Parent-pediatrician communication when breaking bad news
What are parent expectations for announcements of this nature and what impact do emotions have on communication thereafter ?
The fight against treatment resistance is a significant challenge in pediatric oncology research. When resistance occurs this implies difficult conversations around prognosis and shared medical decisions between the oncologist and the parents. Inappropriate communication can lead to misunderstanding as well as information needs and unsatisfied support. The emotions aroused by bad news have an impact on parent-pediatrician communication.
New options to improve parent-clinician communication
The humanities and social sciences (HSS) SIRIC team published a review of existing literature on the patient and clinician experience in the Bulletin du Cancer in March 2021.
This review recaps the expectations of parents around pediatrician communication as well as the influence that the emotions of both oncologists and parents can have on the parent-pediatrician communication. It underlines the information needs of parents, the importance of "empathetic" communication for decision making and parent satisfaction as well as the emotions and defence mechanisms put in place by pediatricians. Parental distress and the perception of this distress by the oncologist is also addressed.
Their analysis gives rise to new avenues of reflection. One of these avenues is the identification of information needs and the distress of parents in order to respond as closely as possible to their expectations and provide support especially in cases where the prognosis is poor. Another avenue of reflection is the differences within within parent couples and the complexity for pediatricians to manage these situations. The last avenue questions the role of nurses in emotion management.
This review is in the frame of the SIRIC project to put in place communication tools in the context of treatment resistance.