Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and Caregivers

Key Points. Providers and nurses recognized the potential added value of palliative care for dialysis-dependent pediatric patients. Most caregivers of dialysis-dependent pediatric patients did not hold positive or negative preconceived notions about a palliative care consultation. Perceived obstacle...

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Main Authors: Joshua Lipsitz, Mark Stockton Beveridge, Katherine Maddox
Format: Article
Language:English
Published: Wolters Kluwer - Lippincott Williams & Wilkins 2024-11-01
Series:Kidney360
Online Access:http://journals.lww.com/10.34067/KID.0000000000000558
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author Joshua Lipsitz
Mark Stockton Beveridge
Katherine Maddox
author_facet Joshua Lipsitz
Mark Stockton Beveridge
Katherine Maddox
author_sort Joshua Lipsitz
collection DOAJ
description Key Points. Providers and nurses recognized the potential added value of palliative care for dialysis-dependent pediatric patients. Most caregivers of dialysis-dependent pediatric patients did not hold positive or negative preconceived notions about a palliative care consultation. Perceived obstacles to palliative care consultation among providers and nurses did not reflect the views of most caregivers. Background. Dialysis-dependent pediatric patients and their families face significant biopsychosocial burdens and low health-related quality of life. Palliative care consultations can alleviate some degree of suffering for patients and families, but remain underutilized within pediatric nephrology. Little is known about how providers, nurses, and caregivers perceive palliative care integration into the multidisciplinary care of dialysis-dependent pediatric patients. Methods. This study surveyed pediatric nephrology providers (physicians and advanced practice providers), inpatient pediatric nephrology bedside nurses, and caregivers of dialysis-dependent pediatric patients at a freestanding tertiary care children's hospital in Dallas, TX. Participants completed a survey regarding knowledge about, experiences with, and perceptions of palliative care in pediatric nephrology. Results. Ten providers, 20 nurses, and 18 caregivers completed the survey. Although 80% of providers and all nurses agreed that palliative care would benefit dialysis-dependent pediatric patients, most believed that palliative care is not as important in pediatric nephrology as it should be. Seventy percent of providers and 45% of nurses believed that they understand the scope of palliative care. Ninety percent of providers and all nurses desired more palliative care education. Of the 22% of caregivers whose child had already received palliative care services, all found the consultation to be helpful. Many providers and nurses worried that a palliative care consultation would signal to families that the nephrology team would be giving up on their child and that their child is approaching the end of life. However, no caregivers thought that a consultation would mean that the nephrology team would be giving up on their child, and only 6% worried that it would indicate that their child is approaching the end of life. Conclusions. These data support further palliative care education for pediatric nephrology providers and nurses and more robust and systematic involvement of subspecialty palliative care for dialysis-dependent pediatric patients.
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spelling doaj-art-c192176875f141aabff87e5a7ad53d732025-08-20T03:15:16ZengWolters Kluwer - Lippincott Williams & WilkinsKidney3602641-76502024-11-015111669167410.34067/KID.0000000000000558202411000-00010Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and CaregiversJoshua Lipsitz0Mark Stockton Beveridge1Katherine Maddox21 Texas Children's Hospital, Houston, Texas2 Imagine Pediatrics, Nashville, Tennessee3 UT Southwestern Medical Center, Dallas, TexasKey Points. Providers and nurses recognized the potential added value of palliative care for dialysis-dependent pediatric patients. Most caregivers of dialysis-dependent pediatric patients did not hold positive or negative preconceived notions about a palliative care consultation. Perceived obstacles to palliative care consultation among providers and nurses did not reflect the views of most caregivers. Background. Dialysis-dependent pediatric patients and their families face significant biopsychosocial burdens and low health-related quality of life. Palliative care consultations can alleviate some degree of suffering for patients and families, but remain underutilized within pediatric nephrology. Little is known about how providers, nurses, and caregivers perceive palliative care integration into the multidisciplinary care of dialysis-dependent pediatric patients. Methods. This study surveyed pediatric nephrology providers (physicians and advanced practice providers), inpatient pediatric nephrology bedside nurses, and caregivers of dialysis-dependent pediatric patients at a freestanding tertiary care children's hospital in Dallas, TX. Participants completed a survey regarding knowledge about, experiences with, and perceptions of palliative care in pediatric nephrology. Results. Ten providers, 20 nurses, and 18 caregivers completed the survey. Although 80% of providers and all nurses agreed that palliative care would benefit dialysis-dependent pediatric patients, most believed that palliative care is not as important in pediatric nephrology as it should be. Seventy percent of providers and 45% of nurses believed that they understand the scope of palliative care. Ninety percent of providers and all nurses desired more palliative care education. Of the 22% of caregivers whose child had already received palliative care services, all found the consultation to be helpful. Many providers and nurses worried that a palliative care consultation would signal to families that the nephrology team would be giving up on their child and that their child is approaching the end of life. However, no caregivers thought that a consultation would mean that the nephrology team would be giving up on their child, and only 6% worried that it would indicate that their child is approaching the end of life. Conclusions. These data support further palliative care education for pediatric nephrology providers and nurses and more robust and systematic involvement of subspecialty palliative care for dialysis-dependent pediatric patients.http://journals.lww.com/10.34067/KID.0000000000000558
spellingShingle Joshua Lipsitz
Mark Stockton Beveridge
Katherine Maddox
Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and Caregivers
Kidney360
title Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and Caregivers
title_full Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and Caregivers
title_fullStr Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and Caregivers
title_full_unstemmed Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and Caregivers
title_short Palliative Care for Dialysis-Dependent Pediatric Patients: A Survey of Providers, Nurses, and Caregivers
title_sort palliative care for dialysis dependent pediatric patients a survey of providers nurses and caregivers
url http://journals.lww.com/10.34067/KID.0000000000000558
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