Department of Pediatrics, University Medical Center Groningen, Groningen, Netherlands
Institute for Medical Education, University Medical Center Groningen, Groningen, Netherlands.
Arch Dis Child. 2021 Mar;106(3):276-281. doi: 10.1136/archdischild-2019-318398. Epub 2020 Oct 30.
Breaking bad news about life-threatening and possibly terminal conditions is a crucial part of paediatric care for children in this situation. Little is known about how the parents of children with life-threatening conditions experience communication of bad news. The objective of this study is to analyse parents' experiences (barriers and facilitators) of communication of bad news.
A qualitative study consisting of a constant comparative analysis of in-depth interviews conducted with parents.
The Netherlands.
Sixty-four parents-bereaved and non-bereaved-of 44 children (aged 1-12 years, 61% deceased) with a life-threatening condition.
None.
Based on parents' experiences, the following 10 barriers to the communication of bad news were identified: (1) a lack of (timely) communication, (2) physicians' failure to ask parents for input, (3) parents feel unprepared during and after the conversation, (4) a lack of clarity about future treatment, (5) physicians' failure to voice uncertainties, (6) physicians' failure to schedule follow-up conversations, (7) presence of too many or unknown healthcare professionals, (8) parental concerns in breaking bad news to children, (9) managing indications of bad news in non-conversational contexts, and (10) parents' misunderstanding of medical terminology.
This study shows healthcare professionals how parents experience barriers in bad news conversations. This mainly concerns practical aspects of communication. The results provide practical pointers on how the communication of bad news can be improved to better suit the needs of parents. From the parents' perspective, the timing of conversations in which they were informed that their child might not survive was far too late. Sometimes, no such conversations ever took place.
向生命垂危或可能处于终末期的儿童的父母传达危及生命的消息是儿科护理的重要组成部分。对于生命垂危的儿童的父母如何经历不良消息的交流，知之甚少。本研究的目的是分析父母在传达不良消息时的经历（障碍和促进因素）。
一项定性研究，对 44 名患有危及生命疾病的儿童（年龄为 1-12 岁，61%死亡）的父母进行深入访谈，并进行恒定性比较分析。
荷兰。
64 名父母-丧亲和非丧亲的 44 名儿童（年龄 1-12 岁，61%死亡）患有危及生命的疾病。
无。
基于父母的经验，确定了沟通不良消息的以下 10 个障碍：（1）缺乏（及时）沟通，（2）医生未能征求父母的意见，（3）父母在谈话期间和之后感到准备不足，（4）对未来治疗缺乏明确性，（5）医生未能表达不确定性，（6）医生未能安排随访谈话，（7）存在过多或未知的医疗保健专业人员，（8）父母在向孩子传达坏消息时的担忧，（9）在非对话环境中管理坏消息的迹象，以及（10）父母对医学术语的误解。
本研究向医疗保健专业人员展示了父母在不良消息对话中经历的障碍。这主要涉及沟通的实际方面。研究结果为如何改进不良消息的沟通以更好地满足父母的需求提供了实用建议。从父母的角度来看，他们被告知孩子可能无法生存的谈话时间太晚了。有时，根本没有这样的对话。
