PAEDIATRIC PALLIATIVE ONCOLOGY ACROSS SWITZERLAND: A CROSS-SECTIONAL SURVEY

E. C. Pedraza S.¹, M. J. Hendriks¹, E. Bergstraesser², E. M. Tinner³, G. Michel¹ (¹Luzern ; ²Zürich ; ³Bern)

Hintergrund

Key words: Paediatric palliative care; Bereavement care; Childhood cancer; Cross-sectional survey.

Despite major success in treatment with survival rates of more than 80%, almost every fifth child diagnosed with cancer cannot be cured and dies. Paediatric palliative oncology has been developed to reduce the suffering of children with cancer and their families and to help them cope with uncertainties they face. Since recent time, paediatric palliative care (PPC) has been recommended as a standard of care within paediatric oncology, but there remains lacking information about its implementation in practice.

Ziel

In this cross-sectional survey, we explored the availability and services of PPC in paediatric oncology centres (N=9) in Switzerland.

Methode

Healthcare experts with experience in PPC working in paediatric oncology centres were approached. Participants were invited by e-mail to complete an online password-protected questionnaire (including two reminders).

Resultate

Experts from all nine Swiss paediatric oncology centres participated in the survey (100% response rate). Seven out of nine centres (78%) are currently offering PPC to paediatric oncology patients. Two centres (22%) have access to PPC care provider but without a specialized PPC service. Seven centres offer inpatient consultation 24/7 coverage, as well as consultation care in home setting (78%); telehealth and outpatient consultation during the day is offered by five centres (56%). PPC consultation is mainly triggered by the diagnosis of a refractory neoplasm (8 centres/89%), followed by a new cancer diagnosis with event free survival anticipated to be not very likely (7 centres/78%). The most common time-point to present the PPC concept to patients and families is at disease-specific time points (e.g. relapse, refractory disease or refractory symptoms (5 centres/56%). Finally, a variety of bereavement supports are reported to be "always offered" by all centres, i.e. psychological counselling at centre, attending service/funeral and medical debriefing (7 centres/78%).

Schlussfolgerung

A summary of the availability and integration of PPC and bereavement care as well as the limits of paediatric palliative oncology in Switzerland are presented. Our results indicate that PPC has been implemented in Swiss paediatric oncology clinics and provide support to patients and families when needed.

This project is supported by the SSPH+ GlobalP3PH (Marie Curie Grant Agreement Number 801076) and the Swiss Cancer League grant No KFS-4995-02-2020.