MANAGING END-OF-LIFE CARE IN PEDIATRICS
Personal INFORMATION of the resident who fills the questionnaire out
Name: Surname:
Date of birth: Gender F /_ / M /_ /
Have you got children? □ no□ yes
When did you get the Degree in Medicine or Surgery?: Where?:
Pediatric universitary hospital:
Year of residency currently attended: 1 /__/ 2 /_ / 3 /__/ 4 /__/ 5 /__/
Other specializations: □no□ yes
Specify ______where______
______where ______
______where ______
Master in ______when /____/____/____/
______when /____/____/____/
InfoRMATION ON HIGHER EDUCATION
1.Did you receive training on how to approach/manage end-of-life care during the Graduation Course in Medicine or Surgery? □ no □ yes
* If your answer is affirmative, which aspects were presented?:
- Clinical aspects /__/
- Ethical aspects /__/
- Legal aspects /__/
- Other (specify) /__/ ______
* If your answer is affirmative, when?:
- During propaedeutic/optional courses /__/
- During Internal Medicine lessons /__/
- During Anesthesia or Resuscitation lessons /__/
- Other (specify) /__/______
* If your answer is affirmative, how many hours did it last? □ < 3 hours
□ 3-5 hours
□ > 5 hours
2.Did you receive training on how to approach/manage end-of-life care at the Pediatric Universitary Hospital? □ no □ yes
* If your answer is affirmative, which aspects were presented ?:
- Clinical aspects /__/
- Ethical aspects /__/
- Legal aspects /__/
- Other (specify) /__/ ______
* If your answer is affirmative, when?:
a. During propaedeutic/optional courses /__/
b. During General Pediatrics lessons /__/
c. During Specialized Pediatrics lessons /__/
d. During lessons of Ethics /__/
e. Other (specify) /__/ ______
* If your answer is affirmative, how many hours did it last? □ < 3 hours
□ 3-5 hours
□ > 5 hours
3.Did you follow conventions/conferences/courses concerning the approach or management of end-of-life-care in Pediatrics? □ no □ yes
* If your answer is affirmative, how many? (indicate the number)
- Monothematic courses /__/__/
- Lessons in Specialized Pediatrics courses /__/__/
- Monothematic conferences about pain/end-of-life care /__/__/
- Reports during conferences /__/__/
- Other (specify)/__/ ______
4.Did you receive training on how to evaluate/manage pain in children at the Pediatric Universitary Hospital? □ no □ yes
* If your answer is affirmative, when?:
a. During propaedeutic/optional courses /__/
b. During lessons at the Pediatric Residency /__/
c. During seminars/__/
d. During clinical activity /__/
e. Other (specify) : ______
* If your answer is affirmative, how many hours did it last? □ < 3 hours
□ 3-5 hours
□ > 5 hours
5.Is it possible to find the following services in your Pediatric Universitary Hospital?
- A Pain Therapy Service /__/
- A Palliative Care Service /__/
- No Palliative Care or Pain Therapy Services / __ /
- Other (specify): /__/ ______
6. If there is a Pain Therapy/Palliative Care Service, is the presence of residents in the service:
- Compulsory/__/
- Optional (on demand) /__/
- No possible /__/
- Other (specify) /__/ ______
6.If it is possible to train at the Pain Therapy and Palliative Care Service, in which year of residency is this programmed?
1 /__/ 2 /__/ 3 /__/ 4 /__/ 5 /__/
Other (specify): /__/ ______
Information concerning clinical experience
Have you ever witnessed the death of a child? □ no □ yes
* If your answer is affirmative, how many times? / _ /
* If your answer is affirmative, in which clinical ward?:
Casualty Number of cases /__/__/ Basic diagnosis ______
______
______
Intensive Unit Care Number of cases /__/__/ Basic diagnosis ______
______
______
Neonatal Intensive Unit Care Number of cases /__/__/ Basic diagnosis______
______
______
Operating theatre/ Surgery Number of cases /__/__/ Basic diagnosis ______
______
______
Pediatrics Number of cases /__/__/ Basic diagnosis ______
______
______
Other (specify) ______Number of cases /__/__/ Basic diagnosis
______
______
______
Have you ever managed the death of a child directly?□ no □ yes
* If your answer is affirmative, in which clinical ward?:
Casualty Number of cases /__/__/ Basic diagnosis ______
______
______
Intensive Unit Care Number of cases /__/__/ Basic diagnosis ______
______
______
Neonatal Intensive Unit Care Number of cases /__/__/ Basic diagnosis______
______
______
Operating theatre/ Surgery Number of cases /__/__/ Basic diagnosis ______
______
______
Pediatrics Number of cases /__/__/ Basic diagnosis ______
______
______
Other (specify) ______Number of cases /__/__/ Basic diagnosis
______
______
______
3. Have you ever prescribed opioids for pain control?□ no □ yes
* If your answer is affirmative specify which ones:______
4. Have you ever used sedo-analgesia protocols for end life care management?
□ no □ yes
* If your answer is affirmative, which drugs have you prescribed? : ______
______
5. Do you know the organizational procedures for corpse management?
□ no □ yes
6. Who managed the communication with the family at the moment of the death?(if there are more cases, specify each case, respecting the temporal order in which the deaths occurred: es 1st case, 2nd case, etc.)
□ attending physician
□ older resident
□I
□ other people (specify) ______
7. How do you evaluate the communication with the family?(if there are more cases, specify each case, respecting the temporal order in which the deaths occurred: es 1st case, 2nd case, etc.)
□ adequate ______
______
______
□ inadequate ______
______
______
□ other (specifiy) ______
8. If you managed communication, did you receive appropriate training before?
□ no □ yes
9. How was the management of deaths from a professional point of view?
(if there are more cases, specify for each case, respecting the temporal order in which the deaths occurred: es 1st case, 2nd case, etc.)
□ excellent
□ good
□ poor
□ very bad
□ other (please specify) ______
10. What would have helped you to professionally face the death of a little patient?
□ sharing the case with other colleagues
□ knowing the case/the clinical situation in advance
□ other ______
11. If you could face the same situation again, would you do anything different?
□ no □ yes
* If your answer is affirmative, what? ______
12. Did you have contacts with the child's parents after he /she had died?
□ no □ yes
* If your answer is affirmative:
□ upon parents' request
□ on your own initiative
□ other ______
13. What do you fear the most in pediatric death management?
□ the clinical aspect
□ the organizational aspect
□ the legal aspect
□ the human/emotional aspect
□ other (specify) ______
14. What effects did the death of a child produce in your professional activity?
□ study/research of clinical tools
□ approach to similar cases/incurable pathologies
□ avoidance of similar pathologies/situations
□ no effects
□ other (please specify) ______
15. Do you feel ready to professionally face end-of-life-care in your job?
□ no □ yes
16. Do you think it is important to have in your curriculum a training on death management?
□ yes □ no
Why?
17. If you had the opportunity to follow a training on death management, would you consider it useful in your clinical practice?
□ no □ yes
Why?
Date Signature
Thank you for the time you have spent in filling this questionnaire out. Your information will enable us to evaluate the state of the art of training on end-of-life care and pain management in Pediatrics and to lay the foundations for future training projects.