Publications (2)2.4 Total impact
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Article: Deaths of children occurring at home in six European countries.
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ABSTRACT: Until now there have been no population-based European data available regarding place of death of children. This study aimed to compare proportions of home death for all children and for children dying from complex chronic conditions (CCC) in six European countries and to investigate related socio-demographic and clinical factors. Data were collected from the death certificates of all deceased children aged 1-17 years in Belgium, the Netherlands, Norway, England, Wales (2003) and Italy (2002). Gender, cause and place of death (home vs. outside home) and socio-demographic factors (socio-economic status, degree of urbanization and number of hospital beds in the area) were included in the analyses. Data were analysed using frequencies and multivariate logistic regression. In total 3328 deaths were included in the analyses; 1037 (31.2%) related to CCC. The proportion of home deaths varied between 19.6% in Italy and 28.6% in the Netherlands and was higher for children dying from CCC in all the countries studied, varying between 21.7% in Italy and 50% in the Netherlands. Among children dying from CCC, home death was more likely for cancer patients and those aged over 10 years. After controlling for potentially related clinical and socio-demographic factors, differences in the proportion of home deaths between countries remained significant, with higher proportions in Belgium and the Netherlands as compared with Italy. Although home deaths comprise a substantial proportion of all deaths of children with CCCs, variation among disease categories and across countries suggest that considerable potential still exists for further improvements in facilitating end-of-life care in the home for those children and families who desire to be in this location.Child Care Health and Development 11/2009; 36(3):375-84. · 1.20 Impact Factor -
Article: Attitudes of Flemish secondary school students towards euthanasia and other end-of-life decisions in minors.
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ABSTRACT: The aim of the study was to investigate attitudes of secondary school students towards acceptability of requests by minors for end-of-life decisions (ELDs) with a possible life-shortening effect: non-treatment decisions, potentially life-shortening alleviation of pain and symptoms (APS) and euthanasia. A cross-sectional survey was conducted among second and fourth grades students in 20 secondary schools in Flanders, Belgium. An anonymous structured questionnaire was administered to measure attitudes towards acceptability of requests for euthanasia and other ELDs, towards the right to be informed about terminal prognosis and their own desire to be informed. In total, 1769 students participated. In case of a terminal patient, 61% found a request for euthanasia acceptable, 60% a request for APS and 69% a request for non-treatment decision, compared with 18% (euthanasia) and 50% (APS) in case of a non-terminal patient. Acceptance was highest among: boys, participants older than 14 years and participants from general as opposed to technical and vocational education. Sixty-six per cent said the parents' opinion not being asked was a circumstance that should hold back a physician from administering a lethal drug. Ninety per cent of participants thought a minor has the right to be informed about terminal prognosis of a disease while 78% would like to be informed themselves. Attitudes towards ELD requests varied with case and participant characteristics and type of ELD. The studied adolescents have a clear wish to be informed about terminal prognosis. Physicians and caregivers should adequately involve adolescents in decision making and tailor prognosis-related information to their needs and level of competency.Child Care Health and Development 02/2009; 35(3):349-56. · 1.20 Impact Factor
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2009
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Ghent University
Gent, VLG, Belgium
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