Characteristics of a population of children hospitalized under health conditions that may need pediatric palliative care
First patients in the Pediatric Palliative Care Unit at the Pereira Rossell Hospital Center (UCPP-CHPR)
Abstract
Introduction: Law 18,335 provides that: "All individuals have the right to receive comprehensive health services ... including palliative care". The World Health Organization (WHO) defined pediatric palliative care as "a global model for health care services both for the child with a disease that limits and/or threatens his life, and his family". Pereira Rossell Hospital Center has created a Pediatric Palliative Care Unit to provide attention and train professionals in these health care services.
Objective:to describe the main characteristics of the first patients seen in the above mentioned unit.
Method: We conducted a retrospective, descriptive study of the characteristics of the children seen from December 30, 2008 through December 30, 2010, based on their files and medical records. All children hospitalized in the intermediate health care in the Department of Pediatrics were included in the study.
Results:87 patients were seen, 54 of them were girls. Median age was three years old (ranging from 28 days until 16 years old). Health conditions requiring palliative care were varied, mainly non-progressive severe neurological disorders. The most frequent cause of hospitalization was respiratory infections, although several other biological, psychological and social problems were seen. 25% of the children died, most of them in the hospital.
Conclusions:pediatric palliative care is a right. Thus, all health professionals working with children must be familiar with the problems presented and receive training for a comprehensive approach of the condition, since it is an obligation of the health system to guarantee this right.
References
(2) American Academy of Pediatrics. Committee on Bioethics and Committee on Hospital Care. Palliative Care for Children (RE 0007) Policy Statement on line Pediatrics 2000; 106 (2): 351-7.Disponible en: http://aappolicy.aappublications.org/cgi/reprint/pediatrics;106/2/351.pdf. Consulta: 18 junio 2008.
(3) European Association for Paliative Care. Taskforce for Palliative Care in Children. Cuidados paliativos para lactantes, niños y jóvenes. Roma: Fondazione Maruzza Lefebvre D' Ovidio Onlus, 2009.
(4) World Health Organization. Who definition of Palliative Care. Disponible en: http://www.who.int/cancer/palliative/definition/en/. Consulta: 18 junio 2008.
(5) Ley Nº 18335. Pacientes y usuarios de los servicios de salud: se establecen sus derechos y obligaciones. Montevideo, 26 agosto de 2008. Disponible en: http://200.40.229.134/leyes/AccesoTextoLey.asp?Ley=18335. Consulta: 18 junio 2008.
(6) Alberti M, Lores R, Menchaca A. Cuidados paliativos en la unidad de cuidados intensivos pediátricos. Rev Méd Urug 2008; 24 (1): 50-5.
(7) Uruguay. Universidad de la República. Facultad de Medicina. Centro Hospitalario Pereira Rossell. Departamento de Pediatría y Especialidades. Programas y normativa. Montevideo: Zonalibro, 2009.
(8) Himelstein BP, Hilden JM, Boldt AM, Weissman D. Pediatric palliative care. N Engl J Med 2004; 350 (17): 1752-62.
(9) Pascual A. Formación en medicina paliativa. In: Gómez Sancho M. Medicina paliativa en la cultura latina. Madrid: Arán, 1999: 1209-19.
(10) Quian. J. El pediatra frente a la muerte de un niño. Introducción a los cuidados paliativos pediátricos. Clín Pediátr Sur 2007; 1 (1): 77-88.
(11) Jeffrey C. Enfermedades crónicas y el cambiante equilibrio entre los cuidados paliativos y curativos. Pediatr Clin N Am 2007; 54 (5): 1069-82.
(12) Rus, Rincón C, Monleón M, Martínez A, Fillol A, Catá E, et. al.University Children's Hospital Niño Jesús of Madrid Spain. Palliative Care Unit. Dying at home: a fact. Congress of the European Association for Palliative Care, 12. Lisbon, Portugal May 18-21 2011.
(13) Contro N, Larson J, Scofield S, Sourkes B, Cohen H. Familiy perspectives on the quality of pediatric palliative care. Arch Pediatr Adolesc Med 156 (1): 14-9. Disponible en: http://archpedi.ama-assn.org/cgi/content/full/156/1/14. Consulta: 3 enero 2009.
(14) Levetown M, American Academy of Pediatrics Committee on Bioethics. Communicating with children and families: from everyday interactions to skill in conveying distressing information. Pediatrics 2008; 121 (5): e1441-60. Disponible en: http://pediatrics.aappublications.org/content/121/5/e1441.full.pdf+html. Consulta: 3 enero 2009.
(15) Oficina del Alto Comisionado de las Naciones Unidas para los Derechos Humanos. Convención sobre los derechos del niño: adoptada y abierta a la firma y ratificación por la Asamblea General en su resolución 44/25, de 20 de noviembre de 1989. Entrada en vigor: 2 de septiembre de 1990, de conformidad con el artículo 49. Disponible en: http://www2.ohchr.org/spanish/law/crc.htm. Consulta: 21 junio 2010.
(16) European Association for Palliative Care. IMPaCCT: standards for paediatric palliative care in Europe. Eur J Palliat Care 2007; 14 (3): 109-14.
(17) Ley 18211. Sistema Nacional Integrado de Salud. Montevideo, 5 diciembre 2007.
(18) Bernadá M, Dall'Orso P, LePera V. Abordaje del niño con una enfermedad pasible de cuidados paliativos: visión desde la Unidad de Cuidados Paliativos del Centro Hospitalario Pereira Rossell. Arch Pediatr Urug 2010; 81 (4): 9-17.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.