Premium
Analysis of the circumstances at the end of life in children with cancer: Symptoms, suffering and acceptance
Author(s) -
HONGO TERUAKI,
WATANABE CHIEKO,
OKADA SHUICHI,
INOUE NORIKO,
YAJIMA SHUHEI,
FUJII YUJI,
OHZEKI TAKEHIKO
Publication year - 2003
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1046/j.1442-200x.2003.01668.x
Subject(s) - medicine , anxiety , nausea , vomiting , cancer , quality of life (healthcare) , constipation , pediatrics , medical record , level of consciousness , psychiatry , nursing , anesthesia
Background: In an effort to improve the quality of life of children with cancer, this study analyzes the signs and symptoms at the end of life in such children. It is hoped that these data will contribute to the development of appropriate programs to address the challenges faced by these children.Procedure: Between 1994 and 2000, 28 children died after treatment for cancer at Hamamatsu University Hospital, Japan. The circumstances, signs and symptoms at the end of life of these children were analyzed through their medical records.Results: Of the 28 children, the underlying diseases were leukemia/lymphoma (LL group; n =11), brain tumors (BT group; n =7), and other solid tumors (OST group; n =10). Records showed poor appetite (100%), dyspnea (82.1%), pain (75.0%), fatigue (71.4%), nausea/vomiting (57.1%), constipation (46.4%) and diarrhea (21.4%) among these children. Anxiety was reported in 53.6% of the entire group of 28 children; however, no child in the BT group manifested anxiety. However, disturbance of consciousness was reported in all children in the BT group, which was significantly greater than in the other groups. Awareness, fear or acceptance of the imminence of his/her own death as indicated by verbal expression was reported in nine children (32.1%).Conclusions: Using the data obtained in the present study, we describe situations faced in the terminal care of children. It is important to address the problems revealed by this analysis in order to achieve improvements in both the physical and psychological care of children with terminal cancer.