부산대학교 도서관

1. Identify and assess varying perspectives of palliative care held by individuals from different disciplinary backgrounds 2. Prepare interventions to develop and improve partnerships between palliative care and pediatric stem cell transplant teams Studies have demonstrated benefit with early integration of palliative care (PC) in stem cell transplant (SCT), yet consultation of specialty PC by pediatric SCT teams remains low. SCT teams rely on collaboration between multiple disciplines with distinct perspectives of patient care. To understand how a multidisciplinary pediatric SCT team perceives specialty PC and the role of PC consultations in SCT. Between July 2020 and March 2021, 19 members of the SCT team at a medium-sized children's hospital participated in semistructured, in-depth interviews. Participants included physicians, nurse practitioners, nurses, social workers, and child life specialists. Interview transcripts were analyzed via thematic analysis. Three major themes emerged. (1) A lack of clarity exists around the indications for PC consultation. Nurses desired broader PC consultation through witnessing patient suffering, whereas physicians felt a need to have a focused "consult question." (2) Participants described unique steps and considerations when consulting PC compared to other disciplines, such as obtaining permission from both medical providers and families prior to consultation. (3) Participants thought that the content of the consultation may extend beyond the scope of the consult question. Whereas nurses were hopeful that consultations for pain management could lead to provision of comprehensive PC, other team members worried that the PC team would hold important conversations—such as exploring goals of care—without the SCT team's involvement. Members of the multidisciplinary SCT team identified specific aspects of PC consultation that differentiate it from consultation with other services. A lack of clarity in indications, process barriers, and uncertain outcomes of consultation create opportunities for PC teams to clarify their role and better collaborate with SCT teams. Through developing a deeper understanding of how SCT teams perceive PC, PC teams can strengthen partnerships with SCT teams and improve the care provided to these children and families. [ABSTRACT FROM AUTHOR]