Document Detail

Moving toward quality palliative cancer care: parent and clinician perspectives on gaps between what matters and what is accessible.
MedLine Citation:
PMID:  23182989     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The National Consensus Project (NCP) published a set of standards for quality palliative care delivery. A key step before applying these guidelines to pediatric oncology is to evaluate how much families and clinicians value these standards. We aimed to determine which elements of palliative care are considered important according to bereaved parents and pediatric oncology clinicians and to determine accessibility of these elements.
METHODS: We administered questionnaires to 75 bereaved parents (response rate, 54%) and 48 pediatric oncology clinicians (response rate, 91%) at a large teaching hospital. Outcome measures included importance ratings and accessibility of core elements of palliative care delivery.
RESULTS: Fifteen of 20 core elements were highly valued by both parents and clinicians (defined as > 60% of parents and clinicians reporting the item as important). Compared with clinicians, parents gave higher ratings to receiving cancer-directed therapy during the last month of life (P < .01) and involvement of a spiritual mentor (P = .03). Of the valued elements, only three were accessible more than 60% of the time according to clinicians and parents. Valued elements least likely to be accessible included a direct admission policy to hospital, sibling support, and parent preparation for medical aspects surrounding death.
CONCLUSION: Parents and clinicians highly value a majority of palliative care elements described in the NCP framework. Children with advanced cancer may not be receiving key elements of palliative care despite parents and clinicians recognizing them as important. Evaluation of barriers to provision of quality palliative care and strategies for overcoming them are critical.
Alisha Kassam; Julia Skiadaresis; Sharifa Habib; Sarah Alexander; Joanne Wolfe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-11-26
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  31     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-26     Completed Date:  2013-04-12     Revised Date:  2013-10-07    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  910-5     Citation Subset:  IM    
Hospital for Sick Children, Ontario, Canada.
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MeSH Terms
Child, Preschool
Delivery of Health Care / organization & administration*,  standards
Health Services Accessibility*
Hospitals, Teaching
Leukemia / therapy
Lymphoma / therapy
Middle Aged
Neoplasms* / therapy
Palliative Care / standards*
Patient Care Team*
Quality of Health Care*
United States
Comment In:
J Clin Oncol. 2013 Aug 20;31(24):3047-8   [PMID:  23943830 ]
J Clin Oncol. 2013 Aug 20;31(24):3047   [PMID:  23878297 ]
Nat Rev Clin Oncol. 2013 Feb;10(2):65   [PMID:  23229178 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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