Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil

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article
Data de publicação
2023
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Scopus
Web of Science
PubMed
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LIPPINCOTT WILLIAMS & WILKINS
Autores
MCNEIL, Michael J.
GODFREY, Alyssa
LOGGETTO, Patricia
OLIVEIRA JUNIOR, Andre de
JOB, Godwin
BOLDRINI, Erica
MURRA, Glaucia Regina Costa
AYUB, Dileiny Antunes Geronutti
LIMA, Allan Francisco Oliveira de
ALMEIDA, Aline Esmeraldo Andrade de
Citação
JCO GLOBAL ONCOLOGY, v.9, article ID e2300057, 10p, 2023
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PURPOSE Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil. METHODS The Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in Brazil. The survey was open from January 2022 to June 2022 and distributed to physicians of all specialties from participating institutions who treat children with cancer. Statistical analysis was complemented by qualitative analysis of open-ended responses. RESULTS A total of 272 respondents participated. Most respondents reported access to PPC experts for consultation (77.2%) and 34.5% indicated previous palliative care training. Physician knowledge of PPC was generally aligned with WHO guidance (median alignment, 93.0%; range, 80.5%-98.2%). However, about half (53.3%) felt comfortable addressing physical needs of patients receiving PPC, 35.3% addressing emotional needs, 25.8% addressing spiritual needs, and 33.5% addressing grief and bereavement needs. Most respondents (65.4%) felt palliative care should be involved from diagnosis, but only 10.3% stated that this occurred in their setting. The most important barriers identified were physician discomfort (89.0%), limited physician knowledge (88.6%), and lack of homebased services (83.8%). CONCLUSION Despite a strong understanding of the role of palliative care, physicians in Brazil reported low confidence delivering PPC to children with cancer. Additionally, physicians generally believed that PPC should be integrated earlier in the disease trajectory of children with cancer. This work will direct educational and capacity building initiatives to ensure greater access to high-quality PPC for children with cancer in Brazil to address patient and family suffering.
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https://observatorio.fm.usp.br/handle/OPI/59213
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICr