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40
3
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
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URL Address
<a href="http://doi.org/10.1542/peds.2011-2695" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2011-2695</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Barriers to conducting advance care discussions for children with life-threatening conditions.
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2012
Subject
The topic of the resource
Child; Female; Humans; Male; United States; Adult; Medical Staff; Questionnaires; Hospitals; Practice; Pediatric; Attitudes; DNAR; DNAR Outcomes; Palliative Care/st [Standards]; Advance Care Planning/og [Organization & Administration]; Critical Illness/th [Therapy]; Attitude of Health Personnel; Communication Barriers; Health Knowledge; Medical Staff; Hospital/es [Ethics]; Hospital/px [Psychology]; Hospital/st [Standards]
Creator
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Durall A; Zurakowski D; Wolfe J
Description
An account of the resource
BACKGROUND AND OBJECTIVE: Advance care discussions (ACD) occur infrequently or are initiated late in the course of illness. Although data exist regarding barriers to ACD among the care of adult patients, few pediatric data exist. The goal of this study was to identify barriers to conducting ACD for children with life-threatening conditions., METHODS: Physicians and nurses from practice settings where advance care planning typically takes place were surveyed to collect data regarding their attitudes and behaviors regarding ACD., RESULTS: A total of 266 providers responded to the survey: 107 physicians and 159 nurses (54% response rate). The top 3 barriers were: unrealistic parent expectations, differences between clinician and patient/parent understanding of prognosis, and lack of parent readiness to have the discussion. Nurses identified lack of importance to clinicians (P = .006) and ethical considerations (P < .001) as impediments more often than physicians. Conversely, physicians believed that not knowing the right thing to say (P = .006) was more often a barrier. There are also perceived differences among specialties. Cardiac ICU providers were more likely to report unrealistic clinician expectations (P < .001) and differences between clinician and patient/parent understanding of prognosis (P = .014) as common barriers to conducting ACD. Finally, 71% of all clinicians believed that ACD happen too late in the patient's clinical course., CONCLUSIONS: Clinicians perceive parent prognostic understanding and attitudes as the most common barriers to conducting ACD. Educational interventions aimed at improving clinician knowledge, attitudes, and skills in addressing these barriers may help health care providers overcome perceived barriers.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2011-2695" target="_blank" rel="noreferrer">10.1542/peds.2011-2695</a>
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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).
Type
The nature or genre of the resource
Journal Article
2012
Adult
Advance Care Planning/og [Organization & Administration]
Attitude Of Health Personnel
Attitudes
Backlog
Child
Communication Barriers
Critical Illness/th [therapy]
DNAR
DNAR Outcomes
Durall A
Female
Health Knowledge
Hospital/es [Ethics]
Hospital/px [Psychology]
Hospital/st [Standards]
Hospitals
Humans
Journal Article
Male
Medical Staff
Palliative Care/st [standards]
Pediatric
Pediatrics
Practice
Questionnaires
United States
Wolfe J
Zurakowski D
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1001/jamapediatrics.2013.2204" target="_blank" rel="noreferrer">http://doi.org/10.1001/jamapediatrics.2013.2204</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Clinician perspectives regarding the do-not-resuscitate order
Publisher
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Jama Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2013
Subject
The topic of the resource
Female; Humans; Male; decision making; Critical Illness; Data Collection; Attitude of Health Personnel; Physicians; Boston; Resuscitation Orders; Nurses; Heart Arrest; advance care planning
Creator
An entity primarily responsible for making the resource
Sanderson A; Zurakowski D; Wolfe J
Description
An account of the resource
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 meaning, implication, and timing of the DNR order for pediatric patients. DESIGN: Physicians and nurses from practice settings where advance care planning typically takes place were surveyed regarding their attitudes and behaviors about DNR orders. RESULTS: In total, 107 physicians and 159 nurses responded to the survey (N = 266). There was substantial variability in the interpretation of the DNR order. Most clinicians (66.9%) believe that a DNR order indicates limitation of resuscitative measures only on cardiopulmonary arrest. In reality, however, more than 85% believe that care changes beyond response to cardiopulmonary arrest, varying from increased attention to comfort to less clinician attentiveness. In addition, most clinicians reported that resuscitation status discussions take place later in the illness course than is ideal. CONCLUSIONS AND RELEVANCE: Clinicians use the DNR order not only as a guide for therapeutic decisions during a cardiopulmonary arrest but also as a surrogate for broader treatment directives. Most clinicians believe that DNR discussions should take place earlier than they actually do. Interventions aimed at improving clinician knowledge and skills in advance care discussions as well as the development of orders that address overall goals of care may improve care for children with serious illness.
2013-10
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/jamapediatrics.2013.2204" target="_blank" rel="noreferrer">10.1001/jamapediatrics.2013.2204</a>
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Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2013
Advance Care Planning
Attitude Of Health Personnel
Backlog
Boston
Critical Illness
Data Collection
Decision Making
Female
Heart Arrest
Humans
JAMA Pediatrics
Journal Article
Male
Nurses
Physicians
Resuscitation Orders
Sanderson A
Wolfe J
Zurakowski D
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1067/mpd.2002.124380" target="_blank" rel="noreferrer">http://doi.org/10.1067/mpd.2002.124380</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Physical therapy and cognitive-behavioral treatment for complex regional pain syndromes
Publisher
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The Journal Of Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Child; Female; Humans; Male; Prospective Studies; adolescent; P.H.S.; Research Support; U.S. Gov't; Nonparametric; Statistics; Cognitive Therapy; Complex Regional Pain Syndromes/psychology/rehabilitation; Physical Therapy Modalities
Creator
An entity primarily responsible for making the resource
Lee BH; Scharff L; Sethna NF; McCarthy CF; Scott-Sutherland J; Shea AM; Sullivan P; Meier P; Zurakowski D; Masek BJ; Berde CB
Description
An account of the resource
Complex regional pain syndromes (CRPS; type 1, reflex sympathetic dystrophy, and type 2, causalgia) involve persistent pain, allodynia, and vasomotor signs. We conducted a prospective, randomized, single-blind trial of physical therapy (PT) and cognitive-behavioral treatment for children and adolescents with CRPS. Children 8 to 17 years of age (n = 28) were randomly assigned to either group A (PT once per week for 6 weeks) or group B (PT 3 times per week for 6 weeks). Both groups received 6 sessions of cognitive-behavioral treatment. Assessments of pain and function were repeated at two follow-up time periods. Outcomes were compared at the three time points through the use of parametric or nonparametric analysis of variance and post hoc tests. All five measures of pain and function improved significantly in both groups after treatment, with sustained benefit evident in the majority of patients at long-term follow-up. Recurrent episodes were reported in 50% of patients, and 10 patients eventually received sympathetic blockade. Most children with CRPS showed reduced pain and improved function with a noninvasive rehabilitative treatment approach. Long-term functional outcomes were also very good.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1067/mpd.2002.124380" target="_blank" rel="noreferrer">10.1067/mpd.2002.124380</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2002
Adolescent
Backlog
Berde CB
Child
Cognitive Therapy
Complex Regional Pain Syndromes/psychology/rehabilitation
Female
Humans
Journal Article
Lee BH
Male
Masek BJ
McCarthy CF
Meier P
Nonparametric
P.H.S.
Physical Therapy Modalities
Prospective Studies
Research Support
Scharff L
Scott-Sutherland J
Sethna NF
Shea AM
Statistics
Sullivan P
The Journal Of Pediatrics
U.S. Gov't
Zurakowski D