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[Evaluation of a home care program for children with cancer]
J M Fernández Navarro1, B Pozuelo Muñoz, P Ortí Martínez
1Unidad de Oncología Pediátrica, Hospital Universitario Infantil La Fe, Valencia.
Insights
This study shows that a pediatric home care team can effectively manage cancer patients, enabling early hospital discharge and reducing hospital stays. The program facilitated home-based treatments and end-of-life care, demonstrating high patient and parent satisfaction.
Area of Science:
- Pediatric Oncology
- Home Healthcare Services
- Patient Management
Background:
- The establishment of a dedicated home care team within a pediatric oncology unit.
- The need for extended care services beyond hospital settings for pediatric cancer patients.
- The geographical scope and operational model of the home care team.
Purpose of the Study:
- To evaluate the medical activities and outcomes of a pediatric home care team over a 17-month period.
- To assess the effectiveness of home-based care in managing pediatric oncology patients.
- To determine patient acceptance and impact on hospital stay duration.
Main Methods:
- Retrospective review of medical activities and patient admissions.
- Analysis of reasons for home care admission, including early discharge, antibiotic, and chemotherapy administration.
- Documentation of care provided to terminally ill children and pain management strategies.
Main Results:
- 127 patients were admitted 433 times, with 61% for early hospital discharge.
- Home care facilitated antibiotic (18%) and chemotherapy (12%) administration.
- Seventeen terminally ill children received care, with five requiring opioid treatment; six of eight in direct care areas died at home.
- Program goals were achieved in 73% of cases, with high parental cooperation (99.5%).
Conclusions:
- The pediatric home care program is well-accepted by patients and families.
- The program effectively reduces hospital stay duration for pediatric oncology patients.
- Home-based care is a viable and beneficial model for managing pediatric cancer patients, including those requiring end-of-life care.
Abstract:
The home care team dependent from the pediatric oncology unit in our institution started working in April, 1997. We evaluate in this paper the medical activities accomplished in seventeen month experience. The team is constituted by a pediatric oncologist, two pediatric nurses and a clinical assistant with experience in the specialty. The geographic area we cover is la Communidad Valenciana. We directly attend children living in Valencia city and its metropolitan area. For the rest of patients, we coordinate the interventions of the local primary care teams and local hospitals. 127 patients have been admitted in the home care unit in 433 occasions. The immediate reasons for the admission were: early discharge from the hospital (61%), followed by the administration of antibiotics (18%) and chemotherapy (12%) at home. We attended 17 children in the terminal phase of their diseases. Five of them required opioid treatment for pain control. Six out of eight patients living in the area of direct intervention of the home care team died at home. The most common cause of discharge (73%) was the achievement of the goals planned when the patient was included in the program. Only in two cases (0.5%) we did not found enough cooperation from the parents and the treatment was completed in the hospital. This program has been well accepted by our patients and their parents and permits to shorten the stay in the hospital.