Pediatric Cardiology Provider Attitudes About Palliative Care: A Multicenter Survey Study

Title

Pediatric Cardiology Provider Attitudes About Palliative Care: A Multicenter Survey Study

Creator

Balkin E M; Kirkpatrick J N; Kaufman BD; Swetz K M; Sleeper L A; Wolfe J; Blume E D

Identifier

10.1007/s00246-017-1663-0

Publisher

Pediatric Cardiology.

Date

2017

Subject

Cardiologist; Controlled Study; Heart Failure; Palliative Therapy; Pediatric Cardiology; Terminal Care; Cardiac Surgeon; Child; Clinical Study; Clinical Trial; Controlled Clinical Trial; Female; Human; Intensivist; Life Expectancy; Male; Medical School; Multicenter Study; Skill

Description

While availability of palliative care consultation for children with advanced heart disease increases, little is known about cardiologist attitudes towards palliative care. We sought to describe perspectives of cardiologists regarding palliative care and to characterize their perceived competence in palliative care concepts. A cross-sectional survey of pediatric cardiologists and cardiac surgeons from 19 pediatric medical centers was performed. Overall response rate was 31% (183/589). Respondents had a median of 18 years of experience since medical school (range 2-49) and most practiced at academic centers (91%). Sixty-percent of respondents felt that palliative care consultations occur "too late" and the majority (85%) agreed that palliative care consultations are helpful. Barriers to requesting palliative care consultation were most frequently described as "referring to palliative care services too early will undermine parents' hope" (45%) and "concern that parents will think I am giving up on their child" (56%). Only 33% of cardiologists reported feeling "very" or "moderately" competent in prognosticating life expectancy while over 60% felt competent caring for children with heart disease around end of life, and nearly 80% felt competent discussing goals of care and code status. Greater perceived competence was associated with subspecialty (heart failure/intensivist vs. other) (OR 3.6, 95% CI 1.6-8.1, p = 0.003) and didactic training (OR 6.27, 95% CI 1.8-21.8, p = 0.004). These results underscore the need for further training in palliative care skills for pediatric cardiologists. Enhancing palliative care skills among cardiologists and facilitating partnership with subspecialty palliative care teams may improve overall care of children with advanced heart disease.

Rights

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Citation List Month

September 2017 List

Notes

Using Smart Source Parsing 1-8), Date of Publication: 29 Jun 2017

Citation

Balkin E M; Kirkpatrick J N; Kaufman BD; Swetz K M; Sleeper L A; Wolfe J; Blume E D, “Pediatric Cardiology Provider Attitudes About Palliative Care: A Multicenter Survey Study,” Pediatric Palliative Care Library, accessed March 29, 2024, https://pedpalascnetlibrary.omeka.net/items/show/10760.