Disclosing Terminal Diagnosis to Children and Their Families: Palliative Professionals' Communication Barriers

Abstract

Few studies have fully explored the problem of communication barriers in pediatric palliative care, particularly the detrimental effects of poor interaction between staff and families on children's health and well-being. A literature review was undertaken to expand the current body of knowledge about staff to patient communications. Articles meeting the inclusion criteria (N = 15) were systematically read and summarized using a data extraction sheet. A narrative synthesis identified 5 overarching themes as barriers to communication. Improvements in staff education and individualized palliative care plans for children and their families may help to overcome communication barriers.

Exploring the Perceived Met and Unmet Need of Life-Limited Children, Young People and Families

“…The importance of good communication within and between services was highlighted as a significant factor in how well families cope with a life-threatened or life-limited child (Coad et al, 2014). Our findings highlighted that good communication meant to families 'honest' conversation with professionals to prepare families for care needs and in the event of premature death.…”

“…The need for good communication that prepares parents or legal guardians for the eventuality that their child might or will die has been identified as an important factor in coping with the situation (Avis & Reardon, 2008;Coad et al, 2014;Midson & Carter, 2010). The importance of good communication within families has also been highlighted as a significant factor in how well they cope with a life-threatened or life-limited child (Coad et al, 2014).…”

“…The importance of good communication within families has also been highlighted as a significant factor in how well they cope with a life-threatened or life-limited child (Coad et al, 2014). Therefore it is important to assess the needs of family members both individually and as a unit.…”

“…Sloper and Beresford (2006) found that, although needs were often recognised by service providers, they were often unmet. The needs of children and young people with long term, life-threatening and life-limiting conditions are on a constant cycle of change through periods of remission from the condition to medical crisis and at each trajectory of the condition family members will have to develop coping strategies (Brown, 2007;Coad, Patel, & Murray, 2014). Most families do succeed at adapting, but this is dependent on well co-ordinated service provision that is easily accessible (Danvers, Freshwater, Cheater, & Wilson, 2003).…”

“…Craig (2006) and Coad et al (2014) have highlighted that caring for a child or young person with a long term, life-threatening and life-limiting condition places an immense burden on families. Radriguez and King's (2009) small-scale study of the impact on parental mental health highlights the continuous adjustment by families throughout the trajectory of a child's illness.…”