112: Paediatric Palliative Care in Canada: A National Survey of Paediatricians
Bibliographic record
Abstract
Paediatric palliative care (PPC) focuses on achieving the best possible quality of life for children with life-threatening conditions and their families. To achieve this goal, paediatricians have to identify the needs of children with life-threatening conditions and provide care that responds adequately to suffering. This study investigates how paediatricians define PPC and their perception of the needs of children with life-limiting diseases. Cross-sectional survey of a sample of 2485 Canadian paediatric specialists and subspecialists. The Canadian Paediatric Surveillance Program (CPSP) provided the sampling frame and survey management. The survey was distributed electronically and in hard copy formats. Of 420 respondents (17% response rate), 219 (52%) cared for patient with PPC needs in the month prior to the survey distribution. Most paediatricians (78%) offered a definition that included, but was not limited to end-of-life, 17% defined it as end-of-life only, and 5% did not know. A majority (58%) agreed with the four broad groups of children who would benefit from PPC (progressive conditions in which treatment is exclusively palliative after diagnosis, conditions for which curative treatment is possible but may fail, conditions requiring intensive long-term treatment aimed at maintaining quality of life, and conditions involving severe, non-progressive disability, causing extreme vulnerability to health complications). Of a total of 1127 children with PPC needs, paediatricians cared directly for 861 (76%) without referral to a PPC team. Most frequent PPC needs in these children were: support for family (94%); coordination of services in the community (88%); physical symptom management (84%); respite care (81%); support for child (80%); and care at the time of death (78%). Only 48% felt that their patients were receiving all the services needed. Although paediatricians overwhelmingly cited the need for many types of PPC services, only 35% had referred their patients to PPC and 18% did not have access to PPC team. Canadian paediatricians care for a large number of children with PPC needs. Despite recommendations to refer children to palliative care early in the course of illness, many paediatricians define palliative care as similar to hospice care. Paediatricians need to become familiar and comfortable with the provision of palliative care to children. Residency training and continuing education programs should include topics such as palliative medicine, communication skills, grief and loss, managing prognostic uncertainty, and decisions to forgo life-sustaining medical treatment, spiritual dimensions of life and illness.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".