title: Establishing Feasibility of Early Palliative Care Consultation in Pediatric Hematopoietic Stem Cell Transplantation.
abstract: Children and adolescents undergoing hematopoietic stem cell transplantation (HSCT) encounter a number of distressing physical symptoms and existential distress but may not be afforded timely access to palliative care services to help ameliorate the distress. This feasibility study investigated the acceptability and outcomes of early palliative care consultation to promote comfort in this population. A longitudinal, descriptive cohort design examined both provider willingness to refer and willingness of families to receive palliative care interventions as well as satisfaction. Feasibility was demonstrated by 100% referral of eligible patients and 100% of patient and family recruitment (N = 12). Each family received 1 to 3 visits per week (ranging from 15 to 120 minutes) from the palliative care team. Interventions included supportive care counseling and integrative therapies. Families and providers reported high satisfaction with the nurse-led palliative care consultation. Outcomes included improvement or no significant change in comfort across the trajectory of HSCT, from the child and parental perspective. Early integration of palliative care in HSCT is feasible and acceptable to families and clinicians.
authors.affiliation: Children's National Health System, Washington, DC, USA dlafond@childrensnational.org.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Lafond
authors.affiliation: Department of Nursing Research and Quality Outcomes, Children's National Health System, Washington, DC, USA.
authors.forename: Katherine Patterson
authors.initials: KP
authors.lastname: Kelly
authors.affiliation: Department of Nursing Research and Quality Outcomes, Children's National Health System, Washington, DC, USA.
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Hinds
authors.affiliation: Children's National Health System, Washington, DC, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Sill
authors.affiliation: University of Maryland School of Nursing, Baltimore, MD, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Michael
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004219:District of Columbia; D005190:Family; D005240:Feasibility Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000451:nursing*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009859:Oncology Nursing; D010166:Palliative Care; D010342:Patient Acceptance of Health Care; D010371:Pediatric Nursing; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: comfort; evidence-based practice; patient- and parent-reported outcomes; pediatric palliative care; satisfaction; stem cell transplant; translation