Symptoms and Suffering at the End of Life in Children with Cancer

Symptoms and Suffering at the End of Life in Children with Cancer

Wolfe J; Grier Holcombe E; Klar Neil; Levin SB; Ellenbogen JM; Salem-Schatz S; Emanuel EJ; Weeks Jane C

New England Journal Of Medicine

2000

Child; Humans; Terminal Care; Health Care Surveys; Parents; Withholding Treatment; Logistic Models; Questionnaires; Physicians; Boston; Longitudinal Studies; Quality of Health Care; quality of life; Empirical Approach; Non-U.S. Gov't; P.H.S.; Professional Patient Relationship; Research Support; U.S. Gov't; Death and Euthanasia; Psychological; Stress; Clodronate; Neoplasms/complications/therapy; Oncology at EOL; Pain/etiology/therapy; Anorexia/etiology/therapy; home care services; Children's Hospital (Boston); Constipation/etiology/therapy; Dana-Farber Cancer Institute (Boston); Diarrhea/etiology/therapy; Dyspnea/etiology/therapy; Fatigue/etiology/therapy; Palliative Care/standards/statistics & numerical data

Cancer is the leading cause of nonaccidental death in childhood.1 There has, however, been little evaluation of the overall experience at the end of life of children who are dying of cancer or of their symptoms other than pain.2,3 A number of studies have demonstrated that among adults, the quality of care at the end of life is suboptimal.4–8 For example, one study of elderly patients found that there was considerable suffering at the end of life, with up to 25 percent of patients experiencing moderate-to-severe pain in the last three days of life.7 It is not known . . .

2000-02

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