Pediatric palliative care and childhood neurosurgery: reflections based on a quantitative analysis of a survey data

Abstract

INTRODUCTION: In recent years, the profile of pediatric patients has changed, with the need for assistance for children living with chronic and life-threatening diseases becoming increasingly frequent. In this scenario, Pediatric Palliative Care (PPC) emerges as an integral and respectful form of assistance for these patients and their families. Understanding that neurosurgery is an extremely important area within Pediatric Palliative Care, as there are many intersections between the two areas, this research aimed to reflect on how this interaction is being carried out in practice. MATERIAL AND METHODS: It is an observational, descriptive, cross-sectional study, of survey type, in which the study population was composed of a convenience sample, using the snowball strategy. Analyses were performed with the aid of the statistical program Stata version 13.0 (Stata Corp, L. C.). Results are presented as frequencies and 95% confidence intervals, graph, and table. RESULTS: The sample represented 90 PPC services, almost all of which have physicians (97.90%). Among the medical specialties, none of the services reported having a neurosurgeon on the team. DISCUSSION: Several themes required by the National Medical Residency Commission for the training of neurosurgeons cover Pediatric Palliative Care, such as pain, bioethics, communicating difficult news and others. Therefore, the real rapprochement of the two areas is extremely important to ensure comprehensive care for the patient. CONCLUSIONS: There are important gaps between Pediatric Palliative Care and Pediatric Neurosurgery, reinforcing the importance of including the topic for neurosurgery residents and continuing education for those already trained.

Scope of services provided to childhood cancer patients by the Brazilian Pediatric Palliative Care Network

“…In this scenario, Pediatric Palliative Care (PPC) emerges as an integral form of assistance for these patients and their families ( 4 ). PPC implies early identification of the degree of serious disease involved, evaluation, and adequate treatment, improving quality of life, promoting dignity and comfort, without accelerating or delaying death, and may even positively influence the course of the disease, an essential aspect for the prognosis of the pediatric patient ( 5 ).…”