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 EM; Kirkpatrick JN; Kaufman B; Swetz KM; Sleeper LA; Wolfe J; Blume ED

Publisher

Pediatric Cardiology

Date

2017

Subject

Attitude of Health Personnel; Clinical Competence/sn [Statistics & Numerical Data]; Heart Diseases/th [Therapy]; Palliative Care/sn [Statistics & Numerical Data]; Physicians/px [Psychology]; Cardiology; Child; Cross-Sectional Studies; Female; Humans; Male; Parents/px [Psychology]

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

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here.

Citation List Month

October 2018 List

Pages

1324-1331

Issue

7

Volume

38

Collection

Citation

Balkin EM; Kirkpatrick JN; Kaufman B; Swetz KM; Sleeper LA; Wolfe J; Blume ED, “Pediatric Cardiology Provider Attitudes About Palliative Care: A Multicenter Survey Study,” Pediatric Palliative Care Library, accessed July 25, 2021, https://pedpalascnetlibrary.omeka.net/items/show/15567.

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