TY - JOUR
T1 - Breaking bad news: what parents would like you to know
AU - Brouwer, Marije A.
AU - Maeckelberghe, Els L. M.
AU - van der Heide, Agnes
AU - Hein, Irma M.
AU - Verhagen, Eduard A. A. E.
N1 - Funding Information: Funding This work was supported by the Dutch Ministry of Health, Welfare and Sport (grant number 324717 (560019968)). Publisher Copyright: © 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Objective: Breaking bad news about life-threatening and possibly terminal conditions is a crucial part of paediatric care for children in this situation. Little is known about how the parents of children with life-threatening conditions experience communication of bad news. The objective of this study is to analyse parents' experiences (barriers and facilitators) of communication of bad news. Design: A qualitative study consisting of a constant comparative analysis of in-depth interviews conducted with parents. Setting: The Netherlands. Participants: Sixty-four parents - bereaved and non-bereaved - of 44 children (aged 1-12 years, 61% deceased) with a life-threatening condition. Interventions: None. Results: Based on parents' experiences, the following 10 barriers to the communication of bad news were identified: (1) a lack of (timely) communication, (2) physicians' failure to ask parents for input, (3) parents feel unprepared during and after the conversation, (4) a lack of clarity about future treatment, (5) physicians' failure to voice uncertainties, (6) physicians' failure to schedule follow-up conversations, (7) presence of too many or unknown healthcare professionals, (8) parental concerns in breaking bad news to children, (9) managing indications of bad news in non-conversational contexts, and (10) parents' misunderstanding of medical terminology. Conclusions: This study shows healthcare professionals how parents experience barriers in bad news conversations. This mainly concerns practical aspects of communication. The results provide practical pointers on how the communication of bad news can be improved to better suit the needs of parents. From the parents' perspective, the timing of conversations in which they were informed that their child might not survive was far too late. Sometimes, no such conversations ever took place.
AB - Objective: Breaking bad news about life-threatening and possibly terminal conditions is a crucial part of paediatric care for children in this situation. Little is known about how the parents of children with life-threatening conditions experience communication of bad news. The objective of this study is to analyse parents' experiences (barriers and facilitators) of communication of bad news. Design: A qualitative study consisting of a constant comparative analysis of in-depth interviews conducted with parents. Setting: The Netherlands. Participants: Sixty-four parents - bereaved and non-bereaved - of 44 children (aged 1-12 years, 61% deceased) with a life-threatening condition. Interventions: None. Results: Based on parents' experiences, the following 10 barriers to the communication of bad news were identified: (1) a lack of (timely) communication, (2) physicians' failure to ask parents for input, (3) parents feel unprepared during and after the conversation, (4) a lack of clarity about future treatment, (5) physicians' failure to voice uncertainties, (6) physicians' failure to schedule follow-up conversations, (7) presence of too many or unknown healthcare professionals, (8) parental concerns in breaking bad news to children, (9) managing indications of bad news in non-conversational contexts, and (10) parents' misunderstanding of medical terminology. Conclusions: This study shows healthcare professionals how parents experience barriers in bad news conversations. This mainly concerns practical aspects of communication. The results provide practical pointers on how the communication of bad news can be improved to better suit the needs of parents. From the parents' perspective, the timing of conversations in which they were informed that their child might not survive was far too late. Sometimes, no such conversations ever took place.
KW - comm child health
KW - palliative care
KW - patient perspective
KW - qualitative research
UR - http://www.scopus.com/inward/record.url?scp=85095768163&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/archdischild-2019-318398
DO - https://doi.org/10.1136/archdischild-2019-318398
M3 - Article
C2 - 33127614
SN - 0003-9888
VL - 106
SP - 276
EP - 281
JO - Archives of disease in childhood
JF - Archives of disease in childhood
IS - 3
M1 - 3054
ER -