Paediatric palliative screening scale as a useful tool for clinicians' assessment of palliative care needs of pediatric patients: a retrospective cohort study
Pediatrics; Prognosis; Palliative care; Pediatrician
BACKGROUND: Although the importance of palliative care in pediatric patients has been emphasized, many health care providers have difficulty determining when patients should be referred to the palliative care team. The Paediatric Palliative Screening Scale (PaPaS) was developed as a tool for screening pediatric patients for palliative care needs. The study aimed to evaluate the PaPaS as a reliable tool for primary care clinicians unfamiliar with palliative care. METHODS: This was a retrospective cohort study of patients referred to the pediatric palliative care teams in two tertiary hospitals in the Republic of Korea between July 2018 and October 2019. RESULTS: The primary clinical and pediatric palliative care teams assessed the PaPaS scores of 109 patients, and both teams reported a good agreement for the sum of the PaPaS score. Furthermore, the PaPaS scores correlated with those obtained using the Lansky performance scale. Although the mean PaPaS score was higher in the pediatric palliative care team, the scores were higher than the cut-off score for referral in both groups. CONCLUSION: The PaPaS can be a useful tool for primary care clinicians to assess the palliative care needs of patients and their families.
Song IG; Kwon SY; Chang YJ; Kim MS; Jeong SH; Hahn SM; Han KT; Park SJ; Choi JY
BMC Palliative Care
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/10.1186/s12904-021-00765-8" target="_blank" rel="noreferrer noopener">10.1186/s12904-021-00765-8</a>
Physician perspectives on end-of-life care and pediatric palliative care for children in the Republic of Korea
advance care planning; palliative therapy; South Korea; adult; child; conference abstract; death; deterioration; diagnosis; female; financial management; human; interview; life sustaining treatment; male; organization; perception; psychosocial care; questionnaire; tertiary care center
Introduction: Despite significant advances in disease treatment, resources for the pediatric palliative care (PPC) for children with serious illnesses are limited in South Korea. The obstacles to provide optimal PPC include inadequate funding, shortage of specialized professionals, and healthcare system, but the perception of health professionals is also very important. Purpose: This study explored pediatric doctors' perception of end-of-life care and needs on PPC in Korea. Materials and Methods: The study survey was developed based on a review of the palliative care literature and sample physician interview. A questionnaire was sent via online survey and mail to the pediatric doctors with specialized boards working at 43 tertiary hospitals in South Korea. Results: A total of 118 doctors responded to the survey. The median age was 37 years, 53% were female and 76% answered they have own child. Eighty percent responded that, in the previous 2 years, they cared for more than one pediatric patient who died. When asked about appropriate age for terminal state disclosure, 6%, 30%, 42% and 14% answered that pediatric patients should be informed if they are aged over 4, 7, 12, and 15 years old respectively. As for the life-sustaining treatments (LSTs) decision, 24% answered that discussions should be started when a child is diagnosed with incurable diseases, and 48% said advance care planning is needed in a state of constant deterioration even though actual death is not expected. Although only 7% of pediatric doctors had personal desire for use of LSTs when their own disease is incurable and in the deteriorating state, more respondents (29%) showed preferences to LSTs for children in the same situation. More than half of the respondents answered that they are not confident about advance care planning including LST decisions. Most respondents reported experiencing difficulties in PPC areas such as symptom management, ethical problems, and psychosocial support more than once every six months. Pediatric doctors indicated to the barriers to pediatric palliative care implementation as follows: the attitude of parents who prefer aggressive treatment (19%), shortage of PPC professionals and organizations (18%), negative perception on PPC among health professionals (16%), lack of financial support for PPC (12%), inadequate linkage between curative and palliative care (12%), and difficulties to decide when to refer a patient to PPC (10%). Conclusion: Our study showed pediatric doctors in Korea have low preferences to LSTs for children in the terminal state and perceive the needs of PPC. The results will guide the health authorities to design PPC program in Korea.
Kim M S; Kim C H; Yu J; Song IG
Cogent Medicine
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).
<a href="http://doi.org/10.1080/2331205X.2017.1408251" target="_blank" rel="noreferrer noopener">10.1080/2331205X.2017.1408251</a>