Repercussions of pediatric palliative care: an integrative review

Pinho, Amanda Andrade Aguiar de; Nascimento, Isabel Regiane Cardoso do; Ramos, Igor Weyber da Silva; Alencar, Vanilla Oliveira

doi:10.1590/1983-80422020284435

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Research • Rev. Bioét. 28 (4) • Oct-Dec 2020 • https://doi.org/10.1590/1983-80422020284435 copy

Repercussions of pediatric palliative care: an integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This article aims to discuss the effects of pediatric palliative care services on hospitals and the quality of life of patients and their families. The research reports the results of an integrative literature review based on 14 articles published between 2013 to 2018. In the studies analyzed, the following aspects were highlighted: efficacy of pediatrics palliative care in hospitals, reductions of hospital costs after implementation of the service, importance of multidisciplinary teams, educational needs of health professionals, and the impact on the quality of life of patients and their families. Results show that pediatrics palliative care provides comprehensive care and should be recognized as an indispensable and specialized service for children with incurable diseases.

Keywords:
Palliative care; Pediatrics; Health services; Hospital care

Authors/year	Title	Objectives	Database
Herbert and collaborators; 2014 ¹⁰10. Herbert A, Bradford N, Donovan L, Pedersen LA, Irving H. Development of a state-wide pediatric palliative care service in Australia: referral and outcomes over two years. J Palliat Med [Internet]. 2014 [acesso 26 jan 2019];17(3):288-95. DOI: 10.1089/jpm.2013.0400 https://doi.org/10.1089/jpm.2013.0400...	“Development of a state-wide pediatric palliative care service in Australia: referral and outcomes over two years”	To map the characteristics of the population cared for by the newly formed pediatric palliative care service in Queensland, Australia, and describe the development of the service for 24 months.	Medline/PubMed and Lilacs
Verberne and collaborators; 2018 ¹¹11. Verberne LM, Kars MC, Schepers SA, Schouten-van Meeteren AYNS, Grootenhuis MA, van Delden JJM. Barriers and facilitators to the implementation of a paediatric palliative care team. BMC Palliat Care [Internet]. 2018 [acesso 26 jan 2019];17:23. DOI: 10.1186/s12904-018-0274-8 https://doi.org/10.1186/s12904-018-0274-...	“Barriers and facilitators to the implementation of a pediatric palliative care team”	To identify barriers and facilitators reported by health professionals in primary, secondary and tertiary care when implementing a pediatric palliative care service that aims to integrate care in the hospital and in the patient's home.	Medline/PubMed
Verberne and collaborators; 2017 ¹²12. Verberne LM, Schouten-van Meeteren AY, Bosman DK, Colenbrander DA, Jagt CT, Grootenhuis MA et al. Parental experiences with a paediatric palliative care team: a qualitative study. Palliat Med [Internet]. 2017 [acesso 26 jan 2019];31(10):956-63. DOI: 10.1177/0269216317692682 https://doi.org/10.1177/0269216317692682...	“Parental experiences with a pediatric palliative care team: a qualitative study”	To obtain information, based on the parents’ perspective, on the support provided by a new pediatric palliative care team.	Medline/PubMed
Smith and collaborators; 2015 ¹³13. Smith AG, Andrews S, Bratton SL, Sheetz J, Feudtner C, Zhong W et al. Pediatric palliative care and inpatient hospital costs: a longitudinal cohort study. Pediatrics [Internet]. 2015 [acesso 8 jan 2019];135(4):694-700. DOI: 10.1542/peds.2014-3161 https://doi.org/10.1542/peds.2014-3161...	“Pediatric palliative care and inpatient hospital costs: a longitudinal cohort study”	To examine the relationship between hospitalization costs and pediatric palliative care.	Medline/PubMed and Lilacs
Ananth and collaborators; 2017 ¹⁴14. Ananth P, Melvin P, Berry JG, Wolfe J. Trends in hospital utilization and costs among pediatric palliative care recipients. J Palliat Med [Internet]. 2017 [acesso 8 jan 2019];20(9):946-53. DOI: 10.1089/jpm.2016.0496 https://doi.org/10.1089/jpm.2016.0496...	“Trends in hospital utilization and costs among pediatric palliative care recipients”	To assess hospital utilization and costs by comparing patients who receive pediatric palliative care with patients who do not receive them at the Boston Children's Hospital.	Medline/PubMed
Conte and collaborators; 2016 ¹⁵15. Conte T, Mitton C, Erdelyi S, Chavoshi N, Siden H. Pediatric palliative care program versus usual care and healthcare resource utilization in British Columbia: a matched-pairs cohort study. J Palliat Med [Internet]. 2016 [acesso 15 jan 2019];19(11):1218-23. DOI: 10.1089/jpm.2016.0177 https://doi.org/10.1089/jpm.2016.0177...	“Pediatric palliative care program versus usual care and healthcare resource utilization in British Columbia: a matched-pairs cohort study”	To compare use of hospital resources between children receiving palliative care and children under usual care.	Medline/PubMed
