title: Symptoms in the palliative phase of children with cancer.
abstract: BACKGROUND
  The aim of the study was to make a comprehensive inventory of the physical, psychological, and social symptoms of children with cancer and their parents during the palliative phase and the extent to which health professionals address those symptoms.
  
  
  METHODS
  Forty parents of children who died 1-3 years prior to data collection (structured questionnaire) were invited to participate in the study.
  
  
  RESULTS
  The response rate was 32 out of 40 parents (80%). Most frequently mentioned physical symptoms were pain, poor appetite, and fatigue. The children's most mentioned psychological symptoms were sadness, difficulty in talking to their parents about their feelings regarding illness and death and fear of being alone. The symptoms of fear of death of the child and fear of physical symptoms were most frequently mentioned parents' psychological symptoms. Health professionals addressed 82% of the children's physical symptoms, 43% of the children's psychological symptoms, and 56% of the parents' psychological symptoms. Parents indicated that after professional attention the proportion of children's physical symptoms that were completely or partially resolved was 18 and 26%, respectively. For children's psychological symptoms the figures were 9 and 25%, respectively, and for parents' psychological symptoms 2 and 23%, respectively.
  
  
  CONCLUSIONS
  The burden of symptoms of the child with cancer during the palliative phase and their parents is high. Health professionals focus mainly on the physical symptoms of the child. Relief of symptoms could not be achieved for a large proportion of symptoms. Further prospective research is necessary to investigate the kind, frequency and intensity of symptoms in order to tailor optimal palliative care to the needs of both child and parent.
authors.affiliation: Department of Pediatric Hematology, Radboud University Nijmegen Medical Centre, The Netherlands. j.theunissen@cukz.umcn.nl
authors.forename: J M J
authors.initials: JM
authors.lastname: Theunissen
authors.forename: P M
authors.initials: PM
authors.lastname: Hoogerbrugge
authors.forename: T
authors.initials: T
authors.lastname: van Achterberg
authors.forename: J B
authors.initials: JB
authors.lastname: Prins
authors.forename: M J F J
authors.initials: MJ
authors.lastname: Vernooij-Dassen
authors.forename: C H M
authors.initials: CH
authors.lastname: van den Ende
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000855:Anorexia / Q000209:etiology / Q000523:psychology / Q000628:therapy; D001293:Attitude to Death; D001932:Brain Neoplasms / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D004644:Emotions; D005221:Fatigue / Q000209:etiology / Q000523:psychology / Q000628:therapy; D005239:Fear; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D008297:Male; D051346:Mobility Limitation; D009369:Neoplasms / Q000150:complications* / Q000191:economics / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D010166:Palliative Care / Q000191:economics / Q000523:psychology*; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D012189:Retrospective Studies; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000191:economics / Q000523:psychology*; D017211:Treatment Failure