Palliative care?! But this child's not dying: The burgeoning partnership between pediatric cardiology and palliative care
cardiology; pediatric cardiology; pediatric palliative care
The field of pediatric cardiology has witnessed major changes over the past few decades that have considerably altered patient outcomes, including decreasing mortality rates for many previously untreatable conditions. Despite this, some pediatric cardiology programs are increasingly choosing to partner with their institutional palliative care teams. Why is this? The field of palliative care has also experienced significant shifts over a similar period of time. Today's palliative care is focused on improving quality of life, for any patient with a serious or life-threatening condition, regardless of where they might be on their disease trajectory. Research has clearly demonstrated that improved outcomes can be achieved for a variety of patient cohorts through early integration of palliative care; recent evidence suggests that the same may be true in pediatric cardiology. All pediatric cardiologists need to be aware of what pediatric palliative care has to offer their patients, especially those who are not actively dying. This manuscript reviews the evolution of palliative care and provides a rationale for its integration into the care of children with advanced heart disease. Readers will gain a sense of how and when to introduce palliative care to their families, as well as insight into what pediatric palliative care teams have to offer. Additional research is required to better delineate optimal partnership between palliative care and pediatric cardiology so that we may promote maximal quality of life of patients concurrently with continued efforts to push the boundaries of quantity of life. Copyright © 2020. Published by Elsevier Inc.
Wan A; Weingarten K; Rapoport A
The Canadian journal of cardiology
2020
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/10.1016/j.cjca.2020.04.041" target="_blank" rel="noreferrer noopener">10.1016/j.cjca.2020.04.041</a>
Factors Associated With Knowledge and Comfort Providing Palliative Care: A Survey of Pediatricians in Mexico
barriers; comfort; education; knowledge; Mexico; pediatric palliative care
BACKGROUND:: Lack of education and training in palliative care has been described to be one of the most important barriers to pediatric palliative care implementation. OBJECTIVE:: To examine what factors determine the degree of knowledge and level of comfort Mexican pediatricians have providing pediatric palliative care. METHODS:: A questionnaire that assessed palliative care concepts was developed and applied online to Mexican pediatricians, both generalists and specialists. RESULTS:: A total of 242 pediatricians responded. The majority had not received palliative care education (92.6%) and felt uncomfortable discussing palliative needs with patients and families (92.1%). The mean score of the questionnaire was 6.8 (+/-1.4) of 10 correct answers. Knowledge in palliative care was associated with exposure to oncologic patients ( P = .01) and previous palliative care education ( P = .02) but inversely related to the pediatrician's age ( P = .01). Comfort addressing patient's palliative care needs was associated with knowledge in palliative care ( P < .01), exposure to oncologic patients ( P = .03), and previous education in palliative care ( P = .02). CONCLUSIONS:: Although Mexican pediatricians have basic knowledge of palliative care concepts, they do not feel comfortable addressing palliative care needs, suggesting that the main barrier for implementing palliative care is not the lack of knowledge but rather feeling uncomfortable when addressing these issues with patients and families. Educational programs should incorporate strategies that could help physicians develop comfort in approaching palliative care patients.
Zuniga-Villanueva G; Ramirez-GarciaLuna J L; Weingarten K
Journal of Palliative Care
2019
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/10.1177/0825859719827021" target="_blank" rel="noreferrer noopener">10.1177/0825859719827021</a>
Virtual Reality: Endless Potential in Pediatric Palliative Care: A Case Report
innovative therapies; pediatric palliative care; symptom management; virtual reality
Pediatric palliative care deals with the physical, psychosocial, and spiritual concerns of patients and their families. And to do this, clinicians must use all the tools at their disposal, including pharmacological and nonpharmacological modalities. Virtual reality is quickly becoming a useful tool in many areas of medicine, including surgical planning, simulation training, rehabilitation, and pain prevention and treatment. Recently it has been used in the adult palliative care population, for symptom management, and memory and legacy creation. We present a case report for, what we believe to be, the first time in the pediatric palliative care population.
Weingarten K; Macapagal F; Parker D
Journal of Palliative Medicine
2019
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/10.1089/jpm.2019.0207" target="_blank" rel="noreferrer noopener">10.1089/jpm.2019.0207</a>