Publication
Wishing well, a home-based Pediatric palliative care service for childhood cancer in thailand
Nuchprayoon I, Chamnanprai S, Raksrithong T · Pediatric Blood and Cancer · 2018
Background/Objectives: Thailand is an upper middle income country in Southeast Asia, with universal health care, including Pediatric cancer treatment. While many children with cancer are curable, some are less fortunate. For children with limited hope for cure, palliative care (PC) is a preferred option for children. Wishing well foundation was established in 2005, with a mission to provide palliative care service for families with cancer children at home. Design/Methods: The PC service starts with counseling parents and family at home. If the family choose palliative care, an individualized care plan was established to enhance quality of life. Children are asked about their wishes and efforts are made to have their wishes fulfilled. Children are invited to attend a cancer camp. Palliative care, including pain and symptom management, are provided at home, with a continuous communications on LINE and by phone. Parents visit a palliative care clinic for morphine and other medications. Home visits are made as needed for children within 200-km radius and families are supported through death and bereavement. Results: Sixty-five children with cancer were provided home palliative care (PC). The average age (+SD) was 10 (+5) years. Most children in this PC cohort (28, 43%) had brain tumors, followed by recurrent solid tumors (24, 37%), and relapsed leukemias/lymphOMAS (13, 20%). The total follow-up time was 75 patient-years. The median survival was 4 months, with 14 (22%) children living >1 year. Of 53 patients who had died, 29 (61%) died at home, 12 (23%) at a local hospital, and 12 (23%) at a cancer center. All families were satisfied. Conclusions: Palliative care can be offered early through a strategic approach that emphasize quality living for children followed by home-based provision of PC. Home palliative care has been expanded to include non-cancer children, and to a network of cancer treatment centers.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.