Çocuk Palyati̇f Bakımı
Synopsis
Palliative care, derived from the Latin word 'palliare' meaning 'covering, relieving', is an interdisciplinary care philosophy that supports the physical, mental, and spiritual needs of children with life-threatening or life-limiting severe illnesses and their families with a holistic approach. Its main purpose is not to add years to the child's life, but to add life to their years and to maximize their quality of life. Children requiring palliative care are grouped into four main categories: progressive diseases where a complete cure is impossible, conditions with no curative treatment such as chronic brain damage, fatal conditions requiring long-term care such as cystic fibrosis, and conditions involving the risk of treatment failure such as cancer and congenital heart diseases. While care services can be provided in hospitals, community health centers, or at home, a multidisciplinary team consisting of a doctor, nurse, social worker, and psychologist takes part in conducting the process. Effective communication (through preparation, assessment, explanation, silence, planning, and communication steps) and symptom management are of vital importance in this process; physical and psychological issues such as pain, nausea-vomiting, constipation, and anxiety are controlled through pharmacological treatment or non-pharmacological methods. The first pediatric palliative care center in Turkey was opened in 2015 at Bursa Dörtçelik Children's Hospital, and increasing the number of these centers and trained healthcare staff is of critical importance for children and their families to lead a comfortable life.
References
World Health Organization. WHO Definition of Palliative Care for Children. http://www.who.int/cancer/palliative/defi nition/en/(accessed Oct 23, 2006).
Sürmeli DM, Akçiçek F. Palyatif bakım: tanımı ve tarihçesi. Türkiye Klinikleri J Gen Surg-Special Topics.2016;9(1):8-11.
Muckaden M, Dighe M, Balaji PD. Paediatric Palliative Care: Theory to Practice. Indian J Palliat Care. 2011;17(Suppl): S52–S60. doi: 10.4103/0973-1075.76244.
Kıvanç MM. Türkiye’de palyatif bakım hizmetleri. HSP. 2017;4(2):132-5.
Arias E, MacDorman MF, Strobino DM, Guyer B. Annual summary of vital statistics. Pediatrics. 2000;106(6):1307-17. doi: 10.1542/peds.106.6.1307.
Feudtner C, diGiuseppe DL, Neff JM. Hospital care for children and young adults in the last year of life: A population-based study. BMC Med 2003;1:3. doi: 10.1186/1741-7015-1-3
Sarman A. Pediyatrik Palyatif Bakım. Balıkesir Sağlık Bilimleri Dergisi. 2019;8(3):153-161.
Clark D, Graham F, Centeno C. Changes in the world of palliative care. Medicine. 2015;43(12):696-8.
T.C Sağlık Bakanlığı Kamu Hastaneleri Genel Müdürlüğü. Palyatif Bakım Hizmetleri. https://khgmozellikli.saglik.gov.tr/svg/palyatif.php
Kaymak SU, Apaydın ZK, Çayköylü A. Kanser hastalarında palyatif bakım. Türkiye Klinikleri J Psychiatry-Special Topics.2014;7(4):85-8.
Zernikow B, Michel E, Craig F, Anderson BJ. Pediatric palliative care. Paediatr Drugs. 2009;11(2):129-51. doi:10.2165/00148581-200911020-00004.
Uslu ŞF, Terzioğlu F. Dünya’da ve Türkiye’de palyatif bakım eğitimi ve örgütlenmesi. Cumhuriyet Hemşirelik Dergisi.2015;4(2):81-90.
Aladangady N, de Rooy L. Withholding and withdrawal of life sustaining treatment for newborn infants. Early Hum Dev. 2012;88(2):65-9. 2012.01.002. doi: 10.1016/j.earlhumdev.
Erden G. Ölüm sürecinde olan çocuk: Ölümü kabul ve tedavi sürecinde etkili yardım. Kriz Dergisi. 2002;10(1):19-27.
Santa-Emma P, Roach R, Gill M, Spayde P, Taylor R. Development and implementation of an inpatient acute palliative care service. J Palliat Med. 2002;5(1):93-100. doi:10.1089/1096621025278505.
Himelstein BP, Hilden JM, Boldt AM, Weissman D. Pediatric palliative care. N Engl J Med. 2004;350(17):1752-62. doi: 10.1056/NEJMra030334.
Field MJ, Behrman RE, editors. Institute of Medicine (U.S.) In: Committee on Palliative and End-of-Life Care for Children and Their Families. When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. Washington, D.C: National Academies Press;2003.
Elçigil A. Pediatrik palyatif bakım ve hemşirelik. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi.2006;9(4):75-81.
Elçigil A. Palyatif bakım hemşireliği. Gülhane Tıp Derg.2012;54:329-34.
Feudtner C. Collaborative communication in pediatric palliative care: A foundation for problem-solving and decisionmaking. Pediatr Clin North Am 2007; 54(5):583-607. doi: 10.1016/j.pcl.2007.07.008
Klick JC, Haurer J. Pediatric Palliative Care. Curr Probl Pediatr Adolesc Health Care 2010;40:120-151. doi: 10.1016/j.cppeds.2010.05.001.
Kocaman Yıldırım N, Kaçmaz N, Özkan M. İleri evre kanser hastalarının karşılanmamış bakım gereksinimleri. J Psychiatr Nurs.2013;4(3):153-8.
McGrath PA. Development of the World Health Organization Guidelines on cancer pain relief and palliative care in children. J Pain Symptom Manage 1996;12(2):87-92. doi: 10.1016/0885-3924(96)00099-1.
Carter BS, Howenstein M, Gilmer MJ, Throop P, France D, Whitlock JA. Circumstances surrounding the deaths of hospitalized children: Opportunities for pediatric palliative care. Pediatrics 2004;114(3):e361-6. doi: 10.1542/peds.2003-0654-F.
Santucci G, Mack JW. Common gastrointestinal symptoms in pediatric palliative care: Nausea, vomiting, constipation, anorexia, cachexia. Pediatr Clin North Am 2007;54(5):673-89. doi: 10.1016/j.pcl.2007.06.001.
