ABSTRACT
Recommendations for best practice from the American Academy of Pediatrics include the availability of palliative care for children with life-threatening or life-limiting health care conditions. The uniqueness of the both the pediatric population and a pediatric health care setting requires changing the culture that previously has provided only curative or hospice care to these individuals. Methods to provide palliative care alongside of treatment and coordination of these efforts must be multidisciplinary and include family members.
Subject(s)
Hospitals, Pediatric/organization & administration , Palliative Care , Patient Care Team , Female , Humans , MaleABSTRACT
Although pediatric palliative care has become more accessible over the past decade, little research has been performed that focuses on the financial impact of providing palliative care in an inpatient hospital setting. Using a case-controlled methodology, health care costs and the distribution of these costs were compared between children who received palliative care to those who did not. In comparing children who received palliative services to case controls, the similarities are striking, and the differences may have clinical significance. Children receiving care coordinated by the palliative care program underwent fewer radiology procedures and received greater assistance from pharmacologic services. This reflects greater attention and interventions provided to treat pain and provide comfort.
Subject(s)
Palliative Care/economics , Pediatrics , Adolescent , Child , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
The authors examine the impact of childhood leukemia on the career development of 11 young adult survivors, using consensual qualitative research. They discuss the results and implications of childhood leukemia on the survivor's career, family, and future expectations, and provide recommendations for addressing the critical coping and management challenges encountered by survivors, their families, and the helping professionals who treat them.
Subject(s)
Career Choice , Family/psychology , Leukemia/psychology , Survivors/psychology , Adaptation, Psychological , Adolescent , Adult , Demography , Female , Humans , Male , Qualitative ResearchABSTRACT
The American Academy of Pediatrics has provided clinical recommendations for palliative care needs of children. This article outlines the steps involved in implementing a pediatric palliative care program in a Midwest pediatric magnet health care facility. The development of a Pediatric Advanced Comfort Care Team was supported by hospital administration and funded through grants. Challenges included the development of collaborative relationships with health care professionals from specialty areas. Pediatric Advanced Comfort Care Team services, available from the time of diagnosis, are provided by a multidisciplinary team of health care professionals and individualized on the basis of needs expressed by each child and his or her family.
Subject(s)
Child Health Services , Child Welfare , Health Services Needs and Demand , Palliative Care , Patient Care Team , Pediatric Nursing , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Program Development , Program Evaluation , Quality of LifeABSTRACT
Little is known about the long-term impact of surviving childhood cancer. Most children diagnosed with cancer now survive into adulthood due to advances in medical treatment. Although the number of survivors of childhood cancer has increased, a review of the literature revealed a paucity of studies that explores survivorship of childhood cancer from the perspective of the adult survivor. The purpose of this phenomenological study was to examine the lived experience of 12 adults who survived childhood cancer. This research methodology allows the meaning or essences of experiences that occurred to be uncovered. Four themes emerged from these data: (1) ongoing consequences for having had cancer, (2) living with uncertainty, (3) the cancer experience is embodied into one's present sense of self, and (4) support is valued. The results of this study demonstrate that a childhood cancer experience affects the life of each survivor, which results in specific health care needs. This knowledge is important as the number of survivors increases. Knowledge of their concerns is imperative prior to providing appropriate health care.
Subject(s)
Adaptation, Psychological , Attitude to Health , Neoplasms/psychology , Survivors/psychology , Activities of Daily Living , Adult , Aftercare , Cost of Illness , Disabled Persons/psychology , Female , Health Services Needs and Demand , Humans , Life Change Events , Male , Middle Aged , Midwestern United States , Neoplasms/complications , Neoplasms/therapy , Nurse's Role , Nursing Methodology Research , Oncology Nursing , Quality of Life , Self Concept , Social Support , Surveys and Questionnaires , UncertaintyABSTRACT
The purpose of this qualitative descriptive study was to allow childhood leukemia patients to describe their quality of life (QoL) in their own words. These personal accounts provide an opportunity for health care personnel to understand the impact that leukemia has on these children. A total of 13 children in three focus group interviews participated. They ranged in age from 5 to 9 years and were either off therapy or had completed at least 6 months of treatment. Four semistructured interview questions were used to guide the interviews. Each question related to a domain identified in previous research as having an effect on QoL. Thus, the areas explored in this study were (a) physical well-being and symptoms, (b) psychological well-being, (c) social well-being, and (d) spiritual well-being. Five themes were identified: (a) fatigue, (b) the effect on activities, (c) medication and treatment effects, (d) relationship changes, and (e) hair loss.
Subject(s)
Leukemia/psychology , Quality of Life , Child , Child, Preschool , Female , Focus Groups , Humans , MaleABSTRACT
Difficulty administering oral corticosteroids to young children who are required to take these medications as part of their cancer treatment has been a concern among health care providers for many years. This problem is due in part to the bad taste associated with these preparations. Palatability is important to consider when prescribing a liquid corticosteroid. Seven members of a nursing research group in an academic pediatric setting evaluated palatability based on taste, aftertaste, texture, smell, and overall reaction to five different liquid corticosteroid formulations. These formulations included Pediapred (Medeva Pharmaceuticals, Rochester, NY), Prelone (Muro Pharmaceuticals, Tewksbury, MA), prednisone oral solution, prednisone intensol, and prednisone 10-mg tablet crushed in 10 mL of cherry syrup. The cost of each formulation was based on the cost to the participating institution. The results showed that the most palatable corticosteroid liquid formulation was also the most cost efficient. The results of this simple study have the potential to influence prescribing habits and provide caregivers with a palatable, cost-efficient corticosteroid liquid formulation.
