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Specialist paediatric palliative care services: what are the benefits?
Sarah Mitchell1, Andrew Morris1, Karina Bennett1
1Warwick Medical School, University of Warwick, Coventry, UK.
Insights
Specialist paediatric palliative care (SPPC) improves quality of life and symptom control for children with life-limiting conditions. Further research is needed to support policy recommendations for SPPC services.
Area of Science:
- Pediatric Palliative Care
- Healthcare Delivery
- Evidence-Based Medicine
Background:
- Increasing number of children and young people (CYP) with life-limiting conditions.
- Paediatric palliative care is a developing field with varied service provision.
- Policy recommends Specialist Paediatric Palliative Care (SPPC) services led by specialist physicians.
Purpose of the Study:
- To review evidence on the benefits of SPPC services.
- Define SPPC as palliative care supported by a specialist physician.
Main Methods:
- Systematic review of studies from 1980-2016.
- Searches across major medical databases.
- Narrative synthesis of findings.
Main Results:
- Eight studies identified, primarily low-level evidence (surveys, case notes).
- SPPC services enhance quality of life and symptom management.
- Positive impacts on place of care and family support observed.
Conclusions:
- SPPC services offer benefits to CYP and families.
- Evidence is limited in quantity and methodological rigor.
- Further research is essential for service development and policy.
Background:
The number of children and young people (CYP) living with life-limiting and life-threatening conditions is rising. Paediatric palliative care is a relatively new aspect of healthcare, the delivery of which is variable, with a wide range of healthcare and voluntary sector providers involved. Policy recommendations are for Specialist Paediatric Palliative Care (SPPC) services to be supported by a physician with specialist training.
Aim:
To examine the research evidence regarding the distinct benefits of SPPC services, with 'Specialist Paediatric Palliative Care' defined as palliative care services supported by a specialist physician.
Method:
Systematic review of studies of SPPC services published in English from 1980 to 2016. Keyword searches were carried out in medical databases (Cochrane, PubMed, EMBASE, CINAHL and AMED) and a narrative synthesis.
Results:
Eight studies were identified, most of which were retrospective surveys undertaken within single institutions; three were surveys of bereaved parents and three were medical notes reviews. Together they represented a heterogeneous body of low-level evidence. Cross-cutting themes suggest that SPPC services improve the quality of life and symptom control and can impact positively on place of care and family support.
Conclusions:
Current evidence indicates that SPPC services contribute beneficially to the care and experience of CYP and their families, but is limited in terms of quantity, methodological rigour and generalisability. Further research is necessary given the significant workforce and resource implications associated with policy recommendations about the future provision of SPPC and to address the need for evidence to inform the design and delivery of SPPC services.