title: End-of-life management in pediatric cancer.
abstract: Pediatric palliative care at the end-of-life is focused on ensuring the best possible quality of life for patients with life-threatening illness and their families. To achieve this goal, important needs include: engaging with patients and families; improving communication and relationships; relieving pain and other symptoms, whether physical, psychosocial, or spiritual; establishing continuity and consistency of care across different settings; considering patients and families in the decision-making process about services and treatment choices to the fullest possible and desired degree; being sensitive to culturally diverse beliefs and values about death and dying; and responding to suffering, bereavement, and providing staff support. Any effort to improve quality of palliative and end-of-life care in pediatric oncology must be accompanied by an educational strategy to enhance the level of competence among health care professionals with regard to palliative care and end-of-life management skills as well as understanding of individualized care planning and coordination processes.
authors.affiliation: Pediatric Oncology Department, Santa Marcelina Hospital, São Paulo, Brazil. clauepelman@uol.com.br
authors.forename: Claudia L
authors.initials: CL
authors.lastname: Epelman
mesh_terms: D000293:Adolescent; D001293:Attitude to Death; D019090:Case Management / Q000458:organization & administration; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D005190:Family / Q000523:psychology; D006801:Humans; D033183:Interdisciplinary Communication; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D011368:Professional-Family Relations; D011788:Quality of Life / Q000523:psychology*; D013727:Terminal Care / Q000458:organization & administration / Q000592:standards