Depression and anxiety in children at the end of life
Child; Humans; Terminal Care; Prevalence; Drug Therapy; Psychotherapy; Depressive Disorder; Stress Disorders; Adjustment Disorders/epidemiology/psychology/therapy; Anxiety Disorders/epidemiology/psychology/therapy; Major/epidemiology/psychology/therapy; Post-Traumatic/epidemiology/psychology/therapy
A significant component of palliative care is the prompt diagnosis and management of distress, anxiety, and depression. This article reviews the symptoms and treatment of anxiety and depressive disorders in children at the end of life. Distinguishing between symptoms and disorders, the importance of open communication, consideration of the child's understanding of death, diagnostic challenges in chronically ill children, and suicidality are discussed. Because treatment options are available, it is imperative that symptoms are recognized and addressed. Understanding the issues involved in screening and diagnosis and the risks and benefits of available treatments can lead to an informed approach to the management of these disorders in the palliative care setting.
2007
Kersun LS; Shemesh E
Pediatric Clinics Of North America
2007
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
<a href="http://doi.org/10.1016/j.pcl.2007.06.003" target="_blank" rel="noreferrer">10.1016/j.pcl.2007.06.003</a>
Adherence to medical recommendations and transition to adult services in pediatric transplant recipients
Humans; Young Adult; Adult; Practice Guidelines as Topic; Drug Monitoring; Treatment Outcome; Risk Assessment; Risk Factors; Continuity of Patient Care; Health Behavior; Patient Education as Topic; Practice; adolescent; Attitudes; Adolescent Transitions; Health Knowledge; Graft Survival; Immunosuppressive Agents/therapeutic use; Graft Rejection/etiology/prevention & control; Medication Adherence; Organ Transplantation/adverse effects
PURPOSE OF REVIEW: Nonadherence to treatment recommendations, especially when associated with transition to adult care providers, account, by some estimates, for most organ rejections and death in long-term pediatric survivors of solid organ transplantations. It is therefore imperative that providers become familiar with the issues related to those major risks and ways to address them. RECENT FINDINGS: It is possible, and important, to routinely measure adherence to medications by using one of several available and proven methods of surveillance. There are numerous ways to improve adherence, and it is in fact possible to improve adherence and therefore outcomes in the transplant setting. The transition to adult services is a vulnerable period. The authors believe that it is possible to improve the transition process, and suggestions are presented in this review. However, solid research into interventions to improve transition is lacking. SUMMARY: Nonadherence to medical recommendations is prevalent and leads to poor outcomes following otherwise successful pediatric transplantation. An especially vulnerable period is the time when a recipient transitions to adult care. Routine monitoring of adherence, evaluating and addressing barriers to adherence, and collaborative, multidisciplinary care are all expected to substantially improve adherence and reduce the risks associated with transition.
2010
Shemesh E; Annunziato RA; Arnon R; Miloh T; Kerkar N
Current Opinion In Organ Transplantation
2010
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
<a href="http://doi.org/10.1097/MOT.0b013e32833984a5" target="_blank" rel="noreferrer">10.1097/MOT.0b013e32833984a5</a>