Threading the cloak: palliative care education for care providers of adolescents, young adults with cancer

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the Cancer Therapy Advisor take:

Palliative care is a critical component of treating patients with cancer but is not always a subject in which oncologists are efficiently trained.

For adolescents and young adults specifically it has been shown that integrating principles of palliative care into standard oncology practice has a positive effect on a patient's experience during their period of cancer treatment. 

According to the authors of this paper, there is a need for the creation of effective guidelines for implementing successful palliative care in adolescents and young adults with cancer.

The authors state that early stages of oncology training should include topics regarding palliative care in order to better prepare clinicians in this subject and the specific needs of young adults should be included within this training due to the ways in which this group is inherently different from adults who are diagnosed with cancer.

The authors of this article go into a detailed review of the unique epidemiologic, psychosocial, and developmental factors that make the provision of palliative care especially challenging in this age group and provide a theoretical framework for the integration of palliative care education.

Despite the challenges of providing this support to patients, especially for oncologists who are simultaneously focused on diagnosing and treating a patient’s cancer, it is a meaningful and important component of a patient’s treatment.

Integration of palliative care at the time of diagnosis enables a supportive partnership with the medical team.
Integration of palliative care at the time of diagnosis enables a supportive partnership with the medical team.

Abstract: Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population.

Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs).

The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care.

Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training.

This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education.

Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed.

Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented.

Guidance is also provided on ways to support an AYA's quality of life as end of life nears.

Keywords: palliative care, education, training, adolescent, young adult

INTRODUCTION

Providing quality comprehensive care to adolescents and young adults (AYAs) with cancer is an often complex and challenging, yet always meaningful task. Their medical providers are trained to investigate, diagnose, and treat cancer.

Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population.

Palliative care aims to improve the quality of life (QOL) for AYA patients and their families by controlling symptoms and alleviating physical, social, psychological, and spiritual suffering.1  

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