“What if?”: Addressing uncertainty with families

Abstract

Children with cancer and their families deal with uncertainty throughout their treatment course. Clinicians must help patients and families manage uncertainty by engaging them in discussions about their worries and fears. Too often, clinicians avoid or defer discussions about anticipated or worried‐about future events—the “what ifs.” Failing to engage in these conversations may lead to increased distress. We have developed a framework for having “what if” conversations with patients and families that enables providers to explore families’ informational and emotional needs. This framework may enable providers to improve families’ prognostic understanding, explore concerns, and examine preferences and goals of care.

Regret and unfinished business in parents bereaved by cancer: A mixed methods study

“…As the disease progresses, healthcare providers might take special care to explore decisions made thus far, providing reassurance, supporting coupled parents when their opinions may differ, and applying the “what if” framework to gently consider feared scenarios. 50 Parents have also described how considering their choices in the context of what a “good parent would do” is helpful in coming to terms with decision-making. 51,52 Thus, clinicians can use interventions such as the Good Parent Tool to explore the personal meaning of being a good parent to their child.…”

Parents’ responses to prognostic disclosure at diagnosis of a child with a high‐risk brain tumor: Analysis of clinician‐parent interactions and implications for clinical practice

“…This study also points up that parents of children with poor prognoses experience fundamental uncertainty at diagnosis. Managing uncertainty, Snaman et al 29 wrote, is an essential part of patient‐centered care. Families would benefit from research into how this intractable uncertainty affects daily life and into how adverse effects can be mitigated.…”

Social distancing and wellbeing: conceptualizing actor distance and actor safe zone for pandemics

“…This imaginationwhich does not necessarily represent realityblocks the return to a PNS state, often caused by thoughts, such as 'what if' and 'if only' (Kirk, 2020;Reyes et al, 2008), phrases which reflect 'the propensity for people to mentally time-travel' (Mandel et al, 2005, p. 2). That is, 'what if' propels people to future events and 'if only' makes people travel to the past (Kirk, 2020;Snaman et al, 2019). For example, the thought, 'what if I will never be able to meet up with anybody ever again due to the risk of getting infected?'…”