Division of Critical Care Medicine, Departments of Pediatrics and
Associate Professor of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Pediatrics. 2018 Nov;142(Suppl 3):S170-S177. doi: 10.1542/peds.2018-0516H.
The families of children with chronic or serious illness are sometimes faced with difficult decisions never previously imagined. We offer a stepwise approach in building a human connection with these families to support them through the decision-making process. We encourage the clinician to stop talking and to actively listen and find common ground. We suggest that offering open and honest information begins with an invitation. We encourage clinicians to explore concepts with the family, including their fears and hopes. We discuss nurturing an emotional connection between the child and family and describe ways to discover a family's preference for involvement in the decision-making process. Central to supporting a family is to place infinite value on the life of their child. We argue that attention to these matters will help the clinician remain in sync with the family to ensure meaningful and high-quality decision-making during highly vulnerable times for families.
患有慢性或严重疾病的儿童的家庭有时会面临以前从未想象过的困难决定。我们提供了一种逐步的方法,与这些家庭建立人性化的联系,在决策过程中为他们提供支持。我们鼓励临床医生停止说话,积极倾听并找到共同点。我们建议通过邀请来提供开放和诚实的信息。我们鼓励临床医生与家庭探讨概念,包括他们的恐惧和希望。我们讨论在孩子和家庭之间培养情感联系,并描述发现家庭对参与决策过程的偏好的方法。支持家庭的核心是无限重视孩子的生命。我们认为,关注这些问题将有助于临床医生与家庭保持同步,以确保在家庭非常脆弱的时期做出有意义和高质量的决策。