Evans Amanda M, Thabrew Hiran, Arroll Bruce, Cole Nyree, Drake Ross
Paediatric Palliative Care Service, Starship Children's Health, Auckland and Mary Potter Hospice, Wellington 6242, New Zealand.
Consult Liaison Psychiatry Team, Starship Children's Health and University of Auckland, Auckland 1010, New Zealand.
Children (Basel). 2021 Apr 29;8(5):356. doi: 10.3390/children8050356.
Psychosocial and palliative care support during stem cell transplants (SCT) is known to improve outcomes.
evaluate the support provided to children and families at the New Zealand National Allogeneic Stem Cell Transplant unit (NATC).
the psychosocial and palliative care support for children who received SCT between December 2012 and April 2018 was audited.
of the 101 children who received SCT, 97% were reviewed by the social work team (SW) and 82% by the psychiatric consult liaison team (CLT) at least once during their illness. However, pre-transplant psychological assessment only occurred in 16%, and during the SCT admission, only 55% received SW support, and 67% received CLT support. Eight out of eighty-five families (9%) were offered support for siblings. Eight of the sixteen children who died were referred for pediatric palliative care (PPC) with all supported and half the families who experienced a death ( = 8; 50%) received bereavement follow up.
although the majority received some social work and psychological support, auditing against the standards suggests the consistency of involvement could be improved. Referrals for PPC were inadequate and largely for end-of-life phase. Sibling support, in particular donor siblings, had insufficient psychological assessment and support. Key recommendations are provided to address this underperformance.
已知在干细胞移植(SCT)期间提供心理社会和姑息治疗支持可改善治疗结果。
评估新西兰国家异基因干细胞移植单位(NATC)为儿童及其家庭提供的支持。
对2012年12月至2018年4月期间接受SCT的儿童的心理社会和姑息治疗支持进行了审核。
在101名接受SCT的儿童中,97%至少在患病期间接受过社会工作团队(SW)的评估,82%接受过精神科咨询联络团队(CLT)的评估。然而,移植前的心理评估仅占16%,在SCT住院期间,只有55%的儿童接受了SW的支持,67%接受了CLT的支持。八十五个家庭中有八个(9%)获得了针对兄弟姐妹的支持。十六名死亡儿童中有八名被转介接受儿科姑息治疗(PPC),所有人都得到了支持,经历孩子死亡的家庭中有一半(=8;50%)接受了丧亲后续跟进。
尽管大多数儿童接受了一些社会工作和心理支持,但对照标准进行审核表明,参与的一致性仍可提高。PPC的转介不足,且主要集中在生命末期。对兄弟姐妹的支持,尤其是供体兄弟姐妹,心理评估和支持不足。针对这种表现不佳的情况提供了关键建议。