Background:
The paradigm of palliative care is a vital component of the care of children with cancer.
Aim:
To assess the availability of palliative care (PC) services and resources for pediatric cancer patients in Turkey.
Methods:
An institutional self assessment tool was sent to the head of the pediatric oncology units /departments.
Results:
All invited centers (n:31) responded the survey. All centers had pediatric oncology doctor(s) and nurse(s), but psychologist, social worker, psychiatrist, and physiotherapist were part of the treatment team in only 26 %, 13%, 7%, 7% of the centers. Three centers reported a PC team, not designated for PC. The perception about the integration of PC into pediatric oncology practice was defined as very poor (7%), poor (63%), or sufficient (30%). Knowledge/skills of oncology professionals on modern PC was defined as insufficient, sufficient, and very good by the 61%, 36% ,3% of the participants, respectively. Pediatric pain team was reported by 7 centers. None reported a clinical ethic committee. Regular meetings of treatment teams were reported by 80%. Sleeping accommodations for parents in child’s room was available in 90%, family lounge in 29 %. One or two beds for terminally ill children were available in 7 centers. Four centers reported periodic education/training on PC for staff, mostly on symptom management. The PC education was defined as poor (74%) or very poor (26%). The majority (80%) emphasized the need to integrate PC services into routine cancer care, instead of designated PC teams, however 61% thought that was not possible with the current human resources. The perceived obstacles to PC implementation were reported as lack of professionals (58%), physical space (48%), and education (26%).
Conclusions:
Pediatric PC services are lacking at the majority of centers due to lack of staff, education, and allocated space. Institutional and governmental attempts are needed for implementing PC services.