Downing Julia, Daniels Alexandra, McNeil Michael J, Ndagire Mariam, Palat Gayatri, Rassam Rime S, Baker Justin N
International Children's Palliative Care Network (ICPCN), BS1 2NT Bristol, UK.
International Children's Palliative Care Network (ICPCN), Durban 3624, South Africa.
Ecancermedicalscience. 2024 Dec 12;18:1823. doi: 10.3332/ecancer.2024.1823. eCollection 2024.
More than 21 million children globally need access to palliative care (PC) - including children with cancer. Providing Paediatric Palliative Care (PPC) for children with cancer is an ethical imperative with pain relief being recognised as a human right and an important public health consideration, with PPC being essential for reducing suffering in children and families. PPC addresses children's symptoms and aims to provide comfort even if a cure is not possible. PC for children with cancer is about ensuring that the child and family have the best possible quality of life starting at diagnosis and throughout the disease trajectory regardless of cancer treatment outcomes. Many principles of PPC for children with cancer are similar to those for children with other serious health conditions. These include the following: promotion of quality of life; provision of PC care across the continuum of care (from diagnosis through to bereavement); pain and symptom management; emotional support; social care; spiritual care; good communication with children and family; advance care planning; end-of-life care; and bereavement care. PPC should be provided across the range of care settings, wherever the child and their family need care, by an inter-disciplinary team providing support to the child, their families (including siblings) and other significant others, and consider the financial impact of having a child with cancer. It should not be a last resort, but an essential component of care. In this paper, we provide a brief overview of the integration of PPC into paediatric cancer care through the review of challenges in providing PPC in paediatric oncology, global examples of clinical provision of PPC in paediatric cancer care, a review of global research priorities in this area and examples of global education programmes aimed at improving PPC in paediatric cancer care.
全球有超过2100万儿童需要获得姑息治疗（PC），其中包括癌症患儿。为癌症患儿提供儿科姑息治疗（PPC）是一项道德责任，缓解疼痛被视为一项人权和重要的公共卫生考量，PPC对于减轻患儿及其家庭的痛苦至关重要。PPC可缓解患儿症状，即便无法治愈也旨在提供舒适感。为癌症患儿提供的PC旨在确保患儿及其家庭从诊断开始直至整个疾病进程中都能拥有尽可能好的生活质量，而不论癌症治疗结果如何。许多针对癌症患儿的PPC原则与针对其他严重健康状况患儿的原则相似。这些原则包括以下方面：提高生活质量；在整个护理连续过程（从诊断到丧亲之痛）中提供PC护理；疼痛和症状管理；情感支持；社会护理；精神护理；与患儿及其家庭进行良好沟通；预先护理规划；临终护理；以及丧亲护理。PPC应在各种护理环境中提供，只要患儿及其家庭需要护理，由一个跨学科团队为患儿、其家庭（包括兄弟姐妹）和其他重要他人提供支持，并考虑到有癌症患儿家庭的经济影响。它不应是最后的手段，而应是护理的重要组成部分。在本文中，我们通过回顾儿科肿瘤学中提供PPC的挑战、儿科癌症护理中PPC临床提供的全球实例、该领域全球研究重点的综述以及旨在改善儿科癌症护理中PPC的全球教育项目实例，简要概述了PPC融入儿科癌症护理的情况。
