Pediatric Chronic Critical Illness: Training Teams to Address the Communication Challenges of Patients With Repeated and Prolonged Hospitalizations

Boss, Renee D.; Hirschfeld, Ryan S.; Barone, Silvana; Johnson, Emily L.; Arnold, Robert M.

doi:10.1016/j.jpainsymman.2020.06.005

Cited by 12 publications

(10 citation statements)

References 25 publications

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“…Our study also highlight what caused the loss of a trusting relationship between participants and HCPs, and what facilitated it. Other studies support our findings and show that effective communication within the PICU multidisciplinary team influenced parents' involvement, and improves the ability of parents to affirm their needs and the competencies of HCPs to strengthen reciprocal trust ( 41 – 43 ). Bad news communication training proved to be useful for HCPs to tell parents that their child may not fully recover from his acute condition, but move to chronic or palliative care ( 43 ).…”

Section: Discussionsupporting

confidence: 85%

“…Other studies support our findings and show that effective communication within the PICU multidisciplinary team influenced parents' involvement, and improves the ability of parents to affirm their needs and the competencies of HCPs to strengthen reciprocal trust ( 41 – 43 ). Bad news communication training proved to be useful for HCPs to tell parents that their child may not fully recover from his acute condition, but move to chronic or palliative care ( 43 ). More recently, Bedford and Bench advocated for an early intervention to support families, which starts at PICU admission and continues throughout the hospital stay.…”

Section: Discussionsupporting

confidence: 85%

“…Second, care processes should be reviewed to provide true family-centered care in which parents are empowered ( 23 , 44 , 47 , 48 , 61 ). Third, individualized and coordinated care should be a priority to meet patient and family needs and provide the highest quality of care ( 38 – 43 ). Table 3 presents specific evidence-based recommendations that should address the practice gap highlighted in this study.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Sources of Stress, Family Functioning, and Needs of Families With a Chronic Critically Ill Child: A Qualitative Study

Grandjean

Ullmann²,

Marston

et al. 2021

Front. Pediatr.

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PICU hospitalization is particularly stressful for families. When it is prolonged and the prognostic is uncertain, it can significantly and negatively affect the whole family. To date, little is known on how families with a chronic critically ill (CCI) child are affected. This national study explored the specific PICU-related sources of stress, family functioning and needs of families of CCI patients during a PICU hospitalization. This descriptive qualitative study was conducted in the eight pediatric intensive care units in Switzerland. Thirty-one families with a child meeting the CCI criteria participated in semi-structured interviews. Interviews, including mothers only (n = 12), fathers only (n = 8), or mother and father dyads (n = 11), were conducted in German, French, or English by two trained researchers/clinical nurses specialists. Interviews were recorded