Gans and collaborators; 2016 ¹⁶16. Gans D, Hadler MW, Chen X, Wu S-H, Dimand R, Abramson JM et al. Cost analysis and policy implications of a pediatric palliative care program. J Pain Symptom Manage [Internet]. 2016 [acesso 17 jan 2019];52(3):329-35. DOI: 10.1016/j.jpainsymman.2016.02.020 https://doi.org/10.1016/j.jpainsymman.20...	“Cost analysis and policy implications of a pediatric palliative care program”	To describe a palliative care program Partners for Children, created in California, addressing the political context of its development, and assess the effects of the initiative, considering its costs.	Medline/PubMed
Jamorabo, Belani, Martin; 2015 ¹⁷17. Jamorabo DS, Belani CP, Martin EW. Complex chronic conditions in Rhode Island's pediatric populace: implications for palliative and hospice services, 2000-2012. J Palliat Med [Internet]. 2015 [acesso 14 jan 2019];18(4):350-7. DOI: 10.1089/jpm.2014.0226 https://doi.org/10.1089/jpm.2014.0226...	“Complex chronic conditions in Rhode Island's pediatric populace: implications for palliative and hospice services, 2000-2012”	To describe mortality trends for children up to 17 years of age with complex chronic conditions in Rhode Island.	Medline/PubMed and Lilacs
Ogelby, Goldstein; 2014 ¹⁸18. Ogelby M, Goldstein RD. Interdisciplinary care: using your team. Pediatr Clin North Am [Internet]. 2014 [acesso 17 jan 2019];61(4):823-34. DOI: 10.1016/j.pcl.2014.04.009 https://doi.org/10.1016/j.pcl.2014.04.00...	“Interdisciplinary care: using your team”	To review the current structure of the palliative care team, showing opportunities to include other members and identifying challenges that arise when the group of professionals involved in the care of a child and their family expands.	Medline/PubMed
Moore, Sheetz; 2014 ¹⁹19. Moore D, Sheetz J. Pediatric palliative care consultation. Pediatr Clin North Am [Internet]. 2014 [acesso 14 jan 2019];61(4):735-47. DOI: 10.1016/j.pcl.2014.04.007 https://doi.org/10.1016/j.pcl.2014.04.00...	“Pediatric palliative care consultation”	To reflect on the benefits of aligning health team, patient and family, based on consultations in palliative care.	Medline/PubMed and Lilacs
Keele, Keenan, Bratton; 2016 ²⁰20. Keele L, Keenan HT, Bratton SL. The effect of palliative care team design on referrals to pediatric palliative care. J Palliat Med [Internet]. 2016 [acesso 14 jan 2019];19(3):286-91. DOI: 10.1089/jpm.2015.0261 https://doi.org/10.1089/jpm.2015.0261...	“The effect of palliative care team design on referrals to pediatric palliative care”	To describe the structure of palliative care teams, assessing whether composition and availability are associated with utility, and examine reference standards.	Medline/PubMed
Frizzola, Miller; 2014 ²¹21. Frizzola M, Miller EG. Referrals to a new pediatric palliative care team: details of the first 12 months of operation. J Palliat Med [Internet]. 2014 [acesso 20 jan 2019];17(5):585-8. DOI: 10.1089/jpm.2013.0206 https://doi.org/10.1089/jpm.2013.0206...	“Referrals to a new pediatric palliative care team: details of the first 12 months of operation”	To describe the patient population assisted by a newly created palliative care program, comparing it with the existing literature.	Medline/PubMed and Lilacs
Benini and collaborators; 2016 ²²22. Benini F, Orzalesi M, Santi A, Congedi S, Lazzarin P, Pellegatta F et al. Barriers to the development of pediatric palliative care in Italy. Ann Ist Super Sanità [Internet]. 2016 [acesso 19 jan 2019];52(4):558-64. DOI: 10.4415/ANN_16_04_16 https://doi.org/10.4415/ANN_16_04_16...	“Barriers to the development of pediatric palliative care in Italy”	To highlight, via data and literature review, critical issues that prevent the planning and development of palliative care services in Italy.	Medline/PubMed
Goldhagen and collaborators; 2016 ²³23. Goldhagen J, Fafard M, Komatz K, Eason T, Livingood WC. Community-based pediatric palliative care for health related quality of life, hospital utilization and costs lessons learned from a pilot study. BMC Palliat Care [Internet]. 2016 [acesso 15 jan 2019];15(1):73. DOI: 10.1186/s12904-016-0138-z https://doi.org/10.1186/s12904-016-0138-...	“Community-based pediatric palliative care for health-related quality of life, hospital utilization and costs lessons learned from a pilot study”	To analyze results from unpublished evaluation studies carried out since 2007, which shows the impact of PedsCare's community palliative care program on the quality of life of patients and on hospital use and cost.	Medline/PubMed

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[1] Correspondence Amanda Andrade Aguiar de Pinho – Rua Bonfim Sobrinho, 540, apt. 701 A, Fátima CEP 60040-500. Fortaleza/CE, Brasil.