Collaborative Communication in Pediatric Palliative Care: A Foundation for Problem-Solving and Decision-Making

Abstract

SummaryIn an ideal world, all of us -patients, parents, family members, nurses, physicians, social workers, therapists, pastoral care workers, and others -would always work together in a collaborative manner to provide the best care possible to the patient: this article is committed to this ideal. The chapter will base the frameworks and suggestions in part upon studies of communication between patients, families, and clinicians, as well as more general works on communication, collaboration, decisionmaking, mediation, and ethics.This article unfolds in four parts. In Part I, we will explore what we mean by collaborative communication. In Part II, we will examine key concepts that influence how we frame the situations that children with life-threatening conditions confront and how these frameworks shape the care we provide. In Part III, we will consider a few general topics that are quite important to the task of collaborative communication, specifically how we use little "habits of thought"-called heuristicswhen we set about to solve complicated problems; how emotion affects the exchange of information between people; and how we can avoid certain pitfalls when engaging in difficult conversations. In Part IV, we will proceed through three common tasks of collaborative communication offering practical advice for patient care. INTRODUCTIONLet us communicate with each other clearly, compassionately, and collaboratively, as we strive to improve the quality of life for children including, when necessary, that part of life that is dying.I offer us this goal at the outset, as it will guide our journey over the course of the following pages, and perhaps beyond. Throughout this article, I will address you, the reader, directly. I do so with respect, aiming to be as straightforward and clear as possible about the cognitive and emotional challenges of communicating in a collaborative manner. While I anticipate that most of you are clinicians, I will also attempt to make our discussion useful for those of you Corresponding author for proof and reprints: Chris Feudtner, MD-PhD-MPH, Children's Hospital of Philadelphia -North, 3535 Market Street, Rm 1523, Philadelphia, PA 19104, Phone: 267.426.5032, Fax: 215.590.0426 feudtner@email.chop.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. who are parents or even patients. In an ideal world, all of us -patients, parents, family members, nurses, physicians, social workers, therapists, pastoral care workers, and others -would always work together in a collaborative manner to provide the best care possible to the patient: this article is c...

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