Abstract
Context
Children and adults with advanced cardiac or respiratory disease may benefit from
specialized palliative care (SPC), but there has been little SPC research in this
area.
Objectives
To explore pediatric cardiologists’ and respirologists’ (pediatric clinicians) beliefs
about and referral practices to SPC and compare these results to adult cardiologists
and respirologists (adult clinicians).
Methods
Pediatric and adult clinicians were sent a survey exploring SPC referral practices
and beliefs. Responses were summarized with descriptive statistics. Pediatric and
adult clinicians’ responses were compared using Pearson's chi-square test.
Results
The response rate was 56% (989/1759); 9% (87/989) were pediatric clinicians. Pediatric
clinicians were more likely than adult clinicians to be female, work in an academic
center, and experience fewer patient deaths (P<0.001). Pediatric clinicians reported better access to SPC clinical nurse specialists,
spiritual care specialists and bereavement counselors (P<0.001), while adult clinicians reported better access to palliative care units (P<0.001). Pediatric clinicians referred to SPC earlier, while adult clinicians tended
to refer after disease directed therapies were stopped (P<0.001). More than half of all clinicians felt patients had negative perceptions of
the phrase “palliative care”. Although most clinicians were satisfied with SPC quality
(73–82%), fewer adult clinicians were satisfied with SPC availability (74 vs. 47%;
P<0.001). Fewer pediatric clinicians felt that SPC prioritized oncology patients (13
vs. 53%; P<0.001).
Conclusion
There are important differences between pediatric and adult clinicians’ beliefs about
and referral practices to SPC. This may reflect unique features of pediatric diseases,
provider characteristics, care philosophies, or service availability.
Key Words
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Article info
Publication history
Published online: July 25, 2022
Accepted:
July 21,
2022
Identification
Copyright
© 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
