Department of Pediatrics, Gillette Children's Specialty Healthcare, St. Paul, Minnesota.
Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, Ohio.
Pediatr Blood Cancer. 2018 Jun;65(6):e26996. doi: 10.1002/pbc.26996. Epub 2018 Feb 8.
The goal of this study was to assess pediatric oncology providers' perceptions of palliative care in order to validate previously identified barriers and facilitators to early integration of a pediatric palliative care team (PCT) in the care of children with cancer.
A 36-question survey based on preliminary, single-institution data was electronically distributed to pediatric oncology physicians, nurse practitioners, nurses, and social workers nationally. The principal outcomes measured included perceived barriers and facilitators to early integration of pediatric palliative care. Data were analyzed using Rv3.1.2 statistical software.
Most respondents agreed that the PCT does not negatively impact the role of the oncologist; however, there were concerns that optimal patient care may be limited by pediatric oncologists' need to control all aspects of patient care (P < 0.001). Furthermore, oncologists, more than any provider group, identified that the emotional relationship they form with the patients and families they care for, influences what treatment options are offered and how these options are conveyed (P < 0.01). Education and evidence-based research remain important to all providers. Respondents reached consensus that early integration of a PCT would provide more potential benefits than risks and most would not limit access to palliative care based on prognosis.
Overall, providers endorse early integration of the PCT for children with cancer. There remains a continued emphasis on provider and patient education. Palliative care is generally accepted as providing a benefit to children with cancer, though barriers persist and vary among provider groups.
本研究旨在评估儿科肿瘤学提供者对姑息治疗的看法，以验证先前确定的在癌症患儿的治疗中尽早整合儿科姑息治疗团队（PCT）的障碍和促进因素。
一项基于初步单机构数据的 36 个问题的调查通过电子方式分发给全国的儿科肿瘤学医生、护士从业者、护士和社会工作者。主要结果测量包括对早期整合儿科姑息治疗的障碍和促进因素的感知。使用 Rv3.1.2 统计软件分析数据。
大多数受访者认为 PCT 不会对肿瘤学家的角色产生负面影响；然而，有人担心，儿科肿瘤学家控制患者护理所有方面的需求可能会限制最佳患者护理（P<0.001）。此外，肿瘤学家比任何提供者群体都更认为，他们与所照顾的患者和家庭之间形成的情感关系会影响提供的治疗选择以及如何传达这些选择（P<0.01）。教育和循证研究仍然对所有提供者都很重要。受访者达成共识，即早期整合 PCT 将提供更多的潜在益处而不是风险，并且大多数人不会根据预后限制获得姑息治疗的机会。
总体而言，提供者支持为癌症患儿尽早整合 PCT。继续强调提供者和患者的教育。姑息治疗通常被认为对癌症患儿有益，尽管障碍仍然存在，并且在提供者群体之间存在差异。
