Publication
WORKLOAD AND PATIENT EXPERIENCE DATA ON THE COMPLEX HEALTHCARE TRANSITION SUPPORT PATHWAY: A TERTIARY CHILDREN'S HOSPITAL EXPERIENCE
Narula P, Cash H · Archives of Disease in Childhood · 2024
ObjectivesPalliative care is an essential component of national health systems and should be available to all people irrespective of age.1Despite this, a large proportion of children and young people (children) worldwide who require palliative care do not receive it.2It is necessary to assess existing evidence to inform feasible, acceptable, and effective mechanisms to facilitate referral and access to palliative care for children. This study aimed to assess the extent and type of evidence regarding barriers and facilitators of referral and access to palliative care for children, and interventions used to reduce barriers and improve access. MethodsThe Arksey and O'Malley scoping review methodological framework,3incorporating recommendations by Levac et al,4informed the review. Five electronic databases were searched (CINAHL, MEDLINE, PsycINFO, EMBASE, and Cochrane Library) for primary studies of any design, and literature or systematic reviews. Papers that reported stakeholder data in relation to referral of children with a life-limiting condition to palliative care services, in any setting, were included. Results196 articles met the inclusion criteria. Results were reported using the five levels of the socioecological framework (individual, interpersonal, organisational, community and society). Key barriers and facilitators identified at each level included: 1) Individual level: child demographic factors, parental attitudes and treatment expectations, and staff understanding and beliefs; 2) Interpersonal level: family support, patient-provider relationships, and staff communication; 3) Organisational level: referral protocols, and staff workforce and leadership; 4) Community level: cultural norms, community resources, and the effect of geography; 5) Society level: policies and legislation, national education, the economic environment, and medication availability. 41 papers looked at interventions to improve referrals to palliative care, including: educational programs, patient screening tools, telehealth, palliative care policies/guidelines, and research dissemination tools. ConclusionThere is a plethora of literature on barriers and facilitators to referral and access to palliative care for children across all levels of the socio-ecological framework. There is a paucity of literature on the development of interventions to reduce barriers and increase referral to palliative care. Next steps are to identify, adapt if necessary and test intervention(s) to facilitate referral and access to palliative care for this group .
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.