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Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey

BACKGROUND: The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice being p...

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Autores principales: Song, In Gyu, Kang, Sung Han, Kim, Min Sun, Kim, Cho Hee, Moon, Yi Ji, Lee, Jung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500719/
https://www.ncbi.nlm.nih.gov/pubmed/32948177
http://dx.doi.org/10.1186/s12904-020-00652-8
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author Song, In Gyu
Kang, Sung Han
Kim, Min Sun
Kim, Cho Hee
Moon, Yi Ji
Lee, Jung
author_facet Song, In Gyu
Kang, Sung Han
Kim, Min Sun
Kim, Cho Hee
Moon, Yi Ji
Lee, Jung
author_sort Song, In Gyu
collection PubMed
description BACKGROUND: The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice being punishable by law, and physicians tended to pursue aggressive treatment. With changes in public opinion on end-of-life care, the Korean government enacted a new law that protect human dignity by respecting patients’ self-determination and facilitating advance care planning. However, little is known about current state of advance care planning for pediatric patients. The study aimed to assess perceptions regarding advance care planning among South Korean pediatricians and clarify any differences in perception among pediatric subspecialties. METHODS: This study was an observational cross-sectional survey that used a web-based self-report questionnaire. Participants comprised of pediatricians currently caring for children with life-limiting conditions in 2018. RESULTS: Of the 96 respondents, 89 were included in the analysis. In a hypothetical patient scenario, more hemato-oncologists and intensivists than neonatologists and neurologists preferred to provide comfort care than aggressive treatment. While 72.2% of hemato-oncologists reported that they usually or always discuss advance care plans with parents during treatment, more than half of other pediatricians reported that they seldom do so. Furthermore, 65% of respondents said that they never discuss advance care planning with adolescent patients. Moreover, there were no notable differences among subspecialties. The most prevalent answers to factors impeding advance care planning were lack of systemic support after performing advance care planning (82.0%) and uncertain legal responsibilities (70.8%). CONCLUSIONS: The pediatricians differed in their experiences and attitudes toward advance care planning based on their subspecialty. Consequently, institutional support and education should be provided to physicians so that they can include children and families in discussions on prognosis.
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spelling pubmed-75007192020-09-21 Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey Song, In Gyu Kang, Sung Han Kim, Min Sun Kim, Cho Hee Moon, Yi Ji Lee, Jung BMC Palliat Care Research Article BACKGROUND: The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice being punishable by law, and physicians tended to pursue aggressive treatment. With changes in public opinion on end-of-life care, the Korean government enacted a new law that protect human dignity by respecting patients’ self-determination and facilitating advance care planning. However, little is known about current state of advance care planning for pediatric patients. The study aimed to assess perceptions regarding advance care planning among South Korean pediatricians and clarify any differences in perception among pediatric subspecialties. METHODS: This study was an observational cross-sectional survey that used a web-based self-report questionnaire. Participants comprised of pediatricians currently caring for children with life-limiting conditions in 2018. RESULTS: Of the 96 respondents, 89 were included in the analysis. In a hypothetical patient scenario, more hemato-oncologists and intensivists than neonatologists and neurologists preferred to provide comfort care than aggressive treatment. While 72.2% of hemato-oncologists reported that they usually or always discuss advance care plans with parents during treatment, more than half of other pediatricians reported that they seldom do so. Furthermore, 65% of respondents said that they never discuss advance care planning with adolescent patients. Moreover, there were no notable differences among subspecialties. The most prevalent answers to factors impeding advance care planning were lack of systemic support after performing advance care planning (82.0%) and uncertain legal responsibilities (70.8%). CONCLUSIONS: The pediatricians differed in their experiences and attitudes toward advance care planning based on their subspecialty. Consequently, institutional support and education should be provided to physicians so that they can include children and families in discussions on prognosis. BioMed Central 2020-09-18 /pmc/articles/PMC7500719/ /pubmed/32948177 http://dx.doi.org/10.1186/s12904-020-00652-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Song, In Gyu
Kang, Sung Han
Kim, Min Sun
Kim, Cho Hee
Moon, Yi Ji
Lee, Jung
Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
title Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
title_full Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
title_fullStr Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
title_full_unstemmed Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
title_short Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
title_sort differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500719/
https://www.ncbi.nlm.nih.gov/pubmed/32948177
http://dx.doi.org/10.1186/s12904-020-00652-8
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