ABSTRACT
BACKGROUND Palliative care for children is an innovative approach that helps improve the quality of life of children suffering from life-limiting illnesses, and their family members. The WHO recognized palliative care as a part of universal health coverage. However, there is inadequate availability and inequitable distribution of palliative care services for children in most parts of the world. We reviewed the existing literature to assess (i) the challenges in providing palliative care services for children suffering from life-limiting illnesses and (ii) the strategies or opportunities to overcome these challenges. METHODS We conducted systematic searches in the PubMed and Scopus databases to find articles published in the past 10 years (January 2011 to December 2020). The population, concept and context (PCC) framework was used to devise a search strategy in an electronic database. RESULTS A total of 1562 articles were found by searching the database and other sources. Title and abstracts of articles were screened, and 206 articles were selected for full-text review. After scrutiny 28 articles met the inclusion criteria. Barriers to and opportunities in the provision of palliative care services for children were identified at policy, organizational, healthcare provider, and patient/family levels. CONCLUSION We found that the majority of barriers to provision of palliative care services for children with life-limiting illnesses can be addressed by adopting research-driven strategies. Adequate and equitable distribution of palliative care services is required for improving children and their family members’ quality of life.
ABSTRACT
Objective: To develop and validate a new tool viz., Intravenous Infiltration and Extravasation Risk Assessment Tool (IIEART) for assessing risk of fluid extravasation in children. Participants: 120 children (aged 2-18 year) undergoing peripheral intravenous cannulation were recruited from four hospitals of Haryana to determine the IIEART scale’s psychometric properties. Methods: The tool was developed under four phases with Modified Delphi rounds among nine experts. After experts’ confirmation of final draft, the reliability and validity of the tool was ascertained. Results: The final IIERAT with 11 items showed good internal consistency (?=0.81) with inter-rater reliability of (?=0.88). To calculate predictive validity, sensitivity and specificity were assessed for 3 consecutive days from the day of cannulation. At a score >21, the sensitivity was 100% and specificity was 100% with area under curve of 1.0 (95% CI 1.0, 1.0) on second day of cannulation. Conclusion: The IIEART developed was found to be valid and reliable and can be used by healthcare personnel to predict pediatric patients at risk for intravenous infiltration and extravasation.