Children with palliative care needs in Papua New Guinea, and perspectives from their parents and health care workers: a qualitative study
Child; child; Palliative Care; adult; article; controlled study; female; human; male; preschool child; palliative therapy; clinical article; interview; parent; Only Child; school child; health care personnel; qualitative research; descriptive research; child health care; health care quality; pediatric ward; adolescent; infant; thematic analysis; medical record; knowledge gap; health care need; Papua New Guinea; acute lymphoblastic leukemia/di [Diagnosis]; bronchiectasis/di [Diagnosis]; cerebral palsy/di [Diagnosis]; congenital heart disease/di [Diagnosis]; congenital malformation/di [Diagnosis]; dyspnea/co [Complication]; germ cell tumor/di [Diagnosis]; Guillain Barre syndrome/di [Diagnosis]; hemosiderosis/di [Diagnosis]; Human immunodeficiency virus infection/di [Diagnosis]; job experience; malignant neoplasm/di [Diagnosis]; Melanesia; neuroblastoma/di [Diagnosis]; Pacific islands; pain/co [Complication]; pulmonary hypertension/di [Diagnosis]; retinoblastoma/di [Diagnosis]; thalassemia/di [Diagnosis]; tuberculosis/di [Diagnosis]
Introduction: The World Health Organisation defines paediatric palliative care (PPC) as caring for the child's body, mind, and spirit, and giving support to the family. In life-limiting conditions it is important that palliative support can be provided even when curative attempts are being utilised. In Papua New Guinea, as in other low- and middle-income countries there is a lack of services and training on PPC. This study aims to describe the characteristics of children with palliative care needs and to assess the perspectives of their parents and health care workers. Methods: A descriptive qualitative study was carried out over 5 months in 2022 at the Port Moresby General Hospital children's wards. Clinical information was gathered from the admission charts of children with life threatening and life limiting conditions and a recorded interview was carried out with the children's parents. A focus group interview with 10 experienced nurses caring for these children was video recorded. The recorded interviews were subjected to thematic analysis. Results: Twenty children and their parents were included in this study. Nine had a cancer diagnosis and 11 had a chronic progressive condition. The common clinical characteristics of children with palliative care needs were pain (n = 9) and shortness of breath (n = 9), and most children had more than one symptom. Several themes were identified in the parent interviews. Most parents could not name their child's diagnosis, but they were able to correctly describe their child's condition using their own terms. Most parents felt involved in their child's management and were satisfied with the care provided. Parents were psychologically affected by their child's situation but were hopeful that God and the medicines would heal their child. Ten nurses were involved in a focus-group interview. Most nurses' understanding of palliative care was from experience not from formal training, but most felt confident in identifying the physical, emotional, and spiritual needs of the children. Understanding of analgesia was limited, as was the availability of appropriate medications included in the WHO Analgesic Ladder. Conclusion: There is a need for a systematic approach to palliative care in Papua New Guinea. Palliative care can be integrated into an overall approach to quality of paediatric care. It is relevant to a broad section of children with severe chronic or malignant conditions and can be carried out with limited resources. It does require some resources, further training and education, and increased provision of basic drugs for symptom control.
Watch V; Anga G; Kilalang C; Pulsan F; Vince JD; Duke T
BMC Palliative Care
2023
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).
