Medical Directors Association, Male, Massachusetts, Organizational Policy, Parents, Parents/ed [education], Parents/education/psychology, Parents/px [psychology], Preschool, Program Evaluation, Resuscitation Orders/psychology, Resuscitation Orders/px [Psychology], Retrospective Studies, Skilled Nursing Facilities/og [Organization & Administration], Skilled Nursing Facilities/organization & administration, Treatment Refusal/psychology, Treatment Refusal/px [Psychology]

Impact of an inpatient palliative care team: a randomized control trial.

BACKGROUND: Palliative care improves care and reduces costs for hospitalized patients with life-limiting illnesses. There have been no multicenter randomized trials examining impact on patient satisfaction, clinical outcomes, and subsequent health…

Tags: 2008, Advance Directives/sn [Statistics & Numerical Data], Advance Directives/statistics & Numerical Data, Aged, Backlog, Beane J, Blum M, Conner D, Cooperative Behavior, Critical Illness/ep [Epidemiology], Critical Illness/epidemiology, Critical Illness/psychology, Critical Illness/px [psychology], Critical Illness/rehabilitation, Critical Illness/rh [Rehabilitation], Della PR, DNAR, DNAR Outcomes, Gade G, Hospice Care/ut [Utilization], Hospice Care/utilization, Hospitalization, Hospitalization/statistics & numerical data, Humans, Journal Article, Journal of Palliative Medicine, Liberson M, McGrady K, Palliative Care/methods, Palliative Care/mt [methods], Patient Care Team, Patient Satisfaction, Prospective Studies, Quality Of Life/psychology, Quality Of Life/px [psychology], Richardson RH, Survival Rate, Venohr I, Williams MP

Advance directives and do-not-resuscitate orders in patients with cancer with metastatic spinal cord compression: advanced care planning implications.

OBJECTIVES: Communication about end-of-life decisions is crucial. Although patients with metastatic spinal cord compression (MSCC) have a median survival time of 3 to 6 months, few data are available concerning the presence of advance directives and…

Simple changes can improve conduct of end-of-life care in the intensive care unit.

PURPOSE: To describe changes to the conduct of withdrawal of life support (WOLS) in two teaching hospital tertiary care medical surgical intensive care units (ICUs) in a single centre over two distinct time periods., METHODS: We used a retrospective…

Pediatric advance care planning.

OBJECTIVE: This study describes the process and population involved in pediatric advance care planning at one Midwest medical center. The outcomes and the parents' perceptions of this planning are also discussed., METHODS: Pediatric patients with…

Tags: 2005, 7 died at home and 2 died at a hospital. Eight of the children's advance directives were followed during the dying process, 9 are deceased, Advance Care Planning/og [Organization & Administration], Advance Care Planning/organization & Administration, Backlog, Child, DNAR, DNAR Outcomes, Female, Hammes BJ, Humans, including preserving their child's quality of life and avoiding unnecessary suffering., individuals in the community raised concerns about the child's advance directive. CONCLUSIONS: Even though the topic of their child's death is difficult, Infant, Interviews As Topic, Journal Article, Journal of Palliative Medicine, Kempf M, Klevan J, Male, Newborn, Parents/psychology, Parents/px [psychology], Pediatrics, PedPal Lit, Preschool, the majority of the interviewed parents found the advance care planning process for the child helpful because it assured the best care for the child, while 1 was not. Th irteen parents were interviewed. Twelve stated that the process of advance care planning benefited their children and their family. Rarely, Williams MS, Wisconsin

What is the evidence that palliative care teams improve outcomes for cancer patients and their families?.

Patients with advanced cancer experience a complex web of problems, all of which interact. Specialist palliative care services have developed to meet these needs, but their effectiveness should be considered. We sought to determine whether specialist…

Tags: 2010, Backlog, Cancer Journal (Sudbury, Mass.), DNAR, Evans CJ, Evidence-based Medicine, Family, Higginson IJ, Humans, Journal Article, Neoplasms/th [therapy], Palliative Care/ma [manpower], Patient Care Team, Treatment Outcome

The impact of a palliative medicine consultation service in medical oncology.

This prospective study of consecutive patients describes the palliative medicine consult service in a tertiary level cancer center and its impact on patient care. All inpatients/outpatients referred to the Palliative Medicine Program in a 4-month…

Finding the right words: using the terms allow natural death (AND) and do not resuscitate (DNR) in pediatric palliative care.

When children are dying in a hospital setting, healthcare providers need to help families make important end-of-life care decisions. Most providers use the term do not resuscitate (DNR) when suggesting a course of action that involves not using…

Developing a policy for do not resuscitate orders within a framework of goals of care.

BACKGROUND: Discussions about DNR (do not resuscitate) orders or code status are common but can be difficult and may not lead to accurate understanding between clinicians and patients. These discussion are often isolated from the larger context of a…

Tags: 2011, Backlog, Broderick A, Decision Making, DNAR, Hospital Administration/es [Ethics], Humans, Joint Commission Journal On Quality And Patient Safety / Joint Commission Resources, Journal Article, Kaldjian LC, Palliative Care/es [Ethics], Palliative Care/og [Organization & Administration], Patient Care Planning/es [Ethics], Patient Care Planning/og [Organization & Administration], Policy, Resuscitation Orders/es [Ethics], Terminal Care/es [ethics], Terminal Care/og [organization & Administration]

Predictive factors for do-not-resuscitate designation among terminally ill cancer patients receiving care from a palliative care consultation service.

