Pediatric Palliative Care, Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Department of Pediatrics, Emory University, Atlanta, Georgia, USA.
Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
J Pain Symptom Manage. 2020 Sep;60(3):512-521.e7. doi: 10.1016/j.jpainsymman.2020.04.009. Epub 2020 Apr 20.
Pediatric palliative care (PPC) can improve quality of life of children with life-threatening conditions and their families. However, PPC resources vary by state and within a state, and PPC resources and personnel are often inequitably distributed toward urban areas with major hospital systems. A community needs assessment (CNA) that evaluates the current status of PPC and pediatric hospice care can help identify gaps and opportunities to improve PPC access.
A CNA was performed in the state of Georgia to explore the scope and gaps of PPC and hospice services and plan for what is needed to grow PPC and hospice services.
The CNA used a mixed-methods approach, including a community profile, literature search, windshield survey, key informant interviews, and a quantitative online survey. The methodology is outlined in a companion article, entitled "A methodological approach to conducting a statewide community needs assessment of pediatric palliative care and hospice resources."
Four key themes were identified from synthesis of primary and secondary data collection: defining and providing PPC, the environment for PPC in Georgia, coordination and collaboration, and the future of PPC in Georgia. Recommendations to improve PPC services in Georgia were categorized by feasibility and importance. High feasibility and high importance recommendations included expanding PPC education for both providers and patients and creating a formal network or coalition of PPC providers and allies who can work collaboratively at multiple care levels across Georgia in expanding PPC services.
In Georgia, this assessment provides the foundation for next steps in coordinated efforts between hospital-based clinicians, state hospice and palliative care organizations, and state policy makers to ultimately expand PPC care available to children and families.
儿科姑息治疗（PPC）可以提高患有危及生命疾病的儿童及其家庭的生活质量。然而，PPC 资源因州而异，在一个州内也存在差异，而且 PPC 资源和人员往往不均等地分配到拥有大型医院系统的城市地区。一项评估 PPC 和儿科临终关怀服务现状的社区需求评估（CNA）可以帮助确定差距和机会，以改善 PPC 的可及性。
在佐治亚州进行了一项 CNA，以探讨 PPC 和临终关怀服务的范围和差距，并计划扩大 PPC 和临终关怀服务所需的资源。
CNA 使用了混合方法，包括社区概况、文献检索、挡风玻璃调查、关键知情人访谈和定量在线调查。该方法在一篇题为“开展全州范围的儿科姑息治疗和临终关怀资源社区需求评估的方法学方法”的文章中进行了概述。
从主要和次要数据收集的综合中确定了四个关键主题：定义和提供 PPC、佐治亚州 PPC 环境、协调与合作以及佐治亚州 PPC 的未来。改善佐治亚州 PPC 服务的建议按可行性和重要性进行了分类。高可行性和高重要性的建议包括扩大提供者和患者的 PPC 教育，以及创建一个正式的 PPC 提供者和盟友网络或联盟，他们可以在整个佐治亚州的多个护理水平上协作，扩大 PPC 服务。
在佐治亚州，这项评估为医院临床医生、州临终关怀和姑息治疗组织以及州政策制定者之间协调努力的下一步提供了基础，最终将扩大为儿童和家庭提供的 PPC 护理。
