Resumen

Background: Proper identification of end-of-life (EoL) pediatric patients is not an easy task because the criteria used to identify them are based on adult patients criteria. Objectives: To explore how pediatricians identify patients with EoL conditions, and to determine the medical actions taken after identification of EoL patients. Material and methods: Setting: Tertiary referral pediatric hospital. Participants: Staff pediatricians (SP) and medical residents (MR). Methods: A self-administered survey was developed and validated. The survey contains five vignettes describing pediatric patients: two met the criteria of EoL according to World Health Organization, and three were considered no EoL (NEoL). Participants were asked to identify whether each case corresponded to an EoL or NEoL patient, also they registered the medical actions they would apply, accordingly. All responses were recorded in a 4-option Likert scale. Ordinal regression was used to assess if some of the participants’ characteristics were likely to influence the identification of EoL or NEoL conditions. Results: Response rate was 84.2% (128/152); the sample consisted of 63 SP and 65 MR. EoL patients were correctly identified by SP and MR in 90% and 93%, while NEoL patients were correctly identified in 30 and 40%, respectively. Palliative care actions were more commonly recommended in EoL patients, although approximately 20% of participants would not provide them. Among NEoL patients, there were more disagreements on the medical actions to be applied; this divergence was statistically significantly. Ordinal regression showed that some of the participants’ characteristics are likely to influence the proper identification of EoL or NEoL conditions; however, these factors were not consistent across the five vignettes. Conclusions: Among pediatricians, the criteria used to identify EoL conditions are not well established, neither the provision of palliative care. Educational interventions are needed to improve quality of life of these children.

Palabras clave: End-of-life. Palliative care. Children. Pediatrician. Education. Attitude.

2013-07-24   |   579 visitas   |   Evalua este artículo 0 valoraciones

Vol. 63 Núm.2. Marzo-Abril 2011 Pags. 135-147 Rev Invest Clin 2011; 63(2-ENGLISH)