<a href="http://doi.org/10.1186/s12904-023-01177-6" target="_blank" rel="noreferrer noopener">10.1186/s12904-023-01177-6</a>
Intersectoral collaboration in home-based end-of-life pediatric cancer care: A qualitative multiple-case study integrating families' and professionals' experiences
Collaboration; Child; Female; Male; Palliative Care; Denmark; Adolescence; Content Analysis; Qualitative Studies; Home Health Care; Data Analysis Software; Descriptive Research; Human; Descriptive Statistics; Pediatric Care; Semi-Structured Interview; In Infancy and Childhood; Cancer Patients; Case Studies; Oncologic Care
Background: Many children and adolescents with incurable cancer and their families prefer to receive end-of-life care and to die at home. This implies a transition of care from hospital to home and presupposes the establishment of a well-functioning collaboration between the family and professionals across health care sectors. Aim: To identify and explore key elements of home-based end-of-life care collaboration for children with cancer, as experienced by their parents and grandparents and the hospital- and community-based professionals involved. Design: Descriptive qualitative multiple-case study. Data were collected by semi-structured interviews and written responses to open-ended questions, and analyzed inductively across cases using qualitative content analysis. Setting/participants: Cases comprised a criterion sample of five children (aged <18 years), who died of cancer at home. Cases were represented by the children's bereaved parents (n = 8) and grandparents (n = 7), and community-based professionals (n = 16). Also, hospital-based professionals (n = 10) were interviewed about the children's end-of-life care through group interviews. Results: We identified five main themes, describing key elements of the end-of-life collaboration: Establishing the collaboration, Bolstering family life, Elucidating organization and integration, Managing challenges, and Closing the collaboration. These themes all came under the overarching theme: A mutual trust-based collaboration. On this basis, we developed the "Home-Based Pediatric End-of-Life Care Model for Children with Cancer." Conclusions: By highlighting key elements in the family-centered, intersectoral and interprofessional end-of-life care collaboration, our "Home-Based Pediatric End-of-Life Care Model for Children with Cancer" offers a framework for further optimization of home-based end-of-life care services for children with cancer and their families.
Hammer NM; Hansson H; Pedersen LH; Abitz M; Sjøgren P; Schmiegelow K; Bidstrup PE; Larsen HB; Olsen M
Palliative Medicine
2023
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).
<a href="http://doi.org/10.1177/02692163221135350" target="_blank" rel="noreferrer noopener">10.1177/02692163221135350</a>
The need of patients living with cancer for palliative care
Health Services Needs and Demand; Palliative Care; Neoplasms; Anxiety; Questionnaires; Adult; Psychometrics; Adolescence; Middle Age; Health Services Accessibility; Aged; Depression; Stress Psychological; Data Analysis Software; Descriptive Research; Human; Descriptive Statistics; Nursing; Self Report; Palliative Care Nursing; Chi Square Test; Jordan; Psychological Distress; Cross Sectional Studies; Patient Attitudes; Convenience Sample; Aged 80 and Over; Cancer Patients; Spiritual Care
Background: A comprehensive assessment of patients' problems and needs is
Alnajar MK; Abdalrahim MS; Mosleh SM; Farhan M; Amro K; Darawad MW
International Journal of Palliative Nursing
2023
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).
<a href="http://doi.org/10.12968/ijpn.2023.29.5.236" target="_blank" rel="noreferrer noopener">10.12968/ijpn.2023.29.5.236</a>
Max's legacy: an evaluation of the impacts of baby loss on staff and families
Female; Descriptive Research; Human; Thematic Analysis; Bereavement; Family Attitudes; Semi-Structured Interview; Abortion, Spontaneous; After Care; Attitude of Health Personnel; Focus Groups; Multimethod Studies; Pregnancy Trimester, First; Pregnancy; Safety; United Kingdom
Background/Aims There is a paucity of literature on the impact of baby loss experiences on family and staff. This study aimed to explore existing support available to families and staff in a UK hospital for first trimester miscarriage, as well as experiences of baby loss, and make recommendations for future care. Methods A mixed-methods service evaluation was conducted. Data were gathered from healthcare professionals (surveys, phase 1; interviews, phase 2) and service users who had experienced baby loss (focus group discussions, phase 3). Qualitative data were analysed thematically, alongside descriptive quantitative results. Results Communication, support, recognition of loss and environment were key contributors to positive and negative experiences for staff and families. Peer support enhanced communication, reduced isolation and increased ability to function on a daily basis following loss. Conclusions Formal, resourced maternity bereavement aftercare services are essential to the support the experiences, outcomes and safety of staff and families experiencing baby loss and miscarriage.
Whitehouse C; Crane R; Rostron H; Cater K
British Journal of Midwifery
2023
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).
