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Healthcare interventions improving and reducing quality of life in children at the end of life : a systematic review

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Abstract
Background Children with serious illness suffer from symptoms at the end of life that often fail to be relieved. An overview is required of healthcare interventions improving and decreasing quality of life (QOL) for children with serious illness at the end of life. Methods A systematic review was performed in five databases, January 2000 to July 2018 without language limit. Reviewers selected quantitative studies with a healthcare intervention, for example, medication or treatment, and QOL outcomes or QOL-related measures, for example, symptoms, for children aged 1–17 years with serious illness. One author assessed outcomes with the QualSyst and GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) Framework; two authors checked a 25% sample. QOL improvement or reduction was categorized. Results Thirty-six studies met the eligibility criteria studying 20 unique interventions. Designs included 1 randomized controlled trial, 1 cross-sectional study, and 34 cohort studies. Patient-reported symptom monitoring increased QOL significantly in cancer patients in a randomized controlled trial. Dexmedetomidine, methadone, ventilation, pleurodesis, and palliative care were significantly associated with improved QOL, and chemotherapy, stem cell transplant, and hospitalization with reduced QOL, in cohort studies. Conclusions Use of patient-controlled symptom feedback, multidisciplinary palliative care teams with full-time practical support, inhalation therapy, and off-label sedative medication may improve QOL. Curative therapy may reduce QOL.
Keywords
Pediatrics, Perinatology, and Child Health, PEDIATRIC PALLIATIVE CARE, ADVANCED CANCER, YOUNG-ADULTS, HOME-CARE, SYMPTOMS, ONCOLOGY, PAIN, PARENTS, DEATH, CHEMOTHERAPY

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MLA
Piette, Veerle, et al. “Healthcare Interventions Improving and Reducing Quality of Life in Children at the End of Life : A Systematic Review.” PEDIATRIC RESEARCH, 2021, doi:10.1038/s41390-020-1036-x.
APA
Piette, V., Beernaert, K., Cohen, J., Pauwels, N., Scherrens, A.-L., van der Werff ten Bosch, J., & Deliens, L. (2021). Healthcare interventions improving and reducing quality of life in children at the end of life : a systematic review. PEDIATRIC RESEARCH. https://doi.org/10.1038/s41390-020-1036-x
Chicago author-date
Piette, Veerle, Kim Beernaert, Joachim Cohen, Nele Pauwels, Anne-Lore Scherrens, Jutte van der Werff ten Bosch, and Luc Deliens. 2021. “Healthcare Interventions Improving and Reducing Quality of Life in Children at the End of Life : A Systematic Review.” PEDIATRIC RESEARCH. https://doi.org/10.1038/s41390-020-1036-x.
Chicago author-date (all authors)
Piette, Veerle, Kim Beernaert, Joachim Cohen, Nele Pauwels, Anne-Lore Scherrens, Jutte van der Werff ten Bosch, and Luc Deliens. 2021. “Healthcare Interventions Improving and Reducing Quality of Life in Children at the End of Life : A Systematic Review.” PEDIATRIC RESEARCH. doi:10.1038/s41390-020-1036-x.
Vancouver
1.
Piette V, Beernaert K, Cohen J, Pauwels N, Scherrens A-L, van der Werff ten Bosch J, et al. Healthcare interventions improving and reducing quality of life in children at the end of life : a systematic review. PEDIATRIC RESEARCH. 2021;
IEEE
[1]
V. Piette et al., “Healthcare interventions improving and reducing quality of life in children at the end of life : a systematic review,” PEDIATRIC RESEARCH, 2021.
@article{8672509,
  abstract     = {{Background
Children with serious illness suffer from symptoms at the end of life that often fail to be relieved. An overview is required of healthcare interventions improving and decreasing quality of life (QOL) for children with serious illness at the end of life.

Methods
A systematic review was performed in five databases, January 2000 to July 2018 without language limit. Reviewers selected quantitative studies with a healthcare intervention, for example, medication or treatment, and QOL outcomes or QOL-related measures, for example, symptoms, for children aged 1–17 years with serious illness. One author assessed outcomes with the QualSyst and GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) Framework; two authors checked a 25% sample. QOL improvement or reduction was categorized.

Results
Thirty-six studies met the eligibility criteria studying 20 unique interventions. Designs included 1 randomized controlled trial, 1 cross-sectional study, and 34 cohort studies. Patient-reported symptom monitoring increased QOL significantly in cancer patients in a randomized controlled trial. Dexmedetomidine, methadone, ventilation, pleurodesis, and palliative care were significantly associated with improved QOL, and chemotherapy, stem cell transplant, and hospitalization with reduced QOL, in cohort studies.

Conclusions
Use of patient-controlled symptom feedback, multidisciplinary palliative care teams with full-time practical support, inhalation therapy, and off-label sedative medication may improve QOL. Curative therapy may reduce QOL.}},
  author       = {{Piette, Veerle and Beernaert, Kim and Cohen, Joachim and Pauwels, Nele and Scherrens, Anne-Lore and van der Werff ten Bosch, Jutte and Deliens, Luc}},
  issn         = {{0031-3998}},
  journal      = {{PEDIATRIC RESEARCH}},
  keywords     = {{Pediatrics,Perinatology,and Child Health,PEDIATRIC PALLIATIVE CARE,ADVANCED CANCER,YOUNG-ADULTS,HOME-CARE,SYMPTOMS,ONCOLOGY,PAIN,PARENTS,DEATH,CHEMOTHERAPY}},
  language     = {{eng}},
  pages        = {{13}},
  title        = {{Healthcare interventions improving and reducing quality of life in children at the end of life : a systematic review}},
  url          = {{http://dx.doi.org/10.1038/s41390-020-1036-x}},
  year         = {{2021}},
}

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