Browse Items · Pediatric Palliative Care Library

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

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…

The use of pediatric advance directives: a tool for palliative care physicians.

Although laws such as the Patient Self-Determination Act encourage individuals to address their end-of-life treatment preferences using advance directives, the wishes of children have traditionally been ignored or, perhaps even worse, overruled.…

Tags: 2008, Advance Care Planning/es [Ethics], Advance Care Planning/og [Organization & Administration], Backlog, Child, Child Advocacy, Child Advocacy/es [Ethics], Child Advocacy/lj [Legislation & Jurisprudence], Child Advocacy/px [Psychology], Decision Making, DNAR, Humans, Journal Article, Minors/lj [legislation & Jurisprudence], Minors/px [Psychology], Palliative Care/es [Ethics], Palliative Care/og [Organization & Administration], Palliative Care/px [psychology], Parental Consent/es [Ethics], Parental Consent/lj [Legislation & Jurisprudence], Parental Consent/px [Psychology], Patient Participation/lj [Legislation & Jurisprudence], Patient Participation/px [Psychology], Pediatrics/es [Ethics], Pediatrics/og [Organization & Administration], Personal Autonomy, Right to Die/es [Ethics], Right to Die/lj [Legislation & Jurisprudence], The American Journal of Hospice & Palliative Care, United States, Zinner SE

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]

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…

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…

The effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital.

OBJECTIVE: To examine the effectiveness of palliative medicine consultation on completion of advance directives/do-not-resuscitate (DNR) orders by racial/ethnic minorities., METHOD: A sample of 1999 seriously ill African American and Hispanic…

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…

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…

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…

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…

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

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…

Physician-older patient communication at the end of life.

Communication with dying patients and their families requires special skills to assist them in this extremely stressful period. This article begins with a case that illustrates many of the challenges of communicating with the dying. It then reviews…

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…

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.

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

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…

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]

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…

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…

Palliative medicine consultation for preparedness planning in patients receiving left ventricular assist devices as destination therapy.

OBJECTIVE: To assess the benefit of proactive palliative medicine consultation for delineation of goals of care and quality-of-life preferences before implantation of left ventricular assist devices as destination therapy (DT)., PATIENTS AND METHODS:…

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

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…

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

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

Impact of writing "comfort measures only" orders in a community teaching hospital.

OBJECTIVES: We compared end-of-life care for patients with and without orders for "comfort measures only" (CMO) and evaluated whether standards for palliative medicine were met., DESIGN: We retrospectively reviewed the charts of 40 patients, 20 with…

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

Impact of a palliative care initiative on end-of-life care in the general wards: A before-and-after study._

BACKGROUND: Data on deaths in the general wards of our hospital in 2007 revealed infrequent discussions on end-of-life care and excessive burdensome interventions., AIM: A physician order form to withhold inappropriate life-sustaining interventions…

Tags: 2014, Advance Care Planning/st [Standards], Advance Care Planning/standards, Aged, Asian, Backlog, Cardiopulmonary Resuscitation, Chronic Disease/ep [Epidemiology], Chronic Disease/epidemiology, Chronic Disease/th [Therapy], Chronic Disease/therapy, Chua G, Clinical Audit, Comorbidity, DNAR, DNAR Outcomes, Do-not-resuscitate Orders, Female, Forms and Records Control, general wards, Hospital Mortality/td [Trends], Hospital Mortality/trends, Humans, Journal Article, Life Support Care/methods, Life Support Care/mt [Methods], Life Support Care/sn [Statistics & Numerical Data], Life Support Care/statistics & numerical data, Lim Tow K, Logistic Models, Male, Palliative Care, Palliative Medicine, Patient Admission/statistics & numerical data, Patient Admission/td [Trends], Patient Admission/trends, Phua J, Program Evaluation, Resuscitation Orders, Retrospective Studies, Seah A, Singapore/ep [Epidemiology], Singapore/epidemiology, Social Class, Tan A, Withholding Treatment/sn [statistics & Numerical Data], Withholding Treatment/statistics & Numerical Data

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…

Hospital care of patients with dementia.

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…

Experience in the use of the palliative care outcome scale.

GOALS OF WORK: The objective of the study is to assess the Palliative Care Outcome Scale (POS) as a potential audit tool within a specialist cancer centre. It also aims to answer the following questions: does the tool identify problem areas and…

Ethnicity, race, and advance directives in an inpatient palliative care consultation service.

OBJECTIVE: Although race and ethnic background are known to be important factors in the completion of advance directives, there is a dearth of literature specifically investigating the effect of race and ethnicity on advance directive completion rate…

Tags: 2013, 80 And Over, Adult, Advance Directives/eh [Ethnology], African Americans/statistics & numerical data, Aged, Asian Continental Ancestry Group/sn [Statistics & Numerical Data], Attitude to Death/eh [Ethnology], Backlog, Cooper LB, Cross-cultural Comparison, Decision Making, DNAR, European Continental Ancestry Group/sn [Statistics & Numerical Data], Female, Hispanic Americans/sn [Statistics & Numerical Data], Humans, Journal Article, Lesser ML, Liberman T, Male, Middle Aged, Mir Tanveer P, New York/ep [Epidemiology], Nouryan CN, Palliative & Supportive Care, Palliative Care/og [Organization & Administration], Pekmezaris R, Program Evaluation, Referral and Consultation/og [Organization & Administration], Resuscitation Orders, Sison CP, Spirituality, Terminal Care/og [organization & Administration], Wolf-Klein GP, Zaide GB

End-of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making.

This report on end-of-life decision-making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters. Chapter 1 reviews what is known about end-of-life care and opinions…

Easing of suffering in children with cancer at the end of life: is care changing?.

PURPOSE: In the past decade studies have documented substantial suffering among children dying of cancer, prompting national attention on the quality of end-of-life care and the development of a palliative care service in our institutions. We sought…

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…

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]

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.…

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