<a href="http://doi.org/10.12968/bjom.2023.31.7.368%5C">10.12968/bjom.2023.31.7.368\</a>"
Palliative care education in an Australian undergraduate pharmacy curriculum: an exploratory descriptive study
Palliative Care; Education; Adolescence; Adult; Female; Human; Male; Questionnaires; Surveys; Australia; Clinical Reasoning; Communication; Confidence; Curriculum; Descriptive Research; Descriptive Statistics; Education Pharmacy; Empathy; Exploratory Research; Mann-Whitney U Test; Prospective Studies; Qualitative Studies; Reflection; Self Concept; Students Undergraduate; Thematic Analysis
Ong JA; Rego J; Ung T; Kumar S; Ash K; Saini B; Yates P
International Journal of Pharmacy Practice
2023
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).
<a href="https://www.mdpi.com/2227-9067/10/3/482"><span>10.1093/ijpp/riac093</span></a>
Specialized pediatric palliative care services in pediatric hematopoietic stem cell transplant centers
hematopoietic stem cell transplantation; palliative therapy; advance care planning; article; bereavement counseling; bereavement support; cause of death; child; controlled study; descriptive research; ethics; female; Hematopoietic Stem Cells; home; hospice; hospital; human; in-hospital mortality; major clinical study; male; mortality; Palliative Care; patient referral; pediatric intensive care unit; place of death; relapse; retrospective study; spiritual care; Stem Cell Transplantation
Hematopoietic stem cell transplantation (HSCT) is widely used in pediatric patients as a successful curative therapy for life-threatening conditions. The treatment is intensive, with risks of serious complications and lethal outcomes. This study aimed to provide insight into current data on the place and cause of death of transplanted children, the available specialized pediatric palliative care services (SPPCS), and what services HSCT professionals feel the SPPCS team should provide. First, a retrospective database analysis on the place and cause of death of transplanted pediatric HSCT patients was performed. Second, a survey was performed addressing the availability of and views on SPPCS among HSCT professionals. Database analysis included 233 patients of whom the majority died in-hospital: 38% in the pediatric intensive care unit, 20% in HSCT units, 17% in other hospitals, and 14% at home or in a hospice (11% unknown). For the survey, 98 HSCT professionals from 54 centers participated. Nearly all professionals indicated that HSCT patients should have access to SPPCS, especially for pain management, but less than half routinely referred to this service at an early stage. We, therefore, advise HSCT teams to integrate advance care planning for pediatric HSCT patients actively, ideally from diagnosis, to ensure timely SPPCS involvement and maximize end-of-life preparation.Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Mekelenkamp H; Schroder T; Trigoso E; Hutt D; Galimard JE; Kozijn A; Dalissier A; Gjergji M; Liptrott S; Kenyon M; Murray J; Corbacioglu S; Bader P
Children
2021
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).
<a href="http://doi.org/10.3390/children8080615" target="_blank" rel="noreferrer noopener">10.3390/children8080615</a>
Grief Journey: Perception and Response Based on Cultural Beliefs in Thai Women Experiencing Perinatal Death
Female; Anxiety; Grief; Adult; Health Personnel; Quality of Health Care; Adolescence; Self Concept; Medical Records; Emotions; Interviews; Purposive Sample; Qualitative Studies; Culture; Fear; Descriptive Research; Human; Hope; Reflection; Content Analysis; Field Notes; Evaluation; Hospitals Community; Women; Health Knowledge; Perinatal Death; Psychosocial Factors; Cultural Competence; Cultural Sensitivity; Forgiveness; Self-Talk; Social Norms; Thailand
Studying perinatal death needs to involve cultural beliefs influencing women's perceptions and responses to illuminate their grief journey following the loss of their baby. There is an urgent need to provide a deep understanding in this area that will be useful in meeting the unmet needs of women experiencing perinatal death. This qualitative study explored the grief journey set among cultural beliefs of Thai women experiencing perinatal death. Twenty-five participants who experienced perinatal death between six months and two years before participating in the study were recruited by purposive sampling through the medical history records of four community hospitals in a province of Thailand. Data were collected by in-depth interviews from September 2020 to March 2021 until data saturation. Content analysis was applied to analyze the data. Findings revealed four themes: 1) bewildering in the dark (wondering what is wrong, anxiety and fear about the anticipated loss, flickering hope); 2) grief response (the world suddenly shuts down, overwhelming sorrow); 3) self-reflection (by talking to self, talking to others); and 4) self-healing (compliance with cultural beliefs, the forgiveness of self and others). In conclusion, healthcare providers should be equipped with essential knowledge for addressing issues holistically based on cultural sensitivity that will be useful in enhancing the utmost ability of women in moving through their grief.
