緩和照護於兒童癌症的新趨勢

New Trend in Palliative Care for Pediatric Cancer

10.6142/VGHN.202203_39(1).0004

吳麗敏(Li-Min Wu)；溫淑慧(Shu-Hui Wen)；陳信宏(Shin-Hong Chen)；蘇以青(Yi-Ching Su)

兒童緩和照護 ； 兒童癌症 ； 以家庭為中心照護 ； pediatric palliative care ； pediatric cancer ； family-centered care

榮總護理

39卷1期（2022 / 03 / 01）

35 - 40

繁體中文

隨著醫療的進步，癌症兒童存活率提高，但惡性腫瘤仍為兒童及青少年常見的死亡原因，這突顯了兒童緩和照護於兒童癌症照護的迫切性。然而談論死亡常被東方文化視為禁忌，以及家人與孩童認知上的不對等，使得兒童生命末期照護更加複雜和不容易。本文經由文獻查證後依兒童緩和照護理念、團隊溝通、生理評估、心理社會照護，以及後續追蹤和輔導等層面逐一說明，期望能增加醫護人員對於兒童緩和照護知識，持續透過跨團隊提供個案和家庭身體、心理、社會高品質的照護，提昇癌症兒童和家庭的生活品質。

Due to advances in medicine, the survival rate of pediatric patients with cancer has increased considerably. However, malignancy among children and adolescents is still the main reason for death in this age group, indicating the importance of pediatric palliative care (PPC). Expressing death is considered taboo in Eastern cultures, and unequal cognition exists between children and parents in this regard. These situations cause additional difficulties in implementing pediatric end-of-life care. Here, a literature review is conducted to introduce the philosophy of PPC, team communication, physical assessment, psychological care, and follow-up care and counseling principles in PPC. We believe that this article will enhance the knowledge of PPC among health care workers. PPC provided by an interdisciplinary team can lead to high-quality care in aspects of physical, mental, and psychosocial care and can improve the quality of life of pediatric patients with cancer and their families.

1. 吳麗敏(2016)。兒童癌症存活者的健康問題和照護。源遠護理，10(2)，12-19。
   連結：
2. Aschenbrenner, A. P.,Winters, J. M.,Belknap, R. A.(2012).Integrative review: Parent perspectives on care of their child at the end of life.Journal of Pediatric Nursing,27(5),514-522.
3. Bell, C. J.,Skiles, J.,Pradhan, K.,Champion, V. L.(2010).End-of-life experiences in adolescents dying with cancer.Support Care in Cancer,18(7),827-835.
4. Brock, K. E.,Tracewski, M.,Allen, K. E.,Klick, J.,Petrillo, T.,Hebbar, K. B.(2019).Simulation-based palliative care communication for pediatric critical care fellows.American Journal of Hospice and Palliative Medicine,36(9),820-830.
5. Docherty, S. L.,Thaxton, C.,Allison, C.,Barfield, R. C.,Tamburro, R. F.(2012).The nu rsing dimension o f p roviding palliative care to children and adolescents with cancer.Clinical Medicine Insights: Pediatrics,6,75-88.
6. Heath, J. A.,Clarke, N. E.,Donath, S. M.,McCarthy, M.,Anderson, V. A.,Wolfe, J.(2010).Symptoms and suffer-ing at the end of life in children with cancer: An Australianperspective.Medical Journal of Australia,192(2),71-75.
7. Hsiao, C. C.,Chiou, S. S.,Hsu, H.T.,Lin, P. C.,Liao, Y. M.,Wu, L. M.(2016).Adverse health outcomes and health concerns among survivors of various childhood cancers: Perspectives from mothers.European Journal of Cancer Care,27(6),e12661.
8. Kaye, E. C.,Friebert, S.,Baker, J. N.(2016).Early integration of palliative care for children with high-risk cancer and their families.Pediatric Blood & Cancer,63(4),593-597.
9. Madden, K.,Magno C. M.,Mills, S.,Dibaj, S.,Williams, J. L.,Liu, D.,Bruera, E.(2019).Systematic symptom reporting by pediatric palliative care patients with cancer: A preliminary report.Journal of Palliative Medicine,22(8),894-901.
10. Nagabharana, T. K.,Joseph, S.,Rizwana, A.,Krishna, M.,Barker, M.,Fall, C.,Kumaran, K.,Krishnaveni, G. V.(2021).What stresses adolescents? A qualitative study on perceptions of stress, stressors and coping mechanisms among urban adolescents in India.Wellcome Open Research,6,106.
11. Olagunju, A. T.,Sarimiye, F. O.,Olagunju, T. O.,Habeebu, M. Y. M.,Aina, O. F.(2016).Child's symptom burden and depressive symptoms among caregivers of children with cancers: An argument for early integration of pediatric palliative care.Annals of Palliative Medicine,5(3),157-165.
12. Rosenberg, A. R.,Wolfe, J.(2017).Approaching the third decade of paediatric palliative oncology investigation: Historical progress and future directions.The Lancet Child & Adolescent Health,1(1),156-67.
13. Siegel, R. L.,Miller, K. D.,Fuchs, H. E.,Jemal, A.(2021).Cancer statistics, 2021.CA: A Cancer Journal for Clinicians,71(1),7-33.
14. Sisk, B. A.,Mack, J. W.,Ashworth, R.,DuBois, J.(2018).Communication in pediatric oncology: State of the field and research agenda.Pediatric Blood & Cancer,65(1),e26727.
15. Snaman, J.,McCarthy, S.,Wiener, L.,Wolfe, J.(2020).Pediatric palliative care in oncology.Journal of Clinical Oncology,38(9),954-962.
16. Soares, V. A.,Da Silva, L. F.,Cursino, E. G.,Goes, F. G. B.(2014).The use of playing by the nursing staff on palliative care for children with cancer.Revista Gaúcha de Enfermagem,35(3),111-116.
17. Upshaw, N. C.,Roche, A.,Gleditsch, K.,Connelly, E.,Wasilewski-Masker, K.,Brock, K. E.(2021).Palliative care considerations and practices for adolescents and young adults with cancer.Pediatric Blood & Cancer,68(1),7.
18. Wang, S. C.,Wu, L. M.,Yang, Y. M.,Sheen, J. M.(2019).The experience of parents living with a child with cancer at the end of life.European Journal of Cancer Care,28(4),e13061.
19. Watson, A.,Weaver, M.,Jacobs, S.,Lyon, M. E.(2019).Interdisciplinary communication: Documentation of advance care planning and end-of-life care in adolescents and young adults with cancer.Journal of Hospice & Palliative Nursing,21(3),215-222.
20. World Health Organization(2018).Integrating palliati vecare and symptom relief into paediatrics: A WHO guide for health care planners.Implementers and Managers.
21. Youngblut, J. M.,Li, J.(2019).Editorial: Parent, grandparent, and sibling responses to the death of an infant or child in intensive care.Pacific Rim International Journal of Nursing Research Thail,23(1),1-5.
22. 黃雅儀,楊倩玲,林素瑛,張珍珍,陳淑貞(2007)。癌童談論死亡的策略。護理雜誌，54(2)，79-84。
23. 衛生福利部統計處 (2021，8 月 16 日 )．民國109 年死因結果摘要表。https://dep.mohw.gov.tw/dos/cp-5069-61850-113.html