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Dublin Core
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Title
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November 2018 List
Text
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November 2018 List
URL Address
<a href="http://doi.org/10.1177/1049909117739853" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/1049909117739853</a>
Dublin Core
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Title
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When and Why Do Neonatal and Pediatric Critical Care Physicians Consult Palliative Care?
Publisher
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American Journal of Hospice and Palliative Care
Date
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2018
Subject
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Care coordination;Communication;complex chronic conditions;critical care;Critical Care/organization & administration;family;Female;health care quality;Humans;Intensive Care Units;Interviews as Topic;Length of Stay;Male;Neonatal/organization & administration;Palliative care;Palliative Care/organization & administration;Patient Care Planning/organization & administration;Pediatric intensive care unit;Pediatric/organization & administration;Pediatricians/psychology;Professional Family Relations;Qualitative Research
Creator
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Richards CA;Starks H;O'Connor MR;Bourget E;Lindhorst T;Hays R;Doorenbos AZ
Description
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BACKGROUND: Parents of children admitted to neonatal and pediatric intensive care units (ICUs) are at increased risk of experiencing acute and post-traumatic stress disorder. The integration of palliative care may improve child and family outcomes, yet there remains a lack of information about indicators for specialty-level palliative care involvement in this setting. OBJECTIVE: To describe neonatal and pediatric critical care physician perspectives on indicators for when and why to involve palliative care consultants. METHODS: Semistructured interviews were conducted with 22 attending physicians from neonatal, pediatric, and cardiothoracic ICUs in a single quaternary care pediatric hospital. Transcribed interviews were analyzed using content and thematic analyses. RESULTS: We identified 2 themes related to the indicators for involving palliative care consultants: (1) palliative care expertise including support and bridging communication and (2) organizational factors influencing communication including competing priorities and fragmentation of care. CONCLUSIONS: Palliative care was most beneficial for families at risk of experiencing communication problems that resulted from organizational factors, including those with long lengths of stay and medical complexity. The ability of palliative care consultants to bridge communication was limited by some of these same organizational factors. Physicians valued the involvement of palliative care consultants when they improved efficiency and promoted harmony. Given the increasing number of children with complex chronic conditions, it is important to support the capacity of ICU clinical teams to provide primary palliative care. We suggest comprehensive system changes and critical care physician training to include topics related to chronic illness and disability.
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<a href="http://doi.org/10.1177/1049909117739853" target="_blank" rel="noreferrer noopener">10.1177/1049909117739853</a>
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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).
2018
American Journal Of Hospice And Palliative Care
Bourget E
Care coordination
Communication
Complex Chronic Conditions
Critical Care
Critical Care/organization & Administration
Doorenbos AZ
Family
Female
Hays R
Health Care Quality
Humans
Intensive Care Units
Interviews As Topic
Length Of Stay
Lindhorst T
Male
Neonatal/organization & administration
November 2018 List
O'Connor MR
Palliative Care
Palliative Care/organization & Administration
Patient Care Planning/organization & administration
Pediatric Intensive Care Unit
Pediatric/organization & Administration
Pediatricians/psychology
Professional Family Relations
Qualitative Research
Richards CA
Starks H