If youâre depressed, a doctor may be able to prescribe medicines to help you feel better.When youâre in deep, emotional pain, it can be tempting to try to numb your feelings with drugs, alcohol, food, or even work.
Of 165 eligible parents, 143 were located, 107 of whom agreed to participate.
We completed 103 interviews between September 1997 and August 1998, for an overall rate of response of 62 percent (103 of 165 eligible parents). For example, chances are youâll grieve longer and harder over the sudden death of a loved one than, say, the end of a romantic relationship.With time, the sadness eases. Weeks at the Center for Outcomes and Policy Research and the Department of Adult Oncology, Dana–Farber Cancer Institute, 44 Binney St., Boston, MA 02115, or at Panel A shows the percentages of children who, according to parental report, had a specific symptom in the last month of life and who had “a great deal” or “a lot” of suffering as a result.
Nearly half the children died in the hospital, and almost half these deaths occurred in the intensive care unit. Youâll be able to return to your daily life.In some cases, grief doesnât get better. Thus, suffering may result in part from a lack of recognition of the problem by the medical team. Additional data were obtained by reviewing medical records.Of 165 eligible parents, we interviewed 103 (62 percent), 98 by telephone and 5 in person. Local obituaries, local passings, local information on the deceased in The Villages, Florida. ), and Adult Oncology (J.C.W.) Eligible parents were sent a letter containing a postage-paid postcard that they could return if they did not wish to participate. Jul 14, 2020
Whenever possible, the questions were drawn from previously validated surveys.A trained interviewer and one of the investigators conducted the interviews.
Of the children who were treated for specific symptoms, treatment was successful in 27 percent of those with pain and 16 percent of those with dyspnea. But be careful. For in-hospital deaths, information was abstracted on whether the patient was intubated in the last 24 hours of life, whether cardiopulmonary resuscitation was performed at the time of death, and whether ventilatory or other types of support were withdrawn.Analyses were conducted with the SAS statistical software package. Suffering from pain was more likely in children whose parents reported that the physician was not actively involved in providing end-of-life care (odds ratio, 2.6; 95 percent confidence interval, 1.0 to 6.7).Children who die of cancer receive aggressive treatment at the end of life. Overall, 70 percent of the parents described their child's death as very peaceful, regardless of the cause.Most parents were satisfied with the overall quality of care provided by the oncologist, with 81 percent rating it as very good or excellent. The quality of care provided by the primary nurse and psychosocial clinician was rated as very good or excellent by 90 percent and 77 percent of the parents, respectively. They were also asked to rate the degree to which the child appeared to suffer as a result of each symptom (on a five-point Likert scale), whether the child received treatment for the symptom, and if so, how successful the treatment was. Almost 80 percent died of progressive disease, and the rest died of treatment-related complications. Seventy-six percent of the children who died of a treatment-related complication underwent bone marrow transplantation as the last cancer-directed therapy.
For most children with cancer, the primary goal of treatment is to achieve a cure.High-quality palliative care is now an expected standard at the end of life.The study was conducted at Children's Hospital and the Dana–Farber Cancer Institute in Boston.
However, our reliance on parental reports does not differ from the norm in pediatrics.
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