الفهرس 
PEDIATRIC MALIGNANCYOnly 14 pages are availabe for public view
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Abstract
mean score of physical domain was (69.1±21.1, 58.1±23.91, 66.47±26.48, 54.75±27.85, 60.87±27.05, 47.85±22.95, 52.2±24.40) respectively. The mean score of emotional domain (33.76±21.3,33.86±26.0,43.18±34.55,48.92±29.30,54.62±31.53,35.3±24.58,36.76±21.71) respectively. The mean score of social domain (78.92±19.8, 69.54±18.05, 77.28±24.91, 71.74±19.74, 79.14±19.28, 65.88±25.32, 67.94±24.56) respectively. Most school aged patients were home schooled. The worst reported score was the emotional domain especially among (13-18 years) as fear, anger and sadness were mostly reported by both parents and children. Among physicians involved with pediatric oncology patients, the response rate was 62%. All reported the lack of well-structured PPC service and the lack of specialty training in palliative care. The most common reported barrier was the lack of institutions offering PPC as well as the lack of trained manpower. Other common reported barrier was physicians` and parents` perception towards palliative care either physicians giving up or caregivers insisting on continuation of standard treatment. Almost half of physicians see that initiation of palliative care and home based palliation is necessary, 70% did not recommend referring to adult PC centers with the main concern being the lack of experience and knowledge of such centers with pediatric age group.
Conclusion: PPC is an essential element of care in patients with malignancy. The lowest score for quality of life were mainly for emotional domain as patients reported fear and worry from the disease prognosis. PPC is not a well established service in our center with most physicians considering PPC as equivalent to end of life care only. The main barrier was lack of manpower and PPC specialized institutions. To improve or initiate this service, specialty training in PPC is a with designation of team of health care professionals (nurse, pediatric oncologist, pain specialist).