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Delphi Method to Develop a Palliative Care Tool for Children and Families in Sub-Saharan Africa
Kamusisi Chinyundo1, Jessica Casas1, Rhahim Bank1
1Global HOPE Botswana (K.C.), Gaborone, Botswana; Baylor College of Medicine (J.C., J.H., M.H.), Houston, Texas, USA; Texas Children's Hospital (J.C., J.H.), Houston, Texas, USA; Global HOPE Malawi (R.B, M.B.), Lilongwe, Malawi; Global HOPE Uganda (A.N., D.B., I.N.), Kampala, Uganda; Princess Marina Hospital (B.G., G.M.M.), Gaborone, Botswana.
Insights
A new pediatric palliative care (PPC) assessment tool was developed for sub-Saharan Africa. This evidence-based approach standardizes care for children and families, addressing a critical need in developing countries.
Area of Science:
- Global Health
- Palliative Care Medicine
- Pediatrics
Background:
- Sub-Saharan Africa lacks a standardized approach to pediatric palliative care (PPC) assessment.
- There is a significant need for evidence-based tools to identify the specialized needs of children and families requiring palliative care in developing nations.
Purpose of the Study:
- To develop a standardized pediatric palliative care assessment approach for sub-Saharan Africa.
- To create an individualized plan of care integrated with the assessment tool.
Main Methods:
- A five-round Delphi method was employed to identify core elements for PPC assessment.
- Consensus was reached among 11 PPC experts on essential assessment questions and care plan components.
- Expert consensus was validated by 36 childhood cancer/palliative care clinicians.
Main Results:
- Five core elements were established as the foundation for the PPC assessment.
- A symptom assessment tool was created, detailing 15 symptoms prevalent in over 65% of patients.
Conclusions:
- The Delphi method successfully facilitated consensus on a standardized PPC assessment tool for sub-Saharan Africa.
- This standardized approach is expected to facilitate data collection, driving improved outcomes and research in pediatric palliative care.
Context:
In sub-Saharan Africa, there is no standardized approach to pediatric palliative care assessment. Because of this, there is a critical demand for evidence-based assessment tools that identify the specialized needs of children and their families requiring palliative care in developing countries.
Objectives:
To develop a standardized approach to pediatric palliative care (PPC) assessment that includes an individualized plan of care for use in sub-Saharan Africa.
Methods:
A Delphi method approach used five rounds to explore core elements that define the essential assessment attributes mandatory for providing excellence in PPC. Using the Delphi method, the consensus from 11 PPC experts was obtained during four Delphi rounds regarding the most important questions to include in a PPC assessment tool and plan of care. During the final Delphi round 5, the expert consensus was confirmed in a separate group of 36 childhood cancer/palliative care clinical providers.
Results:
Five core elements were developed as the foundation for a PPC assessment. A symptom assessment tool was developed that includes 15 symptoms that PPC experts agreed occurred more than 65% of the time in their patients.
Conclusion:
The Delphi method was an effective tool to develop a consensus on a PPC assessment tool to use with children and their families in sub-Saharan Africa. This standardized approach will enable the collection of data to drive outcomes and research.
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