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Paediatric palliative care

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https://www.readbyqxmd.com/read/28814489/right-ventricular-outflow-tract-stent-versus-bt-shunt-palliation-in-tetralogy-of-fallot
#1
Daniel Quandt, Bharat Ramchandani, Gemma Penford, John Stickley, Vinay Bhole, Chetan Mehta, Timothy Jones, David James Barron, Oliver Stumper
OBJECTIVE: This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions. METHODS: Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period...
August 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28793184/survey-highlights-the-need-for-specific-interventions-to-reduce-frequent-conflicts-between-healthcare-professionals-providing-paediatric-end-of-life-care
#2
Marie-Anne Archambault-Grenier, Marie-Hélène Roy-Gagnon, France Gauvin, Hubert Doucet, Nago Humbert, Sanja Stojanovic, Antoine Payot, Sylvie Fortin, Annie Janvier, Michel Duval
AIMS: This study explored how paediatric healthcare professionals experienced and coped with end-of-life conflicts and identified how to improve coping strategies. METHODS: A questionnaire was distributed to all 2,300 professionals at a paediatric university hospital, covering the frequency of end-of-life conflicts, participants, contributing factors, resolution strategies, outcomes and the usefulness of specific institutional coping strategies. RESULTS: Of the 946 professionals (41%) who responded, 466 had witnessed or participated in paediatric end-of-life discussions: 73% said these had led to conflict, more frequently between professionals (58%) than between professionals and parents (33%)...
August 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28705790/children-with-life-limiting-conditions-in-paediatric-intensive-care-units-a-national-cohort-data-linkage-study
#3
Lorna K Fraser, Roger Parslow
OBJECTIVE: To determine how many children are admitted to paediatric intensive care unit (PICU) with life-limiting conditions (LLCs) and their outcomes. DESIGN: National cohort, data-linkage study. SETTING: PICUs in England. PATIENTS: Children admitted to a UK PICU (1 January 2004 and 31 March 2015) were identified in the Paediatric Intensive Care Audit Network dataset. Linkage to hospital episodes statistics enabled identification of children with a LLC using an International Classification of Diseases (ICD10) code list...
July 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28687558/seizure-management-in-children-requiring-palliative-care-a-review-of-current-practice
#4
Nicola Harris, Megumi Baba, Charlotte Mellor, Rebekah Rogers, Kirsty Taylor, Antonia Beringer, Peta Sharples
OBJECTIVES: Controlling seizures in children approaching death can be difficult, and there is a limited evidence base to guide best practice. We compared current practice against the guidance for seizure management produced by the Association of Paediatric Palliative Medicine (APPM). METHODS: Retrospective case note review of episodes of challenging seizure management in children receiving end-of-life care over a 10-year period (2006-2015) in the south-west region of England...
July 7, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28665209/speech-language-pathology-in-paediatric-palliative-care-a-scoping-review-of-role-and-practice
#5
Lillian Krikheli, Bernice A Mathisen, Lindsay B Carey
PURPOSE: Attempts have been made within the literature to clarify the role and scope of speech-language pathologists (SLPs) within paediatric palliative care (PPC). As SLP literature regarding adult/geriatric populations is gaining traction, it is fitting to investigate the role of SLPs in the management of infants and children in end-of-life care. METHOD: Arksey and O'Malley's ( 2005 ) scoping review method was utilised for searching multiple databases. Two database searches were undertaken...
