Browse Items · Pediatric Palliative Care Library

Goal-Concordance in Children with Complex Chronic Conditions

Abstract Objectives: To characterize delivery of goal-concordant end-of-life (EOL) care among children with complex chronic conditions and to determine factors associated with goal-concordance. Study design: This was a retrospective review of goals…

Polypharmacy among Pediatric Cancer Patients Dying In the Hospital

BACKGROUND: Decisions on medication treatment in children dying from cancer are often complex and may result in polypharmacy and increased medication burden. There is no information on medication burden in pediatric cancer patients at the end of life…

Values clarification: Eliciting the values that inform and influence parents' treatment decisions for periviable birth

BACKGROUND: Values clarification can assist families facing the threat of periviable delivery in navigating the complexity of competing values related to death, disability, and quality of life (QOL). OBJECTIVE: We piloted values clarification…

Withholding and withdrawing treatment in pediatric intensive care. Update of the GFRUP recommendations

In 2005, the French-speaking task force on pediatric critical and emergency care [Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP)] issued recommendations on withholding and withdrawing treatments in pediatric critical care. Since…

End-of-Life Care: Consensus Statement by Indian Academy of Pediatrics

Life-Sustaining Treatment Status at the Time of Death in a Japanese Pediatric Intensive Care Unit

BACKGROUND: Substantial variability exists among countries regarding the modes of death in pediatric intensive care units (PICUs). However, there is limited information on end-of-life care in Japanese PICUs. Thus, this study aimed to elucidate the…

Association between religious and socio-economic background of parents of children with solid tumors and DNR orders

BACKGROUND: The influence of socio-economic and religious background on decisions made by parents of children with incurable cancer regarding DNR orders is not fully understood. PROCEDURE: A retrospective analysis of medical charts of patients who…

Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest

This multiorganizational literature review was undertaken to provide an evidence base for determining whether or not recommendations for out-of-hospital termination of resuscitation could be made for children who are victims of traumatic…

Tags: 2014, Adolescent, American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Surgeons Committee on Trauma, Annals Of Emergency Medicine, Backlog, Cardiopulmonary Resuscitation, Child, Fallat ME, Humans, Journal Article, National Association of EMS Physicians, Out-of-Hospital Cardiac Arrest, Pediatric Emergency Medicine Committee - American College of Emergency Physicians, Resuscitation Orders, Thoracotomy, Wounds and Injuries

[French law related to patient's rights and end of life: pediatric intensive care unit's health professionals' opinions]

INTRODUCTION AND OBJECTIVES: To identify the knowledge of caregivers of pediatric intensive care units (PICUs) on the French law related to patients' rights and end of life, their views on withholding/withdrawing life-sustaining treatment (WWLST)…

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

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…

Withdrawal of ventilatory support outside the intensive care unit: guidance for practice

OBJECTIVE: To review the work of one tertiary paediatric palliative care service in facilitating planned withdrawal of ventilatory support outside the intensive care setting, with the purpose of developing local guidance for practice. METHODS:…

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

Pediatric palliative care and pediatric medical ethics: opportunities and challenges

The fields of pediatric palliative care (PPC) and pediatric medical ethics (PME) overlap substantially, owing to a variety of historical, cultural, and social factors. This entwined relationship provides opportunities for leveraging the strong…

Tags: 2014, 20th Century, Adolescent, Backlog, Child, Communication, Ethics, Feudtner C, History, Humans, Infant, Journal Article, Medical, Nathanson PG, Palliative Care, Pediatrics, Resuscitation Orders, Withholding Treatment

Unilateral pediatric "do not attempt resuscitation" orders: the pros, the cons, and a proposed approach

A unilateral do not attempt resuscitation (DNAR) order is written by a physician without permission or assent from the patient or the patient's surrogate decision-maker. Potential justifications for the use of DNAR orders in pediatrics include the…

Tags: 2014, Backlog, Child, Ethics, Extremely Premature, Female, Gross I, Humans, Infant, Journal Article, Male, Medical, Mercurio MR, Murray PD, Newborn, Parental Consent, Pediatrics, Prognosis, Quality Of Life, Resuscitation Orders

