Related Experiment Videos
Variables influencing end-of-life care in children and adolescents with cancer
K J Klopfenstein1, C Hutchison, C Clark
1Department of Pediatrics, Children's Hospital, Columbus, Ohio 43205, USA. kklopfen@chi.osu.edu
Insights
Most children with cancer die at home with hospice support, often after "do not resuscitate" (DNR) orders were made. End-of-life care decisions are influenced by diagnosis, cause of death, and age.
Area of Science:
- Pediatric Oncology
- Palliative Care
- End-of-Life Studies
Background:
- Understanding factors influencing end-of-life care for pediatric cancer patients is crucial.
- Previous research has not fully elucidated the variables impacting terminal care decisions in this population.
Purpose of the Study:
- To describe the variables influencing end-of-life care in children and adolescents diagnosed with cancer.
- To analyze factors associated with the place of death and utilization of hospice services.
Main Methods:
- Retrospective review of medical records for 146 children with cancer who died at a children's hospital.
- Data collected included demographics, diagnosis, cause of death, location of death, life support withdrawal, and "do not resuscitate" (DNR) order details.
Main Results:
- Of 95 evaluated patients, 64% of disease-related deaths occurred at home with hospice support; only 10% died in the ICU on maximal support.
- Patient age, diagnosis (solid tumor vs. leukemia), cause of death, admission length, and DNR order duration significantly correlated with place of death and hospice use.
- Hospice support was utilized by 35% of all patients.
Conclusions:
- The majority of pediatric cancer deaths occur at home, often with hospice involvement, primarily due to progressive disease.
- "Do not resuscitate" orders were common among deceased patients.
- Key end-of-life decisions are significantly influenced by the patient's diagnosis, cause of death, and age.
Background:
The purpose of this study was to describe the variables influencing end-of-life care in children and adolescents dying of cancer.
Materials And Methods:
Records of 146 children with cancer who died at Children's Hospital were reviewed for demographics, diagnosis, location of death, withdrawal of life support, use of "do not resuscitate" (DNR) orders, and the length of time that those orders were in effect.
Results:
Ninety-five patients were evaluated. Fifty-nine died of progressive disease and 36 deaths were therapy-related. Sixty-four percent of disease-related deaths occurred at home with support from home care or hospice. Only 10% of all patients died while receiving maximal aggressive support in the intensive care unit. Age, diagnosis (solid tumor vs. leukemia), cause of death, length of last hospital admission, and the duration of DNR orders had a significant correlation with the place of death and referral to and use of hospice. Thirty-five percent of all patients had hospice support.
Conclusions:
Most children who die of cancer die because of progressive disease at home with hospice support. Do not resuscitate orders were written for most patients who died. End-of-life decisions are influenced by patient diagnosis, cause of death, and age.
Related Concept Videos
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
01:30Ethical Dilemmas II
01:25Continuing Care
01:21Cancer Survival Analysis
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption