Lori Brand Bateman1, Nancy M Tofil2, Marjorie Lee White2, Leon S Dure2, Jeffrey Michael Clair3, Belinda L Needham4. 1. Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA loribateman@uabmc.edu. 2. Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. 3. Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA. 4. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Abstract
OBJECTIVE: The objective of this exploratory study is to describe communication between physicians and the actor parent of a standardized 8-year-old patient in respiratory distress who was nearing the end of life. METHODS: Thirteen pediatric emergency medicine and pediatric critical care fellows and attendings participated in a high-fidelity simulation to assess physician communication with an actor-parent. RESULTS: Fifteen percent of the participants decided not to initiate life-sustaining technology (intubation), and 23% of participants offered alternatives to life-sustaining care, such as comfort measures. Although 92% of the participants initiated an end-of-life conversation, the quality of that discussion varied widely. CONCLUSION: Findings indicate that effective physician-parent communication may not consistently occur in cases involving the treatment of pediatric patients at the end of life in emergency and critical care units. PRACTICE IMPLICATIONS: The findings in this study, particularly that physician-parent end-of-life communication is often unclear and that alternatives to life-sustaining technology are often not offered, suggest that physicians need more training in both communication and end-of-life care.
OBJECTIVE: The objective of this exploratory study is to describe communication between physicians and the actor parent of a standardized 8-year-old patient in respiratory distress who was nearing the end of life. METHODS: Thirteen pediatric emergency medicine and pediatric critical care fellows and attendings participated in a high-fidelity simulation to assess physician communication with an actor-parent. RESULTS: Fifteen percent of the participants decided not to initiate life-sustaining technology (intubation), and 23% of participants offered alternatives to life-sustaining care, such as comfort measures. Although 92% of the participants initiated an end-of-life conversation, the quality of that discussion varied widely. CONCLUSION: Findings indicate that effective physician-parent communication may not consistently occur in cases involving the treatment of pediatric patients at the end of life in emergency and critical care units. PRACTICE IMPLICATIONS: The findings in this study, particularly that physician-parent end-of-life communication is often unclear and that alternatives to life-sustaining technology are often not offered, suggest that physicians need more training in both communication and end-of-life care.
Authors: Katharine E Brock; Harvey J Cohen; Barbara M Sourkes; Julie J Good; Louis P Halamek Journal: J Palliat Med Date: 2017-04-24 Impact factor: 2.947
Authors: Michael P Mendez; Harin Patel; Jordan Talan; Michelle Doering; Jared Chiarchiaro; Rebecca M Sternschein; Trevor C Steinbach; Jacqueline O'Toole; Abdulghani Sankari; Jennifer W McCallister; May M Lee; W Graham Carlos; Patrick G Lyons Journal: ATS Sch Date: 2020-07-14