Indicadores de qualidade para avaliação de serviços de cuidados paliativos pediátricos: uma revisão de escopo

Introduction: Pediatric palliative care (PPC) services have developed worldwide in recent years, and quality indicators (QIs) are essential tools for assessing this development. Objectives: To identify quality indicators used internationally to evaluate and monitor the care provided by PPC services. Materials and methods: A systematic search was carried out in three electronic bibliographic databases, with a time frame between 2000 and 2021 given the early stage of research into quality in PPC. All publications related to QIs and PPC were independently assessed by five researchers and those that met the inclusion criteria were included: full text in English, Portuguese, Spanish or French; reference population made up of children, adolescents and/or young adults with life-limiting or life-threatening illnesses or complex chronic conditions; in the context of PPC or end-of-life care; with a clear definition of the proposed QI where the numerator and denominator can be defined or deduced. The whole process followed the Joanna Briggs Institute (JBI) guidelines for scoping reviews. Results: Seven publications were included, all from the last decade; of these, only two related QIs to the evaluation of care provided by PPC services. A total of 332 QIs were identified and categorized according to the eight domains proposed by the National Consensus Project for Quality Palliative Care, of which 45% were related to aspects of the structure and process of care and 21% to the care of the terminally ill child. In terms of typology, 51% of the QIs were process QIs, 41% were outcome QIs and 8% were structure QIs. Conclusion: This review brought together a significant number of QIs that could be useful as a starting point for evaluating the quality of care provided by PPC services, serving health professionals, managers, health policy makers, researchers and representatives of the child and family.