Assessment of Ambulatory Pediatric Palliative Care in Mecklenburg-Western Pomerania - Status Before Establishment of Specialized Ambulatory Pediatric Palliative Care

Question: Mecklenburg-Western Pomerania with about 1,6 mio. inhabitants - is the least densely populated county in Germany. Currently, in contrast to other regions, there is no Specialized Ambulatory Palliative Care Team for children and adolescents in this region. It was asked which need for such a team is seen by the resident pediatricians, and which structure of care the nursing services provide. Methods: Between May and December 2010, questionnaires were sent to all resident pediatricians. It was asked about the current quality of palliative care and the needs and expectations concerning specialised ambulatory care. In parallel, all nursing services were questioned regarding their capacities for the palliative care for children. Data were transferred to a SPSS database and analysed descriptively and by statistics. Results: The return rate of the questionnaires by the doctors was 30%. Most of them care for children or adolescents suffering from life limiting diseases. Only a minority can provide home care. Concerning specialised medical care, 9.3% saw an urgent need for improvement, 53.5% call it desirable. Regarding nursing service, 23.3% saw urgent, 55.8% desirable need for change. 37.2% answered an urgent, and an equal number a desirable need for improvement of social medical care, and finally, in psychological and spiritual care, 53.5% called improvements urgent, and further 20.9% desirable. Most home care nursing teams out of which no one is specialized in children - do only care for some individual children or adolescents; most employ examined pediatric nurses. All those physicians and nursing teams who answered, expressed interest to cooperate with a future specialized team. Conclusion: Only Specialized Ambulatory Palliative Care Teams for children and adolescents can provide severely sick children and their families the chance to live until death with dignity and self-determination in their chosen surrounding.