Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey
Abstract Background The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice...
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doaj-50a3d866dc1f4c98b0956e94af64b2272020-11-25T02:52:20ZengBMCBMC Palliative Care1472-684X2020-09-011911910.1186/s12904-020-00652-8Differences in perspectives of pediatricians on advance care planning: a cross-sectional surveyIn Gyu Song0Sung Han Kang1Min Sun Kim2Cho Hee Kim3Yi Ji Moon4Jung Lee5Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineDepartment of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalCollege of Nursing, Seoul National UniversityIntegrative Care Hub, Seoul National University Children’s HospitalIntegrative Care Hub, Seoul National University Children’s HospitalAbstract Background The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice being punishable by law, and physicians tended to pursue aggressive treatment. With changes in public opinion on end-of-life care, the Korean government enacted a new law that protect human dignity by respecting patients’ self-determination and facilitating advance care planning. However, little is known about current state of advance care planning for pediatric patients. The study aimed to assess perceptions regarding advance care planning among South Korean pediatricians and clarify any differences in perception among pediatric subspecialties. Methods This study was an observational cross-sectional survey that used a web-based self-report questionnaire. Participants comprised of pediatricians currently caring for children with life-limiting conditions in 2018. Results Of the 96 respondents, 89 were included in the analysis. In a hypothetical patient scenario, more hemato-oncologists and intensivists than neonatologists and neurologists preferred to provide comfort care than aggressive treatment. While 72.2% of hemato-oncologists reported that they usually or always discuss advance care plans with parents during treatment, more than half of other pediatricians reported that they seldom do so. Furthermore, 65% of respondents said that they never discuss advance care planning with adolescent patients. Moreover, there were no notable differences among subspecialties. The most prevalent answers to factors impeding advance care planning were lack of systemic support after performing advance care planning (82.0%) and uncertain legal responsibilities (70.8%). Conclusions The pediatricians differed in their experiences and attitudes toward advance care planning based on their subspecialty. Consequently, institutional support and education should be provided to physicians so that they can include children and families in discussions on prognosis.http://link.springer.com/article/10.1186/s12904-020-00652-8Advance care planningPediatricianPalliative carePrognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
In Gyu Song Sung Han Kang Min Sun Kim Cho Hee Kim Yi Ji Moon Jung Lee |
spellingShingle |
In Gyu Song Sung Han Kang Min Sun Kim Cho Hee Kim Yi Ji Moon Jung Lee Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey BMC Palliative Care Advance care planning Pediatrician Palliative care Prognosis |
author_facet |
In Gyu Song Sung Han Kang Min Sun Kim Cho Hee Kim Yi Ji Moon Jung Lee |
author_sort |
In Gyu Song |
title |
Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey |
title_short |
Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey |
title_full |
Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey |
title_fullStr |
Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey |
title_full_unstemmed |
Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey |
title_sort |
differences in perspectives of pediatricians on advance care planning: a cross-sectional survey |
publisher |
BMC |
series |
BMC Palliative Care |
issn |
1472-684X |
publishDate |
2020-09-01 |
description |
Abstract Background The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice being punishable by law, and physicians tended to pursue aggressive treatment. With changes in public opinion on end-of-life care, the Korean government enacted a new law that protect human dignity by respecting patients’ self-determination and facilitating advance care planning. However, little is known about current state of advance care planning for pediatric patients. The study aimed to assess perceptions regarding advance care planning among South Korean pediatricians and clarify any differences in perception among pediatric subspecialties. Methods This study was an observational cross-sectional survey that used a web-based self-report questionnaire. Participants comprised of pediatricians currently caring for children with life-limiting conditions in 2018. Results Of the 96 respondents, 89 were included in the analysis. In a hypothetical patient scenario, more hemato-oncologists and intensivists than neonatologists and neurologists preferred to provide comfort care than aggressive treatment. While 72.2% of hemato-oncologists reported that they usually or always discuss advance care plans with parents during treatment, more than half of other pediatricians reported that they seldom do so. Furthermore, 65% of respondents said that they never discuss advance care planning with adolescent patients. Moreover, there were no notable differences among subspecialties. The most prevalent answers to factors impeding advance care planning were lack of systemic support after performing advance care planning (82.0%) and uncertain legal responsibilities (70.8%). Conclusions The pediatricians differed in their experiences and attitudes toward advance care planning based on their subspecialty. Consequently, institutional support and education should be provided to physicians so that they can include children and families in discussions on prognosis. |
topic |
Advance care planning Pediatrician Palliative care Prognosis |
url |
http://link.springer.com/article/10.1186/s12904-020-00652-8 |
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