Quality Indicators in Pediatric Palliative Care: Considerations for Latin America.
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ABSTRACT:
SUBMITTER: Zuniga-Villanueva G
PROVIDER: S-EPMC8004984 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
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Quality Indicators in Pediatric Palliative Care: Considerations for Latin America.
Zuniga-Villanueva Gregorio G Ramos-Guerrero Jorge Alberto JA Osio-Saldaña Monica M Casas Jessica A JA Marston Joan J Okhuysen-Cawley Regina R
Children (Basel, Switzerland) 20210323 3
Pediatric palliative care is a growing field in which the currently available resources are still insufficient to meet the palliative care needs of children worldwide. Specifically, in Latin America, pediatric palliative care services have emerged unevenly and are still considered underdeveloped when compared to other regions of the world. A crucial step in developing pediatric palliative care (PPC) programs is delineating quality indicators; however, no consensus has been reached on the outcome ...[more]
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Project description:The demand for palliative care is increasing globally, yet a notable lack of awareness continues to present a significant obstacle to its widespread adoption. The use of digital tools like Google Trends can help gauging public interest in specific topics. We used Google Trends to conduct a systematic search of terms related to palliative care from January 1, 2010, to May 10, 2023. The results were filtered by location, including worldwide and Latin American countries. We found a global increase in searches for terms related to palliative care, with a peak in December 2022 associated with the death of Brazilian footballer Pelé. Countries like Brazil, Mexico, and Colombia mirrored this trend, while others like Argentina and Peru did not. Interest in palliative care is on the rise in Latin America, albeit with notable regional variations.
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Project description:ImportanceThe World Health Organization (WHO) designates early integration of palliative care as an ethical responsibility in the treatment of children with serious illness. Although structural barriers may influence provision of pediatric palliative care (PPC) for children with cancer in resource-limited settings, underlying physician perceptions may also impede early integration of PPC in cancer care.ObjectiveTo investigate perceptions among physicians in Latin America about the integration of palliative care for children with cancer.Design, setting, and participantsThis survey study used the Assessing Doctors' Attitudes on Palliative Treatment (ADAPT) survey, which was developed for physicians who care for children with cancer and was initially distributed in Eurasia. The survey was modified for use in Latin America, including translation into Spanish and adaptation for cultural context. The survey was distributed between August 21, 2020, and January 31, 2021, to physicians treating children with cancer in 17 Latin American countries. Each country had a specific survey distribution method based on guidance of local experts.Main outcomes and measuresThe ADAPT survey evaluated physicians' understanding of palliative care principles, comfort in addressing patient and family suffering, and identification of barriers to PPC integration for children with cancer. Univariate and multivariable linear regression analyses were used to assess factors associated with physicians' knowledge about and comfort with PPC practice and whether independent physician variables were associated with survey response alignment with WHO guidance on PPC. Open-ended questions were analyzed qualitatively to supplement the quantitative data.ResultsA total of 874 physicians from 17 countries participated, with an overall response rate of 39.9% (874 of 2193) and a median country response rate of 51.4% (range, 23.7%-100%). Most respondents were aged 35 years or older (577 [66.0%]), and 594 (68.0%) identified as female. Most physicians (486 [55.6%]) had no formal PPC training, and 303 (34.7%) had no access to PPC experts for consultation. Physician perspectives on PPC were generally aligned with WHO guidance (mean [SD] alignment, 83.0% [14.1%]; range among respondents, 24.0%-100%). However, only 438 respondents (50.1%) felt comfortable addressing physical symptoms of patients receiving PPC, 295 (33.8%) felt comfortable addressing emotional symptoms, and 216 (24.7%) felt comfortable addressing grief and bereavement needs of the patient's family. A total of 829 participants (94.8%) desired further education and training in PPC.Conclusion and relevanceAlthough physicians' perspectives aligned well with WHO guidance for PPC, this survey study identified opportunities for improving physician training in symptom management and emotional support for children with cancer and their families. These findings may inform the development of targeted interventions to improve the quality of PPC for children with cancer in Latin America.
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Project description: Not available
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