Amanda M Evans1, Hiran Thabrew2, Bruce Arroll3, Nyree Cole4, Ross Drake5. 1. Paediatric Palliative Care Service, Starship Children's Health, Auckland and Mary Potter Hospice, Wellington 6242, New Zealand. 2. Consult Liaison Psychiatry Team, Starship Children's Health and University of Auckland, Auckland 1010, New Zealand. 3. Department of General Practice and Primary Health Care, University of Auckland, Auckland 1010, New Zealand. 4. Oncology and Haematogy Service, Birmingham Women's and Children's, Birmingham B15 2TG, UK. 5. Paediatric Palliative Care and Pain Service, Starship Children's Health, Auckland 1023, New Zealand.
Abstract
Psychosocial and palliative care support during stem cell transplants (SCT) is known to improve outcomes. AIM: evaluate the support provided to children and families at the New Zealand National Allogeneic Stem Cell Transplant unit (NATC). METHOD: the psychosocial and palliative care support for children who received SCT between December 2012 and April 2018 was audited. RESULTS: of the 101 children who received SCT, 97% were reviewed by the social work team (SW) and 82% by the psychiatric consult liaison team (CLT) at least once during their illness. However, pre-transplant psychological assessment only occurred in 16%, and during the SCT admission, only 55% received SW support, and 67% received CLT support. Eight out of eighty-five families (9%) were offered support for siblings. Eight of the sixteen children who died were referred for pediatric palliative care (PPC) with all supported and half the families who experienced a death (n = 8; 50%) received bereavement follow up. CONCLUSION: although the majority received some social work and psychological support, auditing against the standards suggests the consistency of involvement could be improved. Referrals for PPC were inadequate and largely for end-of-life phase. Sibling support, in particular donor siblings, had insufficient psychological assessment and support. Key recommendations are provided to address this underperformance.
Psychosocial and palliative care support during stem cell transplants (SCT) is known to improve outcomes. AIM: evaluate the support provided to children and families at the New Zealand National Allogeneic Stem Cell Transplant unit (NATC). METHOD: the psychosocial and palliative care support for children who received SCT between December 2012 and April 2018 was audited. RESULTS: of the 101 children who received SCT, 97% were reviewed by the social work team (SW) and 82% by the psychiatric consult liaison team (CLT) at least once during their illness. However, pre-transplant psychological assessment only occurred in 16%, and during the SCT admission, only 55% received SW support, and 67% received CLT support. Eight out of eighty-five families (9%) were offered support for siblings. Eight of the sixteen children who died were referred for pediatric palliative care (PPC) with all supported and half the families who experienced a death (n = 8; 50%) received bereavement follow up. CONCLUSION: although the majority received some social work and psychological support, auditing against the standards suggests the consistency of involvement could be improved. Referrals for PPC were inadequate and largely for end-of-life phase. Sibling support, in particular donor siblings, had insufficient psychological assessment and support. Key recommendations are provided to address this underperformance.
Authors: Grace Chang; Sara J Ratichek; Christopher Recklitis; Karen Syrjala; Sunita K Patel; Lynnette Harris; Angie Mae Rodday; Hocine Tighiouart; Susan K Parsons Journal: Pediatr Blood Cancer Date: 2011-05-25 Impact factor: 3.167
Authors: C M J Vrijmoet-Wiersma; R M Egeler; H M Koopman; D Bresters; A L Norberg; M A Grootenhuis Journal: Bone Marrow Transplant Date: 2009-11-02 Impact factor: 5.483
Authors: Sharon Manne; Katherine DuHamel; Jamie Ostroff; Susan Parsons; D Richard Martini; Sharon E Williams; Laura Mee; Sandra Sexson; Jane Austin; Joanne Difede; Christine Rini; William H Redd Journal: Pediatrics Date: 2004-06 Impact factor: 7.124
Authors: Paul D Creswell; Lauren E Wisk; Kristin Litzelman; Adelyn Allchin; Whitney P Witt Journal: Support Care Cancer Date: 2013-10-08 Impact factor: 3.603