TY - JOUR
T1 - Parents' perspectives on physician-parent communication near the time of a child's death in the pediatric intensive care unit
AU - Meert, Kathleen L.
AU - Eggly, Susan
AU - Pollack, Murray
AU - Anand, K. J.S.
AU - Zimmerman, Jerry
AU - Carcillo, Joseph
AU - Newth, Christopher J.L.
AU - Dean, J. Michael
AU - Willson, Douglas F.
AU - Nicholson, Carol
AU - Heidemann, Sabrina
AU - Frey, Maureen
AU - Albrecht, Terrance L.
AU - Bell, Michael
AU - Reardon, Jean
AU - Romero, Sandy
AU - Prodhan, Parthak
AU - Hefley, Glenda
AU - Brogan, Thomas
AU - Barker, Ruth
AU - Venkataraman, Shekhar T.
AU - Abraham, Alan
AU - Gold, Jeffrey I.
AU - Ferguson, Elizabeth
AU - Fajardo, J. Francisco
AU - Harrison, Rick
AU - Burr, Jeri
AU - Donaldson, Amy
AU - Holubkov, Richard
AU - Singh, Devinder
AU - Enriquez, Rene
AU - Jenkins, Tammara
PY - 2008/1
Y1 - 2008/1
N2 - OBJECTIVE: Communicating bad news about a child's illness is a difficult task commonly faced by intensive care physicians. Greater understanding of parents' scope of experiences with bad news during their child's hospitalization will help physicians communicate more effectively. Our objective is to describe parents' perceptions of their conversations with physicians regarding their child's terminal illness and death in the pediatric intensive care unit (PICU). DESIGN: A secondary analysis of a qualitative interview study. SETTING: Six children's hospitals in the National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. PARTICIPANTS: Fifty-six parents of 48 children who died in the PICU 3-12 months before the study. INTERVENTIONS: Parents participated in audio recorded semistructured telephone interviews. Interviews were analyzed using established qualitative methods. MEASUREMENTS AND MAIN RESULTS: Of the 56 parents interviewed, 40 (71%) wanted to provide feedback on the way information about their child's terminal illness and death was communicated by PICU physicians. The most common communication issue identified by parents was the physicians' availability and attentiveness to their informational needs. Other communication issues included honesty and comprehensiveness of information, affect with which information was provided, withholding of information, provision of false hope, complexity of vocabulary, pace of providing information, contradictory information, and physicians' body language. CONCLUSIONS: The way bad news is discussed by physicians is extremely important to most parents. Parents want physicians to be accessible and to provide honest and complete information with a caring affect, using lay language, and at a pace in accordance with their ability to comprehend. Withholding prognostic information from parents often leads to false hopes and feelings of anger, betrayal, and distrust. Future research is needed to investigate whether the way bad news is discussed influences psychological adjustment and family functioning among bereaved parents.
AB - OBJECTIVE: Communicating bad news about a child's illness is a difficult task commonly faced by intensive care physicians. Greater understanding of parents' scope of experiences with bad news during their child's hospitalization will help physicians communicate more effectively. Our objective is to describe parents' perceptions of their conversations with physicians regarding their child's terminal illness and death in the pediatric intensive care unit (PICU). DESIGN: A secondary analysis of a qualitative interview study. SETTING: Six children's hospitals in the National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. PARTICIPANTS: Fifty-six parents of 48 children who died in the PICU 3-12 months before the study. INTERVENTIONS: Parents participated in audio recorded semistructured telephone interviews. Interviews were analyzed using established qualitative methods. MEASUREMENTS AND MAIN RESULTS: Of the 56 parents interviewed, 40 (71%) wanted to provide feedback on the way information about their child's terminal illness and death was communicated by PICU physicians. The most common communication issue identified by parents was the physicians' availability and attentiveness to their informational needs. Other communication issues included honesty and comprehensiveness of information, affect with which information was provided, withholding of information, provision of false hope, complexity of vocabulary, pace of providing information, contradictory information, and physicians' body language. CONCLUSIONS: The way bad news is discussed by physicians is extremely important to most parents. Parents want physicians to be accessible and to provide honest and complete information with a caring affect, using lay language, and at a pace in accordance with their ability to comprehend. Withholding prognostic information from parents often leads to false hopes and feelings of anger, betrayal, and distrust. Future research is needed to investigate whether the way bad news is discussed influences psychological adjustment and family functioning among bereaved parents.
KW - Communication
KW - Critical care
KW - Death
KW - Parents
KW - Physicians
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=38049144620&partnerID=8YFLogxK
U2 - 10.1097/01.PCC.0000298644.13882.88
DO - 10.1097/01.PCC.0000298644.13882.88
M3 - Article
C2 - 18477906
AN - SCOPUS:38049144620
VL - 9
SP - 2
EP - 7
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
SN - 1529-7535
IS - 1
ER -