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Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil

PURPOSE: Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil...

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Autores principales: McNeil, Michael J., Godfrey, Alyssa, Loggetto, Patricia, de Oliveira Junior, André, Job, Godwin, Boldrini, Erica, Regina Costa Murra, Glaucia, Antunes Geronutti Ayub, Dileiny, Francisco Oliveira de Lima, Allan, Esmeraldo Andrade de Almeida, Aline, Lopes Garcia, Julia, Beatriz Costa Neves do Amaral, Anna, Cristina Cunha Ferreira e Fonseca, Iêda, Friedrich, Paola, Metzger, Monika L., Devidas, Meenakshi, Agulnik, Asya, Baker, Justin N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581636/
https://www.ncbi.nlm.nih.gov/pubmed/37535886
http://dx.doi.org/10.1200/GO.23.00057
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author McNeil, Michael J.
Godfrey, Alyssa
Loggetto, Patricia
de Oliveira Junior, André
Job, Godwin
Boldrini, Erica
Regina Costa Murra, Glaucia
Antunes Geronutti Ayub, Dileiny
Francisco Oliveira de Lima, Allan
Esmeraldo Andrade de Almeida, Aline
Lopes Garcia, Julia
Beatriz Costa Neves do Amaral, Anna
Cristina Cunha Ferreira e Fonseca, Iêda
Friedrich, Paola
Metzger, Monika L.
Devidas, Meenakshi
Agulnik, Asya
Baker, Justin N.
author_facet McNeil, Michael J.
Godfrey, Alyssa
Loggetto, Patricia
de Oliveira Junior, André
Job, Godwin
Boldrini, Erica
Regina Costa Murra, Glaucia
Antunes Geronutti Ayub, Dileiny
Francisco Oliveira de Lima, Allan
Esmeraldo Andrade de Almeida, Aline
Lopes Garcia, Julia
Beatriz Costa Neves do Amaral, Anna
Cristina Cunha Ferreira e Fonseca, Iêda
Friedrich, Paola
Metzger, Monika L.
Devidas, Meenakshi
Agulnik, Asya
Baker, Justin N.
author_sort McNeil, Michael J.
collection PubMed
description PURPOSE: Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil. METHODS: The Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in Brazil. The survey was open from January 2022 to June 2022 and distributed to physicians of all specialties from participating institutions who treat children with cancer. Statistical analysis was complemented by qualitative analysis of open-ended responses. RESULTS: A total of 272 respondents participated. Most respondents reported access to PPC experts for consultation (77.2%) and 34.5% indicated previous palliative care training. Physician knowledge of PPC was generally aligned with WHO guidance (median alignment, 93.0%; range, 80.5%-98.2%). However, about half (53.3%) felt comfortable addressing physical needs of patients receiving PPC, 35.3% addressing emotional needs, 25.8% addressing spiritual needs, and 33.5% addressing grief and bereavement needs. Most respondents (65.4%) felt palliative care should be involved from diagnosis, but only 10.3% stated that this occurred in their setting. The most important barriers identified were physician discomfort (89.0%), limited physician knowledge (88.6%), and lack of home-based services (83.8%). CONCLUSION: Despite a strong understanding of the role of palliative care, physicians in Brazil reported low confidence delivering PPC to children with cancer. Additionally, physicians generally believed that PPC should be integrated earlier in the disease trajectory of children with cancer. This work will direct educational and capacity building initiatives to ensure greater access to high-quality PPC for children with cancer in Brazil to address patient and family suffering.
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spelling pubmed-105816362023-10-18 Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil McNeil, Michael J. Godfrey, Alyssa Loggetto, Patricia de Oliveira Junior, André Job, Godwin Boldrini, Erica Regina Costa Murra, Glaucia Antunes Geronutti Ayub, Dileiny Francisco Oliveira de Lima, Allan Esmeraldo Andrade de Almeida, Aline Lopes Garcia, Julia Beatriz Costa Neves do Amaral, Anna Cristina Cunha Ferreira e Fonseca, Iêda Friedrich, Paola Metzger, Monika L. Devidas, Meenakshi Agulnik, Asya Baker, Justin N. JCO Glob Oncol ORIGINAL REPORTS PURPOSE: Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil. METHODS: The Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in Brazil. The survey was open from January 2022 to June 2022 and distributed to physicians of all specialties from participating institutions who treat children with cancer. Statistical analysis was complemented by qualitative analysis of open-ended responses. RESULTS: A total of 272 respondents participated. Most respondents reported access to PPC experts for consultation (77.2%) and 34.5% indicated previous palliative care training. Physician knowledge of PPC was generally aligned with WHO guidance (median alignment, 93.0%; range, 80.5%-98.2%). However, about half (53.3%) felt comfortable addressing physical needs of patients receiving PPC, 35.3% addressing emotional needs, 25.8% addressing spiritual needs, and 33.5% addressing grief and bereavement needs. Most respondents (65.4%) felt palliative care should be involved from diagnosis, but only 10.3% stated that this occurred in their setting. The most important barriers identified were physician discomfort (89.0%), limited physician knowledge (88.6%), and lack of home-based services (83.8%). CONCLUSION: Despite a strong understanding of the role of palliative care, physicians in Brazil reported low confidence delivering PPC to children with cancer. Additionally, physicians generally believed that PPC should be integrated earlier in the disease trajectory of children with cancer. This work will direct educational and capacity building initiatives to ensure greater access to high-quality PPC for children with cancer in Brazil to address patient and family suffering. Wolters Kluwer Health 2023-08-03 /pmc/articles/PMC10581636/ /pubmed/37535886 http://dx.doi.org/10.1200/GO.23.00057 Text en © 2023 by American Society of Clinical Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle ORIGINAL REPORTS
McNeil, Michael J.
Godfrey, Alyssa
Loggetto, Patricia
de Oliveira Junior, André
Job, Godwin
Boldrini, Erica
Regina Costa Murra, Glaucia
Antunes Geronutti Ayub, Dileiny
Francisco Oliveira de Lima, Allan
Esmeraldo Andrade de Almeida, Aline
Lopes Garcia, Julia
Beatriz Costa Neves do Amaral, Anna
Cristina Cunha Ferreira e Fonseca, Iêda
Friedrich, Paola
Metzger, Monika L.
Devidas, Meenakshi
Agulnik, Asya
Baker, Justin N.
Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil
title Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil
title_full Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil
title_fullStr Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil
title_full_unstemmed Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil
title_short Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil
title_sort physician perceptions of and barriers to pediatric palliative care for children with cancer in brazil
topic ORIGINAL REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581636/
https://www.ncbi.nlm.nih.gov/pubmed/37535886
http://dx.doi.org/10.1200/GO.23.00057
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