CONTEXT: Since the development of palliative care in the 1980s, "do not resuscitate" (DNR) has been promoted worldwide to avoid unnecessary resuscitation in terminally ill cancer patients., OBJECTIVES: This study aimed to evaluate the effect of a…

Tags: 2014, Aged, Backlog, Chen JS, Chou WC, DNAR, Family/px [psychology], Female, Hsieh C-H, Hsu H-C, Huang K-G, Humans, Hung Y-S, Jaing T-H, Journal Article, Journal of Pain and Symptom Management, Kao Chen-Yi, Liau Chi-Ting, Lin Yung-Chang, Liu Chien-Ying, Liu Keng-Hao, Liver Neoplasms/di [Diagnosis], Liver Neoplasms/pp [Physiopathology], Liver Neoplasms/px [Psychology], Liver Neoplasms/th [Therapy], Male, Middle Aged, Multivariate Analysis, Neoplasms/di [Diagnosis], Neoplasms/pp [Physiopathology], Neoplasms/px [psychology], Neoplasms/th [therapy], Palliative Care, Prognosis, Referral And Consultation, Resuscitation Orders, Resuscitation Orders/px [Psychology], Retrospective Studies, Sex Factors, Shen W-C, Su Po-Jung, Taiwan, Tang Shu-Chuan, Terminally Ill, Terminally Ill/px [Psychology], Time Factors, Wang Hung-Ming, Wu Jin-Hou

Pediatric palliative care.

Palliative care has always been a part of the care of children. It includes any intervention that focuses on relieving suffering, slowing the progression of disease, and improving quality of life at any stage of disease. In addition, for even the…

Alterations in end-of-life support in the pediatric intensive care unit.

OBJECTIVE: Our purpose was to examine alterations in end-of-life support in a multiinstitutional sample of PICUs., METHODS: This was a retrospective, descriptive study. Variables collected included end-of-life support category, race, length of stay,…

Tags: 2010, Advance Directives, Backlog, Brain Death, Child, DNAR, Humans, Intensive Care Units, Journal Article, Lee KJ, Life Support Care, Pediatric, Pediatrics, Resuscitation Orders, Scanlon MC, Terminal Care, Tieves K, Withholding Treatment

Symptom pathways from referral to death: measuring palliative care outcomes.

This article reports on the first stage of a process to develop a clinical performance indicator for a community-based palliative care service that may inform the development of an agreed set of indicators for the whole sector. The study explores…

‘Do Not Attempt Resuscitation’ – Do Standardised Order Forms make a clinical difference above hand-written note entries?

SummaryAim To quantify any effect of Standardised Order Forms (SOFs), versus hand-written note entries for ‘Do Not Attempt Resuscitation’ – on the selection and survival of remaining cardiopulmonary resuscitation (CPR) attempts. Methods A…

Tags: 2009, Advance Directives, Backlog, Cardiopulmonary Resuscitation, DNAR, DNAR Outcomes, Edwards VM, Hall S, Hutchings H, Journal Article, Lewis KE, Patient Selection, Resuscitation, Routine data, Temblett P

Pediatric advance directives: parents' knowledge, experience, and preferences

OBJECTIVES: To explore parents' and caregivers' experience, knowledge, and preferences regarding advance directives (ADs) for children who have chronic illness. METHODS: We conducted a prospective, cross-sectional survey of parents and caregivers of…

Pediatric Advance Care Planning: A Systematic Review

BACKGROUND AND OBJECTIVES: Advance care planning (ACP) is increasingly regarded as the gold standard in the care of patients with life-limiting illnesses. Research has focused on adults, but ACP is also being practiced in pediatrics. We conducted a…

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients.

OBJECTIVE: The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who…

An advance directive in two questions.

It has been two decades since advance directives have become an integral part of health care. Impediments to their optimal usage are common and multifactorial. Decisions commonly have to be made when patients are unable to do so or choose not to…

How children die in hospital.

A retrospective analysis was performed to describe the course of terminal care provided to dying hospitalized children in terms of symptom assessment and management, and communication and decision-making, at the end of life. Seventy-seven of 236…

The role of palliative care in advanced muscular dystrophy and spinal muscular atrophy.

OBJECTIVE: This study examines the potential role for palliative care services in the care of individuals with muscular dystrophy and spinal muscular atrophy, and the support of their families., METHODOLOGY: Semistructured interviews were conducted…

Characteristics of patients who refuse do-not-resuscitate orders upon admission to an acute palliative care unit in a comprehensive cancer center.

BACKGROUND: Refusal of appropriately indicated do-not-resuscitate (DNR) orders may cause harm and distress for patients, families, and the medical team. We conducted a retrospective study to determine the frequency and predictors of refusals of DNR…

Role of advance directives in palliative care units: a prospective study.

Advance directives (ADs) might be useful in achieving improved communication and satisfaction with decision making at the end-of-life. Our aims were to better characterise patients with advanced oncological disease who decided to complete ADs and to…

Attitudes of adolescent cancer survivors toward end-of-life decisions for minors.

OBJECTIVES: The present study aimed to investigate the attitudes of adolescent cancer survivors toward end-of-life decisions with life-shortening effects, including nontreatment decisions (NTDs), intensified alleviation of pain and symptoms (APS),…

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