Authors (including presenting author) :
PAK CH(1), CHAN WW(1), MAN SS(3), HUI WF(2), LO CH(3), HO YB (1), CHAN NC(1), KU SW(2)
Affiliation :
(1)Allied Health Department (Physiotherapy), (2)Department of Paediatrics and Adolescent Medicine, (3)Paediatric Palliative Care (PPC) Team, Hong Kong Children’s Hospital
Introduction :
Paediatric Palliative Rehabilitation (PPR) is a family-centered care approach, involving symptomatic control, stabilizing functional decline, promoting self-care independence and providing family support. In Paediatric Intensive Care Unit (PICU), majority of critically ill children receiving Paediatric Palliative Care (PPC) services also required intensive PPR from multidisciplinary care team to enhance their quality of life.
Objectives :
This review aims to provide an overview of the Physiotherapy team in collaboration with PICU and PPC team in providing PPR service.
Methodology :
It is a retrospective study. The medical records between 27 March 2019 and 7 January 2022 were reviewed with PPC team. The outcome measures include the percentage of physiotherapy services involving in these patients, and the types of physiotherapy services provided in PICU. Specifically, the physiotherapy services were classified into various categories, including 1) respiratory and pain management, 2) early mobilization, 3) seating services, and 4) personalized family support.
Result & Outcome :
In the review period, 102 patients were admitted to PICU requiring PPC services. Seventy-eight of them (76.5%) suffered from oncological conditions while 24 patients (23.5%) suffered from other diseases e.g., cardiac and renal diseases. Almost 59 of them (58%) were referred for Physiotherapy services, and those not referred were primarily more stable patients having short stay for PICU close monitoring. With regard to the Physiotherapy services, 91.2% of the referrals were for respiratory and pain management, while 75.4% were referred for early mobilization. Around 51% of them required Physiotherapy seating services as well as ambulatory equipment prescription to enhance their functional independence. Furthermore, 35.1% of the patients were arranged for personalized family support services. Particularly, Physiotherapists teamed with PICU and PPC teams to formulate the pre-discharge plan and caregivers’ empowerment services, including home respiratory care, positioning and massage for symptomatic relief. Co-jointed home visits were carried out to tackle potential obstacles for safe home discharge. Physiotherapists also provided support for arrangement of outdoor visits (e.g. rehabilitation garden) to facilitate early community integration and to increase morale of family with long term hospitalization. This review presents a comprehensive multidisciplinary team approach in PPR for patients receiving PPC services in PICU. The hand-in-hand collaboration initiates the first step for the goal of the systematic PPR, aiming at providing both children and their family a meaningful journey.
