Quality of Life of Children with Cancer and Chronic Diseases Receiving Palliative Care: A Mixed-Methods Systematic Review and Meta-analysis
Keywords:
Palliative care, Quality of life , Children Cancer, Chronic DiseasesAbstract
This study primarily aimed to assess the quality of research and the effectiveness of programs/palliative care models affecting the QOL of children with cancer and chronic diseases. The studies published from 2012-2023 were sought from 6 foreign and Thai databases. The search yielded 9 studies meeting the review criteria. The quality of studies ranged from 25-75%. The samples ranged from 8 to 5,435 children/AYAs, aged from 1 month to 24 years, most children with cancer. The palliative care ranged from 2 days to 5 years. The care model included specialty palliative care models for children with cancer and chronic diseases at home and in hospitals, end-of-life care, and standard palliative care.
Most studies showed that children receiving palliative care improved their overall QOL, including some components and pain/ disturbing symptoms with and without statistical significance. The results of a meta-analysis from three studies with research quality ranging from 50-75% in a sample of 66 people showed that compared to before receiving palliative care/usual care, children's overall QOL was significantly higher after receiving palliative care (SMD=After-Before=0.66; 95% CI 1.01, 0.31, I2=0%, Random Effect; Z=3.72, p=0.0002). Physical-related QOL was also significantly higher (SMD: After-Before=1.22; 95%CI 1.98-0.45, I2=71%, Random Effect; Z=3.11, p=0.0002). Nursing care should emphasize the importance of palliative care in children with cancer and chronic diseases, especially pain and symptom distress management that affects their QOL.
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