AI Article Synopsis
- The establishment of a Palliative Care Unit (PCU) integrated with the Pediatric Hematology Oncology Department (PHOD) aims to reduce suffering in children with cancer by providing earlier access to palliative care.
- A retrospective study of patient records shows that after the PCU was established in 1999, a significant majority of patients (59%) were admitted to the PCU, with poor prognosis patients benefiting from earlier and more frequent hospitalizations.
- The introduction of the PCU led to a notable decrease in the percentage of patients dying in general or hematology-oncology wards and at home, indicating an improvement in the quality of end-of-life care for pediatric oncology patients.
Article Abstract
Background: The sharp division between curative cancer therapy and palliative care results in the late introduction of palliative care and a high incidence of suffering in children with cancer. We established a Palliative Care Unit (PCU) that is fully integrated with the Pediatric Hematology Oncology Department (PHOD). We wished to explore the impact of such integrative model on patterns of hospitalizations and exposure to palliative care of pediatric oncology patients.
Procedures: Retrospective search of medical records of patients admitted to the PHOD since PCU establishment in 1999, and of children who died from progressive disease between 1990 and 2005 was performed. Differences in clinical and prognostic variables between PCU and non-PCU patients, and differences in location of death before and after PCU establishment were evaluated.
Results: The majority (59%) of patients, who were hospitalized after the PCU establishment, were hospitalized in the PCU, including 49% of the good prognosis patients and 91% of the poor prognosis patients. Poor prognosis patients were hospitalized in the PCU earlier and with higher frequency compared to children with curable disease. After PCU opening there was a significant decline in the percentage of patients who died in the general pediatric ward, hematology-oncology ward, and at home from 40%, 26% and 28% to 4%, 8%, and 16%, respectively.
Conclusions: Our integrative model results in exposure of the majority of children with cancer to palliative care. For poor prognosis patients, palliative care is introduced early enough to allow gradual transition from symptom control after diagnosis to end of life care.
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| http://dx.doi.org/10.1002/pbc.21476 | DOI Listing |
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