Pediatricians' perceptions of and preferred timing for pediatric palliative care
2009
Thompson LA; Knapp C; Madden V; Shenkman EA
Pediatrics
2009
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/10.1542/peds.2008-2721" target="_blank" rel="noreferrer">10.1542/peds.2008-2721</a>
Family support in pediatric palliative care: how are families impacted by their children's illnesses?
Child; Cross-Sectional Studies; Female; Humans; Male; Young Adult; Adult; Health Care Surveys; Parent-Child Relations; Professional-Family Relations; Program Evaluation; Multivariate Analysis; Psychometrics; Florida; Regression Analysis; quality of life; adolescent; Preschool; Adaptation; Psychological; Palliative Care/organization & administration; infant; social support; Pediatrics/organization & administration; Telephone
CONTEXT: Palliative care programs have the opportunity to intercede and provide supportive care to parents whose families have been impacted by their children's illnesses. By understanding how families are impacted, programs can refine their service provision and investigate unmet needs. OBJECTIVE: To determine how families are impacted and what factors are associated with greater impact. DESIGN: 2008 cross-sectional telephone survey. SETTING: Florida. PATIENTS: Eighty-five parents whose children had life-limiting illnesses and were enrolled in Florida's publicly funded pediatric palliative care program. MAIN OUTCOME MEASURE: The Impact on Family (IOF) Scale. RESULTS: The majority of parents who responded to the survey are white non-Hispanic (56%), married (54%), had graduated from college (33%), and live in a two-parent household (60%). For 11 of the 15 IOF questions, the results showed that 50% or more of parents agreed with items on the IOF. For example, 71% of parents indicated that their family had to give things up as a result of their children's illnesses. Multivariate analysis showed that having depressive symptoms was associated with greater impact on the family. CONCLUSION: Our findings stress the importance of considering the needs of all family members when providing care to children and understanding and attempting to address family member's needs that may not be covered by pediatric palliative care services. Particular attention should be paid to parents with depressive symptoms, because they can receive supportive care in their children's pediatric palliative care programs.
2010
Knapp CA; Madden VL; Curtis CM; Sloyer P; Shenkman EA
Journal Of Palliative Medicine
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/10.1089/jpm.2009.0295" target="_blank" rel="noreferrer">10.1089/jpm.2009.0295</a>
Pediatricians' management practices for chronic pain
Biomarkers of Pain
OBJECTIVE: While research has established that pediatric pain is undertreated, it is unclear who should have primary responsibility for its management. This study asks pediatricians who they believe should treat pain and how pain should be assessed and managed. METHODS: We administered a mail and online survey about pediatric chronic pain and palliative care to a random sample of 800 U.S. pediatricians, and performed descriptive and multivariate analyses on 303 respondents. RESULTS: Most pediatrician responders were white, non-Hispanic (55.8%), and had been in practice 10 or more years (68.0%). Only one third of pediatricians (32.3%) felt it was their primary responsibility to treat chronic pain; most believed pain specialists (58.1%), other specialists, (39.6%), or hospice providers (26.1%) should be responsible. For pain assessments, most report using parent (87.1%) or patient (84.2%) verbal reports and one half (49.5%) use pain diaries, although multivariate analyses showed that inpatient pediatricians were significantly less likely to use these modalities. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) were commonly cited medications to usually or always treat pain (61.7% and 66.9%, respectively) and 19.3% report never or rarely prescribing intermittent opiates in their practice. Multivariate analyses showed that there were no consistent physician qualities that predicted the use of opiate prescriptions. CONCLUSIONS: Our findings illustrate that pediatricians' theoretical approaches to chronic pain management are more collaborative than independent. Future research must test if pediatricians could benefit from supplemental pain education, increased emphasis on clinical guidance, and an increased awareness of hospice to be included in the pain management team for children.
2010
Thompson LA; Knapp CA; Feeg V; Madden VL; Shenkman EA
Journal Of Palliative Medicine
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/10.1089/jpm.2009.0265" target="_blank" rel="noreferrer">10.1089/jpm.2009.0265</a>