Autopsies and the Pediatric Intensive Care Unit

Riggs, Dan; Weibley, Richard E.

doi:10.1016/s0031-3955(16)38877-0

Cited by 14 publications

(14 citation statements)

References 31 publications

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“…32 In this study, nearly onethird (30%) currently felt guilty about their child's autopsy and one-third (32.5%) considered the autopsy results added to feelings of guilt. The procedure itself or the results it establishes may be a source of guilt.…”

Section: Complexities Of Pediatric Autopsy For Parents and Implicatiomentioning

confidence: 63%

“…These responses reflect a different view than the guilt-resolving quality typically ascribed to the examination and its findings. 5,13,32 Significant proportions of parents also disagreed that the examination brought them feelings of finality (41%), closure (43%), or acceptance (40%).Such words may implicitly suggest to parents semantic connotations associated with ending or completion. This may be perceived as an end to the relationship with their child or as dishonoring their child in some way.…”

Section: Complexities Of Pediatric Autopsy For Parents and Implicatiomentioning

confidence: 99%

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Bereaved Parents' Perceptions of the Autopsy Examination of Their Child

Sullivan

Monagle

2011

Pediatrics

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Section: Complexities Of Pediatric Autopsy For Parents and Implicatiomentioning

confidence: 63%

Section: Complexities Of Pediatric Autopsy For Parents and Implicatiomentioning

confidence: 99%

Bereaved Parents' Perceptions of the Autopsy Examination of Their Child

Sullivan

Monagle

2011

Pediatrics

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“…Autopsies provide closure and are therefore invaluable in processing grief; they provide information and often consolation, and provision of the results provides an opening point for discussion between the physician and the family. This gives the family an opportunity to make sense of, and bring closure to, the death of their child (28). However, the timeline for autopsies needs to be explained to the parents around the time of death, and probably again in the course of follow-up phone calls, to ensure that their expectations are realistic.…”

Section: Discussionmentioning

confidence: 99%

Death and bereavement in a paediatric intensive care unit: Parental perceptions of staff support

Macnab

Northway

Ryall

et al. 2003

Paediatrics &Amp; Child Health

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OBJECTIVES: To determine which staff behaviours and interventions were helpful to a family who had a child die in the intensive care unit (ICU) and which behaviours could be improved. METHODS: Families whose child died six to 18 months earlier were invited to participate. Families whose child's death involved a coroner's inquiry were excluded. Family members were interviewed by a grief counselor, and completed the Grief Experience Inventory Profile and an empirically designed questionnaire. RESULTS: No family refused to participate. All family members (13 families, 24 individuals) reported that they wanted, were offered and had: time to be alone with their child, time to hold the child, chances to discuss their feelings, and an opportunity to cry and express their emotions openly. Tangible mementos of the child were appreciated. Support provided by nursing staff was rated as excellent. Some physicians appeared to be abrupt, cold and unfeeling. Hospital social workers and chaplains, when available, were appreciated. Parents valued access to private space and holding their child, but these options needed to be suggested, as they did not know to ask for them. Some families wanted more information about funeral arrangements; most wanted more timely information about autopsy results and feedback on organ donations. Follow-up contact from the hospital about four weeks after the death was valued. Families saw the study as an opportunity to provide feedback that may help others. CONCLUSIONS: Many acute bereavement interventions need to be initiated by staff because families do not know to request them. Physicians do not always meet individual family's needs for support. Contact initiated by staff following a death is appreciated.

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“…93,[253][254][255] As parents reflect on the whirlwind events of their final days with their child, numerous questions arise. They need a vehicle to have these questions answered efficiently.…”

Section: Autopsies As Communication Opportunitiesmentioning

confidence: 99%

Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information

Levetown¹

2008

Pediatrics

403

296

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Health care communication is a skill that is critical to safe and effective medical practice; it can and must be taught. Communication skill influences patient disclosure, treatment adherence and outcome, adaptation to illness, and bereavement. This article provides a review of the evidence regarding clinical communication in the pediatric setting, covering the spectrum from outpatient primary care consultation to death notification, and provides practical suggestions to improve communication with patients and families, enabling more effective, efficient, and empathic pediatric health care. INTRODUCTION/OVERVIEWHealth care communication is a critical, but generally neglected, component of pediatric and pediatric subspecialty practice and training and is a skill that can and must be taught. [1][2][3][4][5][6][7][8][9][10][11][12][13] The practicing clinician's ability to communicate openly and with compassion is essential for effective and efficient routine health care; this ability becomes a vital lifeline for parents and children confronted with lifealtering and sometimes life-ending conditions. [13][14][15][16] The purpose of this report is to provide research-based and practical guidance to enable effective communication with pediatric patients and their families in a number of common settings and situations. Although child abuse, sexuality, divorce, and many other situations are not individually addressed, the principles and approaches discussed apply equally to these situations.Communication is the most common "procedure" in medicine. Health care communication is different from normal social discourse, because intimate and very private issues are often discussed. These include hopes and fears, developmental concerns, sexuality, and mental health disorders. Painful issues, such as abuse, school failure, drug use, and terminal illness, are also discussed. Communication is the foundation of the therapeutic relationship; it is the basis of fiduciary and ethical obligations of physicians to patients and their families. Effective health care communication is an essential tool for accurate diagnosis [17][18][19] and for the development of a successful treatment plan, 20-23 correlating with improved patient knowledge, 15,24 functional status, 25,26 adherence to the agreed-on treatment regimen, 20,21,27-32 improved psychological and behavioral outcomes, 15,33-36 and even reduced surgical morbidity. 3,4,37 In the case of distressing news, skillful communication can enable a family to adapt better to a challenging situation, 12,38,39 including a child's unanticipated impairments. [40][41][42][43] Poor communication, on the other hand, can prompt lifelong anger 31,42,44-48 and regret, 14,40 can result in compromised outcomes for the patient and family, and can have medicolegal consequences for the practitioner. 49

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Autopsies and the Pediatric Intensive Care Unit

Cited by 14 publications

References 31 publications

Bereaved Parents' Perceptions of the Autopsy Examination of Their Child

Bereaved Parents' Perceptions of the Autopsy Examination of Their Child

Death and bereavement in a paediatric intensive care unit: Parental perceptions of staff support

Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information

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