June 30, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28659021/parental-experiences-with-a-paediatric-palliative-care-team-a-qualitative-study
#6
Lisa M Verberne, Antoinette Yn Schouten-van Meeteren, Diederik K Bosman, Derk A Colenbrander, Charissa T Jagt, Martha A Grootenhuis, Johannes Jm van Delden, Marijke C Kars
BACKGROUND: Parents of children with a life-limiting disease have to rely on themselves at home while adequate paediatric palliative care is lacking. In several countries, paediatric palliative care teams are introduced to ensure continuity and quality of care and to support the child and the family. Yet, little is known about how parents experience such multidisciplinary teams. AIM: To obtain insight into the support provided by a new paediatric palliative care team from the parents' perspective...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28644748/paediatric-palliative-medicine-2nd-ed
#7
Roger Woodruff
Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28631529/use-of-buccal-morphine-in-the-management-of-pain-in-children-with-life-limiting-conditions-results-of-a-laboratory-study
#8
Renée McCulloch, Mohammed Sattar, Ellen M Henderson, Majella E Lane, Myra Bluebond-Langner
BACKGROUND: Children and infants with impaired swallow or compromised enteral absorption require alternative routes for administration of analgesia. Recent clinical guidance and practice for paediatric palliative care teams, who often treat such children, supports buccal morphine sulphate as a fast acting, effective and easily administered agent for pain relief. However, a consideration of the physicochemical properties and potency of morphine would suggest that it is not a suitable candidate for delivery via the transmucosal route, raising questions about its use in children and infants...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28627303/the-surprise-question-in-paediatric-palliative-care-a-prospective-cohort-study
#9
Kimberley Burke, Lucy Helen Coombes, Antoinette Menezes, Anna-Karenia Anderson
BACKGROUND: The question 'would you be surprised if this patient died in the next 12-months' is widely used for identifying adult patients in the last year of life. However, this has not yet been studied in children. AIM: To assess the prognostic accuracy of the surprise question when used by a multidisciplinary team to predict survival outcomes of children with life-limiting conditions over a 3 and 12 month period. DESIGN: A prospective cohort study...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28602938/-let-s-bring-her-home-first-patient-characteristics-and-place-of-death-in-specialized-pediatric-palliative-home-care
#10
Hans Ulrich Bender, Martin Bernhard Riester, Gian Domenico Borasio, Monika Führer
CONTEXT: Specialized pediatric palliative home care (SPPHC) is the main pediatric palliative care structure in Germany. Detailed data on patient characteristics and care are sparse. Describing this population in terms of diagnoses and care needs is essential for further development of palliative care services for these patients. OBJECTIVES: We asked whether the population at our center 1) was representative compared with national mortality statistics; 2) showed differences in the clinical course among the four diagnostic categories established by the Association for Children with Terminal Conditions/Royal College of Paediatrics and Child Health; and 3) was different to published populations in pediatric palliative care regarding diagnoses, care, and place of death...
June 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28494634/changing-place-of-death-in-children-who-died-after-discharge-from-paediatric-intensive-care-units-a-national-data-linkage-study
#11
Lorna K Fraser, Sarah Fleming, Roger Parslow
BACKGROUND: Although child mortality is decreasing, more than half of all deaths in childhood occur in children with a life-limiting condition whose death may be expected. AIM: To assess trends in place of death and identify characteristics of children who died in the community after discharge from paediatric intensive care unit. DESIGN: National data linkage study. SETTING/PARTICIPANTS: All children resident in England and Wales when admitted to a paediatric intensive care unit in the United Kingdom (1 January 2004 and 31 December 2014) were identified in the Paediatric Intensive Care Audit Network dataset...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28492812/palliative-care-in-paediatric-oncology-in-nursing-education
#12
Tuani Magalhães Guimarães, Liliane Faria da Silva, Fátima Helena Espírito Santo, Juliana Rezende Montenegro Medeiros de Moraes, Sandra Teixeira de Araújo Pacheco
Objective: To identify and understand the view of students regarding palliative care in paediatric oncology during a graduate programme. Methods: Exploratory research with a qualitative approach conducted in a school of nursing in Rio de Janeiro. Data were collected from September to November 2014, through semi-structured interviews with 20 students enrolled in the last period of a graduate programme. The data were subjected to thematic analysis. Results: The results produced two thematic units: the (un)preparedness of nursing students regarding palliative care in paediatric oncology and how the subject of palliative care in paediatric oncology is approached in the graduate programme...
