This study evaluates the effectiveness of an existing Specialised Paediatric Palliative Care programme and reports on its potential to improve patient-, family-, health professionals-, and healthcare-related outcomes. Data will be compared between an intervention and a comparison group.
The number of children and adolescents living with life-limiting conditions and potentially in need for specialised paediatric palliative care (SPPC) is rising. As a highly complex subfield of palliative care, paediatric palliative care focuses on the support and involvement of the entire family, and on the impact not only at the patient level, but also at the family and health systems level. Ideally, a specialised multiprofessional team fills the complex healthcare needs of children and their families. A consultative care model might be well-suited to address each family's most important needs. The question, however, of how SPPC is beneficial for whom and under what circumstances remain largely unanswered as validation of innovative care programmes in controlled studies is lacking. This study's overall target is to evaluate the effectiveness of SPPC and to report on its potential to improve patient-, family-, health professional-, and healthcare-related outcomes. The primary objective is to explore how SPPC influences the quality of life (QOL) of caregivers, i.e. parents. Secondary objectives are to explore how SPPC influences the QOL of patients including their symptom severity and distress as well as the QOL of their siblings and of healthcare professionals not specialised in PPC. Further objectives are to determine whether the provision of SPPC reduces the utilisation of healthcare resources and direct and indirect health-related costs for families, and to evaluate implementation outcomes such as adoption, i.e., the uptake of SPPC. This interventional multi-centre study will apply a hybrid design to determine the clinical effectiveness (comparative effectiveness research) of an existing SPPC programme, while gathering information on its delivery and potential implementation in a real-life situation. This study will be conducted in compliance with the protocol, the current version of the Declaration of Helsinki, the ICH-GCP as well as all national legal and regulatory requirements.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
70
All services provided to children/families by a member of the multiprofessional SPPC team in Zurich according to local guidelines will be considered as study intervention. This includes direct consultation of the patient/family, as well as patient-/family-related consultation of the frontline care team. Bereavement support is considered an integrated part of SPPC and after the death of a child, follow-up bereavement support is routinely offered at the individual or group level as appropriate for parents and siblings.
Cantonal Children's Hospital
Aarau, Switzerland
University Children's Hospital
Basel, Switzerland
Department of Pediatrics, University Hospital Inselspital
Bern, Switzerland
University Children's Hospital Zurich
Zurich, Switzerland
Change in Caregiver QOL - QOLLTI-F Questionnaire
Longitudinal assessment of self-reported caregiver (parental) Quality of Life (QOL) using the QOLLTI-F (Quality of Life in Life Threatening Illness - Family Carer Version) questionnaire.
Time frame: Up to day 330 after study entry
Change in Child's QOL - DISABKIDS Chronic Generic Measure (DCGM-37) Questionnaire
Longitudinal assessment of child's Quality of Life using the DCGM-37 DISABKIDS questionnaire.
Time frame: Up to day 330 after study entry
Change in child's symptoms - Memorial Symptom Assessment Scale (MSAS) Questionnaire
Longitudinal assessment of child's symptoms by using the Memorial Symptom Assessment Scale (MSAS) questionnaire. MSAS assesses severity, frequency and distress for symptom evaluation using separate 4 or 5 point Likert scales. Higher values are associated with higher symptom burden.
Time frame: Up to day 330 after study entry
Change in Siblings QOL - KIDSSCREEN-27 Questionnaire
Longitudinal assessment of sibling's health related Quality of Life using the KIDSSCREEN-27 questionnaire.
Time frame: Up to day 630 after study entry
Professional's QOL (ProQOL) Questionnaire
Assessing self-reported healthcare professional's Quality of Life using the ProQOL questionnaire.
Time frame: Cross-sectional at the end of study year 1
Professional's QOL (ProQOL) Questionnaire
Assessing self-reported healthcare professional's Quality of Life using the ProQOL questionnaire.
Time frame: Cross-sectional at the end of study year 2
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Chang in grief - "Würzburger Trauerinventar (WüTi)" Questionnaire
Longitudinal assessment of parental grief processes using the "Würzburger Trauerinventar (WüTi)" questionnaire.
Time frame: Up to 1 year after the child's death
Change in parental QOL during bereavement - WHOQOL-BREF Questionnaire
Longitudinal assessment of parental Quality of Life during bereavement using the WHO Quality of Life-BREF questionnaire.
Time frame: Up to 1 year after the child's death