Communication Challenges of Oncologists and Intensivists Caring for Pediatric Oncology Patients: A Qualitative Study

Odeniyi, Folasade; Nathanson, Pamela; Schall, Theodore E.; Walter, Jennifer K.

doi:10.1016/j.jpainsymman.2017.06.013

Cited by 40 publications

(61 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Deliberations within the mixed group attributed higher information quality ratings from those reported in the palliative care-and oncology-only groups at Hospital 2 but lower at Hospital between palliative care and oncology teams at the diagnostic stage in which the LDT will be implemented. This nding corroborates what has been found in the patient decision-making and communication literature speci c to the care of critically ill children with cancer (24).…”

Section: Discussionsupporting

confidence: 89%

Assessing the Quality of Deliberative Stakeholder Consultations with Pediatric Palliative Care Clinicians and Oncologists in Canada

Rahimzadeh¹,

Longo²,

Gagnon³

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective—This paper presents findings from a quality assessment of deliberative stakeholder consultations with healthcare professionals in Canada on the implementation of a precision diagnostic for life-threatening pediatric brain tumors. Background—Advanced understanding of the basic biology and pharmacogenomics of pediatric brain tumors portend a clinical future in which oncologists base their clinical decisions in large part on results from laboratory derived tests (LDT) using next generation sequencing. Less is known, however, about how interprofessional healthcare teams perceive the opportunities and challenges of adopting LDTs in clinical practice, or how to best communicate LDT results to pediatric patients and their families. Deliberative stakeholder consultations present a promising alternative to traditional deliberative democratic methods. They allow researchers to unveil normative ethical and social values underpinning a forthcoming policy or new standard of care from the perspectives of key stakeholder groups, as well as make practical recommendations relevant for implementation.Methods—Using the DeVries framework for assessing the quality of deliberative process and information, we analyzed data from 44 post-consultation evaluation surveys from pediatric oncology and palliative care teams at two tertiary pediatric healthcare centers in Canada. Medians/means based on a 10-point Likert scale are reported. We also conducted turn-taking analysis and word-contribution analysis from the text transcriptions of each deliberation to assess equality of participation.Results—Deliberants agreed the quality of the deliberative process was fair (averages ranging from 9-10/10) and the opportunities to both receive expert information and discuss with others about the implementation of a new LDT were helpful (9.5/10). While the session improved understanding of the implementation barriers and opportunities, the session had marginal effects on deliberants’ perceived impact on their own clinical practice where median ratings ranged from 3-10/10. Participation was proportionate in at least four of the six deliberations, where no deliberant took more than 20% of total turns and contributed equal to, or less than 20% of total words.Conclusion—The quality assessments performed lend evidence to the informational value and overall fairness of the deliberative process achieved in this study to identify implementation and communication needs of healthcare professionals at the point when LDTs become standard for diagnosing life-threatening brain tumors in children.

show abstract

Section: Discussionsupporting

confidence: 89%

Assessing the Quality of Deliberative Stakeholder Consultations with Pediatric Palliative Care Clinicians and Oncologists in Canada

Rahimzadeh¹,

Longo²,

Gagnon³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…43 A single event, such as receiving bad news in an insensitive way (via vocal or body behavior), or the feeling of being dismissed can cause parents profound distress 31 and increase anxiety, distrust, and dissatisfaction with care. 44 The presence of a nurse during family meetings can increase parents' understanding of key discussion points. 45 Along with team members such as social workers, child-life therapists, psychologists, and chaplains, nurses can serve as a voice for families and help inform physicians about parents' wishes.…”

Section: Open and Honest Information Sharing When Given The Green Lightmentioning

confidence: 99%

Supporting Family Decision-making for a Child Who Is Seriously Ill: Creating Synchrony and Connection

Madrigal

Kelly

2018

Pediatrics

View full text Add to dashboard Cite

NIHThe 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. abstract by guest on July 9, 2020 www.aappublications.org/news

show abstract

“…4,5 Fellows and Attendings in fields with high exposure to EOL situations including the pediatric intensive care unit and Hematology/Oncology report lack of education and training as a barrier to having goals of care and EOL conversations. 18,19 Emerging research has also identified that pediatric trainees caring for a patient who dies frequently exhibit diagnostic criteria of acute stress reaction (ASR) or posttraumatic stress disorder (PTSD) with a small percentage actually meeting criteria for these diagnoses. 7 Discrepancies in the recognition of the need for palliative care education among residents and their program directors has improved, 6 with a recent national survey of pediatric program directors concluding that 81% of all respondents and 96% of general pediatrics program directors felt palliative care education would be beneficial.…”

Section: Introductionmentioning

confidence: 99%

Development and Implementation of an End-of-Life Curriculum for Pediatric Residents

Wilson

Herbst

Gonzalez-del-Rey

2018

Am J Hosp Palliat Care

View full text Add to dashboard Cite

show abstract

Communication Challenges of Oncologists and Intensivists Caring for Pediatric Oncology Patients: A Qualitative Study

Cited by 40 publications

References 19 publications

Assessing the Quality of Deliberative Stakeholder Consultations with Pediatric Palliative Care Clinicians and Oncologists in Canada

Assessing the Quality of Deliberative Stakeholder Consultations with Pediatric Palliative Care Clinicians and Oncologists in Canada

Supporting Family Decision-making for a Child Who Is Seriously Ill: Creating Synchrony and Connection

Development and Implementation of an End-of-Life Curriculum for Pediatric Residents

Contact Info

Product

Resources

About