A new holistic-evolutive approach to pediatric palliative care / Carlo V. Bellieni.

Format:

Book

Author/Creator:

Bellieni, Carlo Valerio.

Language:

English

Subjects (All):

Terminally ill children.

Children--Diseases--Palliative treatment.

Genre:

Electronic books.

Physical Description:

1 online resource

Place of Publication:

Cham, Switzerland : Springer, 2022.

Summary:

This book illustrates why a holistic approach is important in Pediatric Palliative Care (PPC). Readers will learn this approach has a horizonta axis, featuring the patients mental and physical needs, as well as their environments. It has also a "vertical axis" the evolutive changes of the patients throughout their development and their illness, their aspirations and fears. An evolutive (or dynamic) approach is mandatory. Each child/parent has a different experience of illness and a different path to recovery that is influenced by their age, gender, culture, but also by the state of their grief. To take care of them, we need to know the state of the subjects we are dealing with throughout their evolution in age (children) and in sorrow (both children and parents). Jungs and Piaget schemes will be of support. This book also helps caregivers to know what ethics is. It teaches a new insight on the word ethics not a series of principles or norms, but an approach based on humanistic virtues. Two criteria will be proposed to this aim: an ethics based on the refusal of inauthentic behaviors (or those behaviors that are copies of animals or machines) and a new criterion that even children have some ethical duties (not based on rules, but on naturally acceptance that their sight is modulated by the presence of their parents and friends). This ethical approach is explained to caregivers in a practical mode, ready for clinical exigencies. This book is also unique because it demonstrates that PPC also involves the true care of caregivers. It will explain how to approach, measure and overcome caregivers burn-out. Special attention is devoted to the approach to babies and childrens pharmacological and non-pharmacological analgesia and sedation. Pain assessment methods will be illustrated, as well as the development of a PPC web on the territory. This text includes perinatal and neonatal PPC. The book will be of valuable support to all those intensivists, pediatricians, nurses, psychologists, physiotherapists and healthcare professionals working in PPC units.

Contents:

Part I. Communication Throughout Palliative Care

Crucial Importance Of The Dialogue

Certain news is indelible

The importance of silence

Informed Consent: Ethical And Practical Peculiarities

Understanding The Phase Of Grief To Speak Properly To The Patient

Phases or stages of grief

The pathological or unresolved grief

When should I ask for help?

What are postponed griefs?

It Is Difficult To Use The Word Death

Dealing with death and babies

Piaget's Theory: How Children Change Their Mode To Understand Throughout Their Growth

How The Piaget Models Are Applied To The Dialogue With The Children About Death

Special children

Obstacles To Communication

Desire to protect the child from distress

Parents' emotional well-being

Factors that influence the communication of health professionals

Learning To Communicate According To The Patient's Character And Mood

Bringing Your Patients Mentally Close: The Briggs Indicator

Part II. Ethics And Palliative Care

What Is "Ethical"

Not principles but virtues

The drama of imitation and of being mere copies of the human

The conditions for ethics: Reason, Realism, Empathy

Does The Child Have Ethical Responsibilities?

The role of coherence and imitation

Children are not small adults

Suicide

Children are not allowed to choose something against their health

Parents Cannot Choose But Childrens Health And Wellbeing

The Words Of Health Show That Healthcare Is Alliance And Not Mere Procedures

Origin of the words medicine health care

What Is Health

Health is socially helped satisfaction

Health is possible even for the sick

Health and loneliness are false friends

Pain and environment limit real health

Part III. Perinatal Care

Treating As Human Those Who Do Not Seem Human: The Philosophical Dilemma

Fetal Palliative Care

Newborns: To Heal Them All, And At Any Price?

Criteria

The probabilistic criterion

Best interest principle

The least harm criterion

The least pain criterion

Measuring Pain And Stress

Scales

Other tools to measure pain

Part IV. Therapies

Analgesic Therapies

Drugs

Adjuvant analgesics

Non-pharmacological therapies

Distraction: Physiological Basis

Sedation

Self-sedation

Refractory symptoms

Sedation is not always necessary

Opioids In Pediatrics

Main opioids used in pediatrics

Recommendations

Most common objections

Opioid withdrawal

When to start or continue opioids for chronic pain

Selection, dosage, duration, monitoring and suspension of opioids

Special Needs

Part V. Landmarks For A Holistic-Evolutive Approach

The Three Paradoxes Of Caring For Terminal Children

The baby scares us

Paradox of the contemporary flowering and death

Paradox of inverted reason

Paradox of the spectator's shadow (Platos myth)

Wrong Cases Of Pediatric Palliative Care

Use of a smoky principle

Therapeutic obstinacy

Contagious Pain

Caregivers burnout

The pain of the parents

A vicious circle.

Notes:

Includes bibliographical references.

Online resource; title from PDF title page (SpringerLink, viewed June 10, 2022).

ISBN:

9783030962562

3030962563

OCLC:

1321899253

Access Restriction:

Restricted for use by site license.