[Palliative care for children in onco-hematology: Role of a specific home-care team]

Bull Cancer. 2018 Sep;105(9):771-779. doi: 10.1016/j.bulcan.2018.05.007. Epub 2018 Jul 7.
[Article in French]

Abstract

Background/objective: Our home-care unit (HCU) is specialized for pediatric cancer patients and has a strong palliative care activity. We believe that the introduction of home-care services can influence the place of palliative care and of death as well as the length of hospitalization. We aimed at describing characteristics and care course of patients treated in our HCU, and tried to identify some factors contributing to home care at the end of life.

Design/methods: We conducted a retrospective, observational, monocentric study about patients in pediatric onco-hematology, treated at least one day in our home-care unit, who died between July 1st 2013 and December 31st 2015. Statistical analysis was descriptive and analytic.

Results: A total of 74 patients known by our HCU died during study period. Eight were excluded. Forty-three out of 66 patients died at home. During the last 3 months of life, oncology patients have significantly less classical hospitalization, when compared to hematology patients. The implication of general physicians (GP) and nurses and information given to the family increase the possibility for home death. No significant association was found between ages at death, distance between home and hospital, other life conditions and place of death.

Conclusions: Our HCU has a strong palliative care activity and a high rate of children dying at home. Good collaborations between our pediatric onco-hematology team and our HCU as well as between our HCU and caregivers optimize palliative care.

Keywords: End of life; Fin de vie; Home-care unit (HCU); Hospitalisation à domicile (HAD); Onco-hématologie pédiatrique; Pediatric oncohematology; Pediatric palliative care; Soins palliatifs pédiatriques (SPP).

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Cause of Death
  • Child
  • Child, Preschool
  • Female
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / therapy
  • Home Care Services / organization & administration
  • Home Care Services / statistics & numerical data*
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Neoplasms / mortality*
  • Neoplasms / therapy
  • Palliative Care / organization & administration
  • Palliative Care / statistics & numerical data*
  • Retrospective Studies
  • Terminal Care / organization & administration
  • Terminal Care / statistics & numerical data*
  • Young Adult