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Although resource limitations may constrain the ability of physicians to provide palliative care to children with cancer, physician perceptions of palliative care may also have a big impact on which courses of treatment are chosen. This study, published in JAMA Network Open, sought to understand the perception of palliative care among physicians treating children with cancer in Latin America.

This study relied on the Assessing Doctors’ Attitudes on Palliative Treatment survey. The survey was modified for use in Latin America and distributed to 874 physicians in 17 different countries. The authors used univariate and multivariate linear regression analyses to understand factors related to the physicians’ knowledge about and comfort with pediatric palliative care. Additionally, open-ended questions were used to supplement this quantitative data.

Ultimately, the authors found that physicians’ perspectives on palliative care for children with cancer were generally aligned with the World Health Organization guidelines. However, despite this alignment, it is important to note that 56% of these physicians lacked formal training in pediatric palliative care, and 35% lacked access to pediatric palliative care experts for consultation.

Not surprisingly, given this lack of expertise in pediatric palliative care, only 50%, 34%, and 29% of physicians surveyed felt comfortable treating their patients’ physical, emotional, and spiritual needs, respectively. Moreover, only 25% of physicians felt comfortable addressing the grief of their patients’ family members. 

In conclusion, this study suggests that physicians in Latin America often lack the expertise required to feel comfortable providing palliative care for their pediatric patients with cancer. The study authors advocate for regionally adapted educational interventions, which could help Latin American physicians better address the physical, emotional, and spiritual needs of their pediatric patients with cancer and improve bereavement care for their families [1].

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Source:

[1] McNeil, M. J., Ehrlich, B., Wang, H., Vedaraju, Y., Bustamante, M., Dussel, V., Friedrich, P., Garcia, X., Gillipelli, S., Gomez Garcia, W., Graetz, D., Kaye, E. C., Metzger, M., Sabato, C., Devidas, M., Baker, J. N., & Agulnik, A. (2021). Physician perceptions of pediatric palliative care for children with cancer in Latin America. JAMA Network Open. https://doi.org/10.2139/ssrn.3937562