Evidence map›Paper›PMID 40410812›Full record

GuidelineBMC palliative care2025

A Dutch clinical practice guideline for paediatric palliative care: a systematic review and recommendations on psychosocial care including preloss and bereavement care.

Kim C van Teunenbroek, Renée L Mulder, A A Eduard Verhagen, Leontien C M Kremer, Jeanette L Falkenburg, Petra Honig-Mazer, Esther M M van den Bergh, Marijke C Kars, Johannes M A Verheijden, Hester Rippen and 4 more

Abstract readPractice GuidelineSystematic Review
In one paragraph

Guideline in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kim C van TeunenbroekPrincess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands. k.c.vanteunenbroek@prinsesmaximacentrum.nl.
Renée L MulderPrincess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands.
A A Eduard VerhagenDepartment of Pediatrics, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Leontien C M KremerPrincess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands.
Jeanette L FalkenburgIntensive Care Unit and Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands.
Petra Honig-MazerDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands.
Esther M M van den BerghPrincess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands.
Marijke C KarsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Johannes M A VerheijdenDutch Knowledge Centre for Children's Palliative Care, Utrecht, the Netherlands.
Hester RippenStichting Kind en Ziekenhuis, Utrecht, the Netherlands.
Brigitt C M BorggreveDutch Foundation for Palliative Care (PZNL), Utrecht, the Netherlands.
Eline M Kochen *Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Erna M C Michiels *Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands.
working groups psychosocial care, and preloss and bereavement care of the Dutch paediatric palliative care guideline

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildren with life-threatening and life-limiting conditions and their families are confronted with many uncertainties, incremental losses, and difficult decisions. Attentiveness to psychosocial care, including psychological, social, and spiritual concerns, is essential during the child's life until end-of-life and during bereavement and determines quality of life and wellbeing of child and family. However, use and integration of psychosocial care is found to be challenging. In this paper, we provide recommendations that aim to optimise psychosocial care including preloss and bereavement care in paediatric palliative care.

methodsA multidisciplinary guideline development panel of 25 experts in paediatric palliative care and nine parents was established to develop recommendations on psychosocial care including preloss and bereavement care. We performed a systematic literature search to identify evidence focussing on effectivity of interventions described in systematic reviews (SRs) of randomised controlled trials (RCTs) and RCTs. From the search, we also derived evidence from SRs of observational, qualitative, or mixed-method studies on preloss and bereavement care. The GRADE methodology was used for appraising evidence. We used existing guidelines to deal with lack of evidence. Recommendations were formulated based on evidence, existing guidelines, clinical expertise, and patient and family values.

resultsWe identified a total two SRs of RCTs and six RCTs that reported on the effect of psychological interventions, spiritual support interventions, and bereavement care intervention. The evidence showed that only some of the interventions improve certain psychosocial outcomes in children or parents. We were unable to draw conclusions on which intervention is most effective, due to the high variability in interventions and measured outcomes. The evidence from ten SRs of observational, qualitative, or mixed-method studies was used as a basis for preloss and bereavement care recommendations. In total, we formulated 48 recommendations. DISCUSSION: With the provided recommendations, we aim to optimise psychosocial care for children with life-threatening and life-limiting conditions and their families. Psychosocial care should be tailored to the child and family. We found a lack of evidence on psychosocial care including preloss and bereavement care. Although very challenging, we propose implementing strategies to improve research and thereby further optimise quality of paediatric palliative care. These strategies include the development of a standard set of outcomes and to conduct well-designed multisite RCTs.

Indexed as

BereavementPalliative CarePediatricsChildHumansNetherlandsEvidence-based guidelinePaediatric palliative carePreloss and bereavementPsychosocial care

Identifiers

PMID40410812
PMCPMC12100996

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.