Ebrahimi Alireza, Ebrahimi Sedigheh
Student of Medicine, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Associate Professor, Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran.
J Med Ethics Hist Med. 2018 Dec 30;11:16. eCollection 2018.
One issue that has received less attention in present health care protocols is pediatric palliative care (PPC), which is an approach to care starting with the diagnosis of life-threatening diseases in children. It embraces physical, emotional and spiritual elements. Ethical issues are major concerns in today's pediatric health care guidelines and must be considered by residents and attending physicians in this field. The present study was conducted in Namazi Teaching Hospital, Shiraz, Iran Forty-eight out of 92 pediatricians were enrolled in this research, including 8 attendings, 6 fellows, and 34 residents. The study questionnaire consisted of 66 items. It was built based on previous reliable and validated questionnaire; also the calculated Cranach's alpha was 0.815. Data were analyzed and presented by mean SD and percentage. While seventy-five percent of the participants reported involvement in pediatric palliative care, fifty-six percent did not acknowledge any information about the subject. More than half of the participants perceived the pediatric palliative care services in Namazi Hospital as somewhat or completely satisfactory. Furthermore, thirty-five percent of the applicants stated that they encounter an ethical problem with regard to PPC once a week. There are many challenges to providing decent palliative care for children, including symptom controlling, shifting to end of life care, background dissimilarities of patients, financial restrictions, and acceptance of death. Our applicants believed that offering psycho-spiritual support was the most important challenge in PPC. However, further investigations are needed to determine other requirements for providing a comprehensive guideline on PPC.
在当前医疗保健方案中较少受到关注的一个问题是儿科姑息治疗（PPC），这是一种从儿童被诊断出患有危及生命的疾病时就开始的护理方法。它包含身体、情感和精神等方面。伦理问题是当今儿科医疗保健指南中的主要关注点，该领域的住院医师和主治医师必须加以考虑。本研究在伊朗设拉子的纳马齐教学医院开展。92名儿科医生中有48人参与了这项研究，包括8名主治医师、6名研究员和34名住院医师。研究问卷由66个项目组成。它是基于先前可靠且经过验证的问卷编制而成；计算得出的克朗巴哈系数为0.815。数据通过均值标准差和百分比进行分析和呈现。虽然75%的参与者报告参与过儿科姑息治疗，但56%的人表示对该主题没有任何了解。超过一半的参与者认为纳马齐医院的儿科姑息治疗服务有些或完全令人满意。此外，35%的参与者表示他们每周会遇到一次与儿科姑息治疗相关的伦理问题。为儿童提供体面的姑息治疗存在许多挑战，包括症状控制、转向临终关怀、患者背景差异、经济限制以及对死亡的接受。我们的参与者认为提供心理 - 精神支持是儿科姑息治疗中最重要的挑战。然而，需要进一步调查以确定提供全面的儿科姑息治疗指南的其他要求。
