{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T03:35:35Z","timestamp":1789702535274,"version":"4.0.1"},"reference-count":20,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T00:00:00Z","timestamp":1570579200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Palliat Care"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The majority of children with advanced heart disease in the inpatient setting die in an intensive care unit under 1 year of age following multiple interventions. While pediatric cardiology and palliative care provider attitudes have been described, little is known about pediatric cardiothoracic surgeon attitudes toward palliative care in children with advanced heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe perspectives of pediatric cardiothoracic surgeons regarding palliative care in pediatric heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cross-sectional web-based national survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 220 surgeons who were e-mailed the survey, 36 opened the survey and 5 did not meet inclusion criteria (n = 31). Median years of practice was 23.5 (range: 12-41 years), and 87.1% were male. Almost all (90%) reported that they had experience consulting palliative care. While 68% felt palliative care consultation was initiated at the appropriate time, 29% felt it occurred too late. When asked the appropriate timing for palliative care consultation in hypoplastic left heart syndrome, 45% selected \u201cat time of prenatal diagnosis\u201d and 30% selected \u201cwhen surgical and transcatheter options have been exhausted.\u201d Common barriers to palliative care involvement included the perception of \u201cgiving up\u201d (40%) and concern for undermining parental hope (36%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>While a majority of pediatric cardiothoracic surgeons are familiar with palliative care, there is variation in perception of appropriate timing of consultation. Significant barriers to consultation still exist, including concern that parents will think they are \u201cgiving\u201d up, undermining parental hope, and influence of palliative care on the medical care team\u2019s approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0825859719874765","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T00:18:01Z","timestamp":1570666681000},"page":"17-21","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Congenital Cardiothoracic Surgeons and Palliative Care: A National Survey Study"],"prefix":"10.1177","volume":"36","author":[{"given":"Emily","family":"Morell","sequence":"first","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, University of California, San Francisco School of Medicine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jess","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Oklahoma Health Sciences Center, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Rajagopal","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, University of California, San Francisco School of Medicine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth D.","family":"Blume","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston Children\u2019s Hospital, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4779-5467","authenticated-orcid":false,"given":"Rachna","family":"May","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Oklahoma Health Sciences Center, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,10,9]]},"reference":[{"key":"bibr1-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.025"},{"key":"bibr2-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0434"},{"key":"bibr3-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2012.03.001"},{"key":"bibr4-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.074"},{"key":"bibr5-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.1829"},{"key":"bibr6-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.0305"},{"key":"bibr7-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0047"},{"key":"bibr8-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.08.033"},{"key":"bibr9-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1663-0"},{"key":"bibr10-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0612"},{"key":"bibr11-0825859719874765","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.03.071"},{"key":"bibr12-0825859719874765","unstructured":"World Health Organization. WHO definition of palliative care. 1998. www.who.int\/cancer\/palliative\/definition\/en. 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