Nedruetai P; Puangpaka K; Bih-Ching S
Pacific Rim International Journal of Nursing Research
2022
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).
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
Mothers of angels: (re)living the death of the child as a coping strategy
Adult; Attitude to Death; Child; Coping; Data Analysis Software; Death -- In Infancy and Childhood; Descriptive Research; Exploratory Research; Focus Groups; Hardiness; Human; Mother-Child Relations; Mothers -- Psychosocial Factors; Qualitative Studies; Thematic Analysis
Objective: To describe the experiences lived by mothers facing the death of their children. Method: A qualitative, exploratory and descriptive research conducted in Guarapuava-PR, with six participants of the "Marias" group that brings together mothers who lost their children and share their experiences to spontaneously help other women in the process of mourning. Data collection took place from May to August 2017, through a focus group. The speeches were organized by the Iramuteq® software and analyzed according to Creswell. Results: Age ranged from 28 to 40 years old, and most participants were married and catholic. The categories express the need to strengthen bonds and to create ways in which women can express themselves; the importance of the social network to accommodate mourning; the relevance of ethical and humanized care; and group identity as an element to promote resilience. Conclusion and implications for practice: Describing the potentialities and weaknesses in the process of loss and grief enables a qualifying and humanizing care, overcoming care gaps, stimulating the creation of creative and dialogical spaces in maternal care. These results may guide the professional approach by considering the sociocultural context and the risk factors experienced by the mothers, by supporting the development of resilient skills and enabling a humanized and individualized care. Objetivo: Describir las experiencias vivenciadas por las madres frente a la muerte de sus hijos. Método: Investigación descriptiva, exploratoria y cualitativa realizada en Guarapuava-PR, con seis participantes del grupo "Marías" que reúne a madres que perdieron a sus hijos y comparten sus vivencias además de ayudar a otras mujeres espontáneamente en el proceso de duelo. Los datos se recolectaron entre mayo y agosto de 2017, por medio de un grupo focal. Las conversaciones se organizaron por medio del software Iramuteq® y se analizaron según Creswell. Resultados: La edad varió entre 28 y 40 años, y la mayoría de las participantes estaban casadas y eran católicas. Las categorías expresan la necesidad de fortalecer vínculos y de crear medios con los que las mujeres puedan expresarse; la importancia de la red social para sobrellevar el duelo; la relevancia de una atención ética y humanizada y la identidad grupal como elemento promotor de la resiliencia. Conclusión e implicaciones para la práctica: Describir las potencialidades y debilidades en el proceso de pérdida y duelo permite calificar y humanizar el cuidado, superando las lagunas asistenciales y estimulando la creación de espacios creativos y de diálogo en el cuidado materno. Estos resultados pueden orientar el enfoque profesional al considerar el contexto sociocultural y los factores de riesgo que experimentan las madres, apoyando el desarrollo de habilidades resilientes y haciendo posible un cuidado humanizado e individualizado. Objetivo: Descrever as experiências vivenciadas pelas mães frente à morte do filho. Método: Pesquisa descritiva exploratória qualitativa realizada em Guarapuava-PR, junto a seis participantes do grupo "Marias" que reúne mães que perderam seus filhos e compartilham suas vivências além de ajudar outras mulheres espontaneamente no processo de luto. A coleta de dados ocorreu de maio e agosto/2017, por meio de grupo focal. As falas foram organizadas pelo software Iramuteq® e analisada segundo Creswell. Resultados: Idade variou entre 28 a 40 anos, maioria casadas e católicas. As categorias expressam a necessidade fortalecer vínculos e criar meios em que possam se expressar; importância da rede social para acolher o luto; relevância do atendimento ético e humanizado e a identidade grupal como elemento promotor da resiliência. Conclusão e implicações para a prática: Descrever as potencialidades e fragilidades no processo de perda e luto possibilita qualificar e humanizar o cuidado, com a superação de lacunas assistenciais estimulando a criação de espaços criativos e dialógicos no acolhimento materno. Estes resultados podem orientar a abordagem profissional ao considerar o contexto cultural, social e fatores de risco em que as mães vivenciam, ao apoiar o desenvolvimento de habilidades resilientes e possibilitando um cuidado humanizado e individualizado.
