Perceptions of specialty palliative care and its role in pediatric stem cell transplant: A multidisciplinary qualitative study

TY - JOUR

T1 - Perceptions of specialty palliative care and its role in pediatric stem cell transplant

T2 - A multidisciplinary qualitative study

AU - Collins, Griffin S.

AU - Beaman, Hannah

AU - Ho, Alvin M.

AU - Hermiston, Michelle L.

AU - Cohen, Harvey J.

AU - Dzeng, Elizabeth W.

N1 - Funding Information: The authors would like to thank the members of the SCT team who volunteered to participate in this study and Lisa Purser for her commitment to advancing pediatric palliative care. This study was supported by funds from the UCSF Division of Pediatric Hematology and Oncology. Publisher Copyright: © 2021 Wiley Periodicals LLC

PY - 2022/1

Y1 - 2022/1

N2 - Background: Consultation of specialty palliative care remains uncommon in pediatric stem cell transplant (SCT) despite growing evidence that early integration of palliative care improves outcomes in patients with advanced cancers or undergoing SCT. Little is known about how multidisciplinary pediatric SCT teams perceive palliative care and its role in SCT. Procedure: We conducted semistructured interviews of members of a multi-disciplinary SCT team to understand their perceptions of palliative care, how specialty palliative care is integrated into SCT, and to identify barriers to increased integration. Eligible participants included physicians, nurses, inpatient nurse practitioners, social workers, and child life specialists. Data were analyzed using thematic analysis. Results: Four major themes were identified. First, SCT team members held a favorable perception of the palliative care team. Second, participants desired increased palliative care integration in SCT. Third, participants believed that the palliative care team had insufficient resources to care for the large number of SCT patients, which led to the SCT team limiting palliative care consultation. And, finally, the lack of a standardized palliative care consultation process prevented greater integration of palliative care in SCT. Conclusions: SCT team members held a favorable perception of palliative care and saw a role for greater palliative care integration throughout the SCT course. We identified modifiable barriers to greater palliative care integration. SCT teams who desire greater palliative care integration may adapt and implement an existing model of palliative care integration in order to improve standardization and increase integration of specialty palliative care in SCT.

AB - Background: Consultation of specialty palliative care remains uncommon in pediatric stem cell transplant (SCT) despite growing evidence that early integration of palliative care improves outcomes in patients with advanced cancers or undergoing SCT. Little is known about how multidisciplinary pediatric SCT teams perceive palliative care and its role in SCT. Procedure: We conducted semistructured interviews of members of a multi-disciplinary SCT team to understand their perceptions of palliative care, how specialty palliative care is integrated into SCT, and to identify barriers to increased integration. Eligible participants included physicians, nurses, inpatient nurse practitioners, social workers, and child life specialists. Data were analyzed using thematic analysis. Results: Four major themes were identified. First, SCT team members held a favorable perception of the palliative care team. Second, participants desired increased palliative care integration in SCT. Third, participants believed that the palliative care team had insufficient resources to care for the large number of SCT patients, which led to the SCT team limiting palliative care consultation. And, finally, the lack of a standardized palliative care consultation process prevented greater integration of palliative care in SCT. Conclusions: SCT team members held a favorable perception of palliative care and saw a role for greater palliative care integration throughout the SCT course. We identified modifiable barriers to greater palliative care integration. SCT teams who desire greater palliative care integration may adapt and implement an existing model of palliative care integration in order to improve standardization and increase integration of specialty palliative care in SCT.

KW - BMT

KW - palliative care

KW - psychosocial

KW - qualitative research

KW - quality of life

KW - stem cell transplantation

UR - http://www.scopus.com/inward/record.url?scp=85118200660&partnerID=8YFLogxK

U2 - 10.1002/pbc.29424

DO - 10.1002/pbc.29424

M3 - Article

C2 - 34705322

AN - SCOPUS:85118200660

SN - 1545-5009

VL - 69

JO - PEDIATRIC BLOOD AND CANCER

JF - PEDIATRIC BLOOD AND CANCER

IS - 1

M1 - e29424

ER -