Lacerda Ana, Bravo-Carretero Isabel M, Ehrlich Bella S, Job Godwin, Avilés Martínez María, Leiss Ulrike, Kokkinou Georgia, Scheinemann Katrin, Craig Finella, Krottendorfer Kerstin, Devidas Meenakshi, Baker Justin N, Agulnik Asya, McNeil Michael J
European Society of Paediatric Oncology (SIOP) Europe Palliative Care Working Group Steering Committee, Brussels, Belgium.
European Association for Palliative Care Children and Young People Reference Group Steering Committee, Vilvoorde, Belgium.
Front Oncol. 2024 Oct 23;14:1461668. doi: 10.3389/fonc.2024.1461668. eCollection 2024.
Integrating pediatric palliative care (PPC) into pediatric oncology standard care is essential. Therefore, it is important to assess physicians' knowledge and perceptions of PPC to optimize its practice.
To evaluate the knowledge, comfort levels, and perspectives of physicians regarding the timing and perceived barriers to integrating PPC into pediatric cancer care across Europe.
The Assessing Doctors' Attitudes on Palliative Treatment (ADAPT) survey, originally developed for other global regions, was culturally and contextually adapted for Europe.
SETTING/SUBJECTS: The survey was distributed via the European Society of Paediatric Oncology (SIOPE) membership listserv. Any physicians caring for children with cancer across Eastern, Southern, Central, and Northern Europe were invited to complete the survey.
A total of 198 physicians from 29 European countries completed the ADAPT survey. Physicians demonstrated relative agreement with the World Health Organization's guidance; median alignment was 83.4% (range 59.9%-94.1%). Although most respondents felt comfortable addressing physical (84.4%) and emotional (63.4%) needs, they felt less comfortable addressing spiritual needs (41.9%) and providing grief and bereavement support (48.5%). There were significant regional differences, such as physicians in Eastern and Southern Europe reporting a lack of PPC specialists, opioids, and home-based care, while those in Northern and Central Europe did not.
Physicians caring for children with cancer throughout Europe have a good understanding of PPC. However, misconceptions about PPC persist, requiring educational and capacity-building efforts. Additionally, the regional differences in perceived barriers must be addressed to ensure equitable access to PPC for all European children with cancer.
将儿童姑息治疗（PPC）纳入儿科肿瘤标准治疗至关重要。因此，评估医生对PPC的知识和认知对于优化其实践非常重要。
评估欧洲各地医生关于将PPC纳入儿科癌症护理的时机以及感知障碍的知识、舒适度和观点。
最初为其他全球地区开发的评估医生对姑息治疗态度（ADAPT）调查，在文化和背景上针对欧洲进行了调整。
地点/受试者：该调查通过欧洲儿科肿瘤学会（SIOPE）会员邮件列表分发。邀请了北欧、南欧、中欧和东欧任何照顾癌症儿童的医生完成该调查。
来自29个欧洲国家的198名医生完成了ADAPT调查。医生们对世界卫生组织的指导意见表现出相对一致的看法；中位数一致性为83.4%（范围为59.9%-94.1%）。尽管大多数受访者对满足身体需求（84.4%）和情感需求（63.4%）感到自在，但他们对满足精神需求（41.9%）和提供悲伤及丧亲支持（48.5%）感到不那么自在。存在显著的地区差异，例如东欧和南欧的医生报告缺乏PPC专家、阿片类药物和居家护理，而北欧和中欧的医生则没有这种情况。
欧洲各地照顾癌症儿童的医生对PPC有很好的理解。然而，对PPC的误解仍然存在，需要开展教育和能力建设工作。此外，必须解决感知障碍方面的地区差异，以确保所有欧洲癌症儿童都能公平获得PPC。
