Dutch guideline for paediatric palliative care

summary

In November 2022, the revised version of the Dutch evidence-based guideline for paediatric palliative care was published. In this guideline, recommendations are provided on different topics related to paediatric palliative care, including symptom treatment, advance care planning and shared decision-making, organization of care, psychosocial care, and preloss and bereavement care. An overview of the complete guideline methodology and included topics is provided in ‘Palliative care for children: methodology for the development of a national clinical practice guideline’ [van Teunenbroek 2023].

Recommendations on symptoms

Here, we provide all translated recommendations on the diagnosis, (non-)pharmacological treatment, and evaluation of the following symptoms: anxiety & depression, delirium, dyspnoea, haematological symptoms, coughing, skin complaints, nausea & vomiting, neurological symptoms, pain, death rattle and fatigue. Furthermore, we provide recommendations on paediatric palliative sedation, and forgoing hydration & nutrition including communication, preparation, execution, and evaluation.

The recommendations are based upon evidence (if available), clinical expertise, and patient and family values. The strength of each recommendation is graded according to published evidence-based methods and categorised as strong to do (green), moderate to do (yellow) or strong not to do (red).

For (non-)pharmacological treatment of symptoms, the evidence-based recommendations have been published in the paper entitled ‘A Dutch Paediatric palliative care guideline: a systematic review and evidence-based recommendations for symptom treatment’ [van Teunenbroek 2024]. This paper provides an overview of the identified evidence, key considerations and recommendations for symptom treatment. 

Recommendations on advance care planning, shared decision-making, and psychosocial care including preloss and bereavement care

The translated recommendations on Advance Care planning, shared decision-making, psychosocial care, and preloss and bereavement care will be published here as soon as possible.