Gramazio Soares L; Kuchla É; de Azevedo Mazza V; Gramazio Soares L; Raimondo Ferraz M I; Padilha Mattei A
Anna Nery School Journal of Nursing / Escola Anna Nery Revista de Enfermagem
2020
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).
<a href="http://doi.org/10.1590/2177-9465-EAN-2019-0030" target="_blank" rel="noreferrer noopener">10.1590/2177-9465-EAN-2019-0030</a>
The Long-Term Care Experiences and Care Needs of Parents Caring for Children With Adrenoleukodystrophy
Needs Assessment; Descriptive Research; Hospice Care; Human; Interviews; Helplessness Learned; Guilt; Psychosocial Aspects of Illness; Qualitative Studies; Parental Attitudes; Individualized Medicine; Long Term Care; Peroxisomal Disorders -- Psychosocial Factors
Background: Children suffering from adrenoleukodystrophy (ALD) requires life-long care. Little is known about the care needs of parents of ALD children at different stages of their disease. Purpose: The purpose of this study was to understand the long-term care experiences and care needs of parents caring for their ALD children. Methods: A descriptive qualitative study with 7 in-depth interviews was conducted with parents. Results: The results of these care experiences were distinguished into three phases: "pathogenesis to diagnosis", "rapid deterioration of physiological functions", and "bedridden until the death". The long-term care experiences revealed five themes, including "chaos and helplessness to seek medical attention then being forced to accept", "self-accusation and guilt", "strengthening parents' toughness", "seizing the moment and facing the future", and "accompanying children through life without pain". Within the three phases, the care needs comprised the three themes of "integrating resources and providing immediate care", "obtaining information and support regarding ALD rapidly", and "establishing individualized long-term care". Conclusion/Implication for Practice: This study revealed the long-term care experiences and care needs of the parents of ALD children. Providing individualized care, nursing instruction, and telephone consultation as well as connecting case managers with the hospice-care team will help facilitate and meet the care needs of these parents.
Jui-Chun F; Wei-Wen W U; Miao-Ju C; Shu-Yuan L; Su-Fen C
Journal of Nursing
2019
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).
<a href="http://doi.org/10.6224/JN.201902_66(1).05" target="_blank" rel="noreferrer noopener"> 10.6224/JN.201902_66(1).05</a>
Meeting the needs of young adults with life-limiting conditions: A UK survey of current provision and future challenges for hospices
Adult; Content Analysis; Convenience Sample; Cross Sectional Studies; Data Analysis Software; Descriptive Research; Descriptive Statistics; Health Services Needs and Demand; Hospice Care; Human; Terminally Ill Patients -- In Adulthood; Thematic Analysis; United Kingdom; Young Adult
AIM: The aim of this study was to seek views of UK children's and adult hospices on the availability and challenges of providing services for young adults with life-limiting conditions. BACKGROUND: Internationally, there are a growing number of young adults with life-limiting conditions and/or complex needs which are degenerative, progressive and diverse and involve complex life-long symptom, medication management as well as palliative care. There are 55,721 young adults, aged 18-40 in England, which continues to increase. The hospice sector is experiencing demands to extend services for this population despite concerns about the appropriateness of adult hospices and their nursing staff to provide care for the complex and unfamiliar conditions of this patient group. Evidence is needed of hospices' views and the main challenges faced providing services for young adults. DESIGN: Descriptive cross-sectional survey. METHODS: xChildren and adult hospices completed an online survey exploring service provision and their views of respite care for young adults with life-limiting conditions from 18 years old and onward. Data were collected between October 2015 - February 2016. FINDINGS: Respondents (N = 76 hospices) reported that children's hospices predominantly provided short breaks and end-of-life care; adult hospices provided mainly symptom management, end-of-life care and day services. Main challenges were lack of existing adult respite services; lack of funding and capacity; lack of a skilled workforce in adult hospices; and the need for better integrated service provision. CONCLUSION: Examples of good collaborative working were reported. With an increasing population of young adults and pressure on families, it is vital that services work together to find sustainable solutions to the challenges.