Clinician perspectives regarding the do-not-resuscitate order

IMPORTANCE: While data exist regarding the frequency and timing of the do-not-resuscitate (DNR) order in children, little is known about clinician attitudes and behaviors regarding this order. OBJECTIVE: To identify clinician attitudes regarding the…

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

The attitudes of neonatal professionals towards end-of-life decision-making for dying infants in Taiwan

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and…

End-of-life decision making in Taiwan: healthcare practice is rooted in local culture and laws that should be adjusted to patients' best interests

The observed Taiwanese neonatal professionals' more conservative attitudes than their worldwide colleagues towards end-of-life (EOL) decision making may stem from cultural attitudes toward death in children and concerns about medicolegal liability.…

Tags: 2013, Attitude Of Health Personnel, Attitude To Death, Backlog, Decision Making, Female, Hospital, Humans, Journal Article, Journal of Medical Ethics, Male, Medical Staff, Neonatology, Nursing Staff, Resuscitation Orders, Tang Siew Tzuh, Terminal Care

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…

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…

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…

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.…

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…

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…

Cardiopulmonary resuscitation in patients with cancer.

Cancer is the second leading cause of death in the United States, with most of these deaths taking place in the hospital setting. Discussions on end-of-life care and on cardiopulmonary resuscitation in particular are an important component in the…

Tags: 2007, Backlog, Cardiopulmonary Resuscitation, Decision Making, DNAR, Humans, Journal Article, Marik PE, Neoplasms/th [therapy], Palliative Care, Quality Of Life, Resuscitation Orders, The American Journal of Hospice & Palliative Care, Varon J

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…

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

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…

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…

One-year survival and neurological outcome after pediatric cardiopulmonary resuscitation

OBJECTIVE: Reported survival after cardiopulmonary resuscitation (CPR) in children varies considerably. We aimed to identify predictors of 1-year survival and to assess long-term neurological status after in- or outpatient CPR. DESIGN: Retrospective…

Decisions to forgo life-sustaining therapy in ICU patients independently predict hospital death

OBJECTIVE: More than one-half the deaths of patients admitted to intensive care units (ICUs) occur after a decision to forgo life-sustaining therapy (DFLST). Although DFLSTs typically occur in patients with severe comorbidities and intractable acute…

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…

Circumstances surrounding end of life in a pediatric intensive care unit

OBJECTIVE: Approximately 60% of deaths in pediatric intensive care units follow limitation or withdrawal of life-sustaining treatment (LST). We aimed to describe the circumstances surrounding decision making and end-of-life care in this setting.…

Discussing do-not-resuscitate orders in the hospital setting: Part 1

2002

Tags: 2002, Backlog, Communication, Decision Making, Hospitalization, Human, Journal Article, Journal of Palliative Medicine, Patient Education, Patient Participation, Resuscitation Orders, Terminal Care, von Gunten CF, Weissman DE

Discussing do-not-resuscitate orders in the hospital setting: Part 2

2002

Tags: 2002, Backlog, Emotions, Human, Journal Article, Journal of Palliative Medicine, Medical Futility, Resuscitation Orders, von Gunten CF, Weissman DE

Limitations and withdrawals of medical intervention in pediatric critical care

OBJECTIVE--To investigate the use and implementation in pediatric intensive care units (PICUs) of three levels of restriction of medical intervention: do not resuscitate (DNR), additional limitations of medical interventions beyond DNR, and…

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…

Variables influencing end-of-life care in children and adolescents with cancer

BACKGROUND: The purpose of this study was to describe the variables influencing end-of-life care in children and adolescents dying of cancer. MATERIALS AND METHODS: Records of 146 children with cancer who died at Children's Hospital were reviewed for…

Assessing preferences about the DNR order: does it depend on how you ask?

Despite increasing emphasis on advance directives, there has been little methodologic work to assess preferences about the "do not resuscitate" (DNR) order. This developmental work assessed, in a non-patient group, the performance of a…

Browse Items (52 total)