title: Quality of care at the end of life in children with cancer.
abstract: OBJECTIVE
  Current Australian guidelines for the provision of paediatric palliative care highlight the importance of services being focused on the needs of the child and family. We aimed to establish parents' level of satisfaction with the quality of care currently being provided to children dying of cancer.
  
  
  METHODS
  We interviewed 96 parents of children who died of cancer in Melbourne, Australia between 1996 and 2004 to ascertain how they rated the care provided to their child during the end-of-life period.
  
  
  RESULTS
  A majority of parents were satisfied with the care provided by their primary oncologist, local doctors, palliative care services and home-care nurses. Most parents felt that discussions about key medical and treatment decisions were appropriate and clearly understood. Parents were generally satisfied with the leadership roles undertaken in decision-making in the end-of-life period; however, parents who were not satisfied indicated that they would like additional involvement of their primary oncologist.
  
  
  CONCLUSIONS
  Current approaches to end-of-life care in children with cancer appear to be satisfactory. The main focus should continue to be on open and honest communication.
authors.affiliation: Children's Cancer Centre, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria 3052, Australia. john.heath@rch.org.au
authors.forename: John A
authors.initials: JA
authors.lastname: Heath
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Clarke
authors.forename: Maria
authors.initials: M
authors.lastname: McCarthy
authors.forename: Susan M
authors.initials: SM
authors.lastname: Donath
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Anderson
authors.forename: Joanne
authors.initials: J
authors.lastname: Wolfe
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000379:methods / Q000592:standards*; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D011787:Quality of Health Care; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods / Q000592:standards*; D014739:Victoria