Newton-Wellesley Hospital, Newton, Massachusetts 02445, USA.
J Palliat Med. 2012 Dec;15(12):1362-8. doi: 10.1089/jpm.2012.0019. Epub 2012 Sep 14.
Families with young children often struggle to talk about and cope with a parent's life-threatening illness and potential death. Adult interdisciplinary palliative medicine teams often feel unprepared to facilitate the open communication with these children that has been shown to reduce anxiety, depression, and other behavioral problems. In pediatric settings, child life specialists routinely provide this support to hospitalized children as well as their siblings and parents. Although these services are the standard of care in pediatrics, no research reports their use in the care of children of adults with serious illness.
Our aim is to describe a pilot child life consultation service for the children of seriously ill adult inpatients.
We summarize the support needs of these children, their families, and the medical staff caring for them and report our experience with developing a child life consultation service to meet these needs.
SETTING/SUBJECTS: Our service assists seriously ill adult inpatients and their families in a university medical center.
Informal feedback from families and staff was uniformly positive. During consultations, family and child coping mechanisms were assessed and supported. Interventions were chosen to enhance the children's processing and self-expression and to facilitate family communication.
All hospitals should consider providing broad-based in-service training enabling their staff to improve the support they offer to the children of seriously ill parents. Medical centers with access to child life services should consider developing a child life consultation service to further enhance this support. More research is needed to evaluate both the short- and long-term clinical impact of these interventions.
有年幼子女的家庭在谈论和应对父母病危和潜在死亡时常常感到力不从心。成人跨学科姑息治疗团队常常感到无法准备好与这些儿童进行开放的沟通，而这种沟通已被证明可以减轻焦虑、抑郁和其他行为问题。在儿科环境中，儿童生活专家通常为住院儿童以及他们的兄弟姐妹和父母提供这种支持。尽管这些服务是儿科护理的标准，但没有研究报告它们在照顾重病成年患者的儿童中的使用情况。
我们的目的是描述一项针对重病成年住院患者子女的儿童生活咨询服务的试点。
我们总结了这些儿童、他们的家庭以及照顾他们的医务人员的支持需求，并报告了我们开发儿童生活咨询服务以满足这些需求的经验。
地点/对象：我们的服务对象是一家大学医疗中心的重病成年住院患者及其家庭。
来自家庭和工作人员的非正式反馈是一致积极的。在咨询过程中，评估并支持了家庭和儿童的应对机制。选择干预措施是为了增强儿童的处理和自我表达能力，并促进家庭沟通。
所有医院都应考虑提供广泛的在职培训，使他们的工作人员能够改善对重病父母子女的支持。有儿童生活服务的医疗中心应考虑开发儿童生活咨询服务，以进一步加强这种支持。需要更多的研究来评估这些干预措施的短期和长期临床影响。