May 4, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28487434/fifteen-minute-consultation-practical-pain-management-in-paediatric-palliative-care
#13
Emily Jane Harrop, Karen Brombley, Katherine Boyce
Pain and distress in the paediatric palliative care population can be very difficult to manage. Clinical scenarios range from the acute management of cancer-related pain at the end of life to the ongoing long-term support of children with complex multimodal pain related to progressive neurological conditions. Understanding the child's underlying condition, possible causes of pain and their preferred mode of communication are important to the delivery of holistic care. Modification of environmental factors, basic care consideration and non-pharmacological measures have a large role to play, alongside conventional analgesics...
May 9, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28432088/gps-and-paediatric-oncology-palliative-care-a-q-methodological-study
#14
Sue Neilson, Faith Gibson, Stephen Jeffares, Sheila M Greenfield
OBJECTIVE: This mixed-methods study set in the West Midlands region of the UK demonstrates the effectiveness of Q methodology in examining general practitioners' (GPs') perception of their role in children's oncology palliative care. METHODS: Using data obtained from the analysis of semistructured interviews with GPs who had cared for a child receiving palliative care at home and bereaved parents, 50 statements were identified as representative of the analysis findings...
April 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#15
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28386399/development-of-research-priorities-in-paediatric-pain-and-palliative-care
#16
Christina Liossi, Anna-Karenia Anderson, Richard F Howard
Priority setting for healthcare research is as important as conducting the research itself because rigorous and systematic processes of priority setting can make an important contribution to the quality of research. This project aimed to prioritise clinical therapeutic uncertainties in paediatric pain and palliative care in order to encourage and inform the future research agenda and raise the profile of paediatric pain and palliative care in the United Kingdom. Clinical therapeutic uncertainties were identified and transformed into patient, intervention, comparison and outcome (PICO) format and prioritised using a modified Nominal Group Technique...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28377450/specialist-paediatric-palliative-care-services-what-are-the-benefits
#17
Sarah Mitchell, Andrew Morris, Karina Bennett, Laiba Sajid, Jeremy Dale
BACKGROUND: The number of children and young people (CYP) living with life-limiting and life-threatening conditions is rising. Paediatric palliative care is a relatively new aspect of healthcare, the delivery of which is variable, with a wide range of healthcare and voluntary sector providers involved. Policy recommendations are for Specialist Paediatric Palliative Care (SPPC) services to be supported by a physician with specialist training. AIM: To examine the research evidence regarding the distinct benefits of SPPC services, with 'Specialist Paediatric Palliative Care' defined as palliative care services supported by a specialist physician...
April 4, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28370728/towards-culturally-competent-paediatric-oncology-care-a%C3%A2-qualitative-study-from-the-perspective-of-care-providers
#18
J Suurmond, A Lieveld, M van de Wetering, A Y N Schouten-van Meeteren
In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication...
March 28, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28329430/maintaining-family-life-balance-while-facing-a-child-s-imminent-death-a-mixed-methods-study
#19
Katri Eskola, Eva Bergstraesser, Karin Zimmermann, Eva Cignacco
AIM: To understand parents' experiences and needs during a child's end-of-life care at home and to identify systemic factors that influence its provision. BACKGROUND: A child's end-of-life phase is an extremely difficult time for the whole family. Parents have specific needs, especially when they care for a dying child at home. DESIGN: Concurrent embedded mixed methods design. METHODS: This sub-study of the nationwide survey, 'Paediatric End-of-Life Care Needs in Switzerland' (2012-2015) included 47 children who received EOL care at home from 2011-2012...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28294926/-paediatric-palliative-care-multidisciplinary-and-pro-active
#20
G C B Bindels de Heus, L M Ball, E M C Michiels, H A Moll, E H Niks, S M van Walraven
Every child with a life-limiting or threatening illness, and his or her family, has a right to palliative care. Palliative care is not limited to end-of-life care, but starts from the moment of diagnosis and is independent of whether there are curative options. To optimise quality of life of both the child and the family, the emphasis of care should be on both somatic and psychosocial and spiritual aspects from the very start, and goals should be set together with the child and the family. A multidisciplinary and pro-active approach is essential if this is to be achieved...
2017: Nederlands Tijdschrift Voor Geneeskunde
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