E-poster Presentation 2014 World Cancer Congress

Availability of palliative care services for children with cancer in Turkey (#588)

Kamer Mutafoglu 1 , Dilek İnce 2 , Tezer Kutluk 3
  1. Department of Pediatric Oncology, Dokuz Eylul University, Institute of Oncology, Izmir, Turkey
  2. Department of Pediatric Oncology, Behcet Uz Childrens Hospital, Izmir, Turkey
  3. Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey

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.