A Provider-Based Survey To Assess Bereavement Care Knowledge, Attitudes, and Practices in Pediatric Oncologists

Jensen, Jasmin; Weng, Cindy

doi:10.1089/jpm.2015.0430

Cited by 35 publications

(41 citation statements)

References 30 publications

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“…The palliative care team began with funding from the Institute for Healthcare Improvement and later expanded with funding from a philanthropic grant. In the absence of such funding, PPC programs may struggle to support enough staff to enable some critical aspects of an integrated PPC team, such as 24/7 availability of staff for consults and the provision of bereavement care . Thus, even when formal PPC programs are in place, access to comprehensive services for children with cancer still may be limited.…”

Section: Resultsmentioning

confidence: 99%

“…29 Although most of these plans cover some home health services, 15 they may exclude or inadequately reimburse supportive services for children with cancer (eg, services provided by psychologists and social workers; physical therapy; bereavement services) that are characteristic of palliative care. [30][31][32] Few plans offer coverage for respite care, a service that might be important for parents coping with the demands of caring for a child with a high-risk cancer. In addition, coverage of home nursing or therapy may be capped at a certain number of clinician visits.…”

Section: Coverage Of Ppc Servicesmentioning

confidence: 99%

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Barriers to accessing palliative care for pediatric patients with cancer: A review of the literature

Haines

Frost

Kane

et al. 2018

Cancer

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Although many of the 16,000 children in the United States diagnosed who are with cancer each year could benefit from pediatric palliative care, these services remain underused. Evidence regarding the barriers impeding access to comprehensive palliative care is dispersed in the literature, and evidence specific to pediatric oncology remains particularly sparse. The purpose of the current review was to synthesize the existing literature regarding these barriers and the strategies offered to address them. The authors completed a literature search using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases. In total, 71 articles were reviewed. Barriers to accessing pediatric palliative care were categorized according to the 4 levels of a modified socioecological model (ie, barriers related to policy/payment, health systems, organizations, and individuals). Major themes identified at each level included: 1) the lack of consistent and adequate funding mechanisms at the policy/payment level, 2) the lack of pediatric palliative care programs and workforce at the health systems level, 3) difficulties integrating palliative care into existing pediatric oncology care models at the organizational level, and 4) the lack of knowledge about pediatric palliative care, discomfort with talking about death, and cultural differences between providers and patients and their families at the individual level. Recommendations to address each of the barriers identified in the literature are included. Cancer 2018;124:2278-88. © 2018 American Cancer Society.

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Section: Resultsmentioning

confidence: 99%

Section: Coverage Of Ppc Servicesmentioning

confidence: 99%

Barriers to accessing palliative care for pediatric patients with cancer: A review of the literature

Haines

Frost

Kane

et al. 2018

Cancer

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“…41 The limited exposure to targeted PC education in residency and fellowship means hospitals do not have staff with the training to meet the palliative needs of pediatric oncology patients. [42][43][44] Improvements have been made to increase training opportunities as the number of pediatric PC fellowships in the US have doubled since 2013. 45 However, adequate workforce availability remains a priority to expand the number of institutions that can offer PC to children with cancer.…”

Section: Discussionmentioning

confidence: 99%

Palliative care initiation in pediatric oncology patients: A systematic review

et al. 2018

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Palliative care (PC) aims to improve quality of life for patients and their families. The World Health Organization and American Academy of Pediatrics recommend that PC starts at diagnosis for children with cancer. This systematic review describes studies that reported PC timing in the pediatric oncology population. The following databases were searched: PubMed, Web of Science, CINAHL, and PsycInfo databases. Studies that reported time of PC initiation were independently screened and reviewed by 2 researchers. Studies describing pilot initiatives, published prior to 1998, not written in English, or providing no empirical time information on PC were excluded. Extracted data included sample characteristics and timing of PC discussion and initiation. Of 1120 identified citations, 16 articles met the inclusion criteria and comprised the study cohort. Overall, 54.5% of pediatric oncology patients received any palliative service prior to death. Data revealed PC discussion does not occur until late in the illness trajectory, and PC does not begin until close to time of death. Despite efforts to spur earlier initiation, many pediatric oncology patients do not receive any palliative care service, and those who do, predominantly receive it near the time of death. Delays occur both at first PC discussion and at PC initiation. Efforts for early PC integration must recognize the complex determinants of PC utilization across the illness timeline.

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“…In addition to the approaches above, it is critically important that PHO receive the necessary preparation in their training years. When surveyed about the gaps in their training, PHO fellows identified coping with death and dying, bereavement, achieving work–life balance, managing complex relationships with patients, breaking bad news, and symptoms of depression and burnout . Oncologists who identified having inadequate training experienced increased distress, reduced satisfaction at work, increased depersonalization, and reduced personal accomplishment .…”

Section: Management Of Burnoutmentioning

confidence: 99%