Knighting K; Bray L; Downing J; Kirkcaldy AJ; Mitchell TK; O'Brien MR; Pilkington M; Jack Barbara A
Journal of Advanced Nursing
2018
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).
<a href="http://doi.org/10.1111/jan.13702" target="_blank" rel="noreferrer noopener">10.1111/jan.13702</a>
Self-concept of siblings of children with cancer
Child; Female; Male; Questionnaires; Human; sibling bereavement; Support; Childhood Neoplasms -- Psychosocial Factors; Data Analysis Software; Descriptive Research; Exploratory Research; psychosocial; Purposive Sample; Self Concept -- Evaluation; Self Concept -- In Infancy and Childhood; Siblings -- Psychosocial Factors; Southwestern United States; T-Tests
Childhood cancer can have detrimental effects on the psychosocial well-being of healthy siblings of children with cancer. The limited research done over the past 40 years has identified adjustment difficulties such as poor self-concept, depression, sorrow, anxiety, and feelings of loneliness in children who have a sibling with cancer. To date, clinical research investigating self-concept is scarce as it relates to siblings of children with cancer. The purpose of this study was to examine self-concept in siblings of children with cancer who attended summer camp. A nonprobability purposive sample consisted of 50 school-age siblings of children with cancer. Using the Personal Attribute Inventory for Children (PAIC) to measure children's selfconcept, the researcher found that healthy siblings who attended summer camp scored higher on the PAIL than healthy siblings who did not attend camp. This research suggests that social support such as a camp experience may play an important function in coping with having a brother or sister with childhood cancer.
2001-04
Murray Js
Issues In Comprehensive Pediatric Nursing
2001
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).
Journal Article
Analysis Of Death And Palliative Care In A Neonatal Intensive Care Unit
Neonatal Intensive Care Unit; Newborn Death; Palliative Therapy; Analgesia; Analgesic Agent; Article; Clinical Article; Descriptive Research; Female; Follow Up; Hospitalization; Human; Male; Newborn; Pain Assessment; Prematurity; Resuscitation; Retrospective Study; Sedation; Sedative Agent
Objective: To characterize cases of children admitted to the Neonatal Intensive Care Unit of a tertiary university hospital who died in the period ranging from January 01, 2012 to July 31, 2014, and who required palliative care and/or were subjected to it. Methods: A retrospective descriptive study was carried out by reviewing the medical records of these patients to collect data and to perform descriptive statistical analysis. Results: During the study period, 49 children died after at least 48 hours from the time of admission. Of those, 18% children were extremely premature infants and 77% children had malformations. Although necessary for all of the patients in this study, palliative care was provided for only 20% of patients who died. Among the 12 babies who were not resuscitated, 33% of babies were not in palliative care. The Pain and Palliative Care Unit of the institution followed only four neonates in palliative care. These patients were using many invasive devices, had high therapeutic investment, and also altered pain scale scores. Conclusions: This study exhibited a large proportion of newborn infants with serious diseases and health conditions. In a few cases the patients received palliative care, but most of them were not even discussed under palliative point of view. We hope that this study will call attention to the need to propose protocols and implement training for the best treatment of these children.
Marcola L; De Barbosa S M M; Zoboli I; Polastrini R T V; Ceccon M E J
Revista Paulista De Pediatria
2017
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).
10.1590/1984-0462/;2017;35;2;00012