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Understanding communication among health care professionals regarding death and dying in pediatrics

Published online by Cambridge University Press:  06 August 2013

Julianne Harrison ,
Elana Evan ,
Amy Hughes ,
Shahram Yazdani ,
Myke Federman  and
Rick Harrison
Julianne Harrison*
Affiliation:
Pediatric Critical Care Mattel Children's Hospital UCLA
Elana Evan
Affiliation:
UCLA Children's Comfort Care Program
Amy Hughes
Affiliation:
UCLA Children's Comfort Care Program
Shahram Yazdani
Affiliation:
UCLA Division of General Pediatrics
Myke Federman
Affiliation:
Pediatric Critical Care Mattel Children's Hospital UCLA
Rick Harrison
Affiliation:
Pediatric Critical Care Mattel Children's Hospital UCLA
*
Address correspondence and reprint requests to: Julianne Harrison, 8926 West 25th Street, Los Angeles, CA 90034. E-mail: [email protected] 718-208-7994
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Abstract

Objective:

Effective communication regarding death and dying in pediatrics is a vital component of any quality palliative care service. The goal of the current study is to understand communication among health care professionals regarding death and dying in children. The three hypotheses tested were: (1) hospital staff (physicians of all disciplines, nurses, and psychosocial clinicians) that utilize consultation services are more comfortable communicating about death and dying than those who do not use such services, (2) different disciplines of health care providers demonstrate varying levels of comfort communicating about a range of areas pertaining to death and dying, and (3) health care staff that have had some type of formal training in death and dying are more comfortable communicating about these issues.

Methods:

A primary analysis of a survey conducted in a tertiary care teaching children's hospital.

Results:

Health care professionals who felt comfortable discussing options for end of life care with colleagues also felt more comfortable: initiating a discussion regarding a child's impending death with his/her family (r = 0.42), discussing options for terminal care with a family (r = 0.58), discussing death with families from a variety of ethnic/cultural backgrounds (r = 0.51), guiding parents in developmentally age-appropriate discussions of death with their children (r = 0.43), identifying and seeking advice from a professional role model regarding management concerns (r = 0.40), or interacting with a family following the death of a child (r = 0.51). Among all three disciplines, physicians were more likely to initiate discussions with regards to a child's impending death (F = 13.07; p = 0.007). Health care professionals that received formal grief and bereavement training were more comfortable discussing death.

Significance of the results:

The results demonstrated that consultation practices are associated with a higher level of comfort in discussing death and dying in pediatrics.

Keywords

CommunicationConsultationDeathPediatricsPalliative careTraining
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 5 , October 2014 , pp. 387 - 392
Copyright
Copyright © Cambridge University Press 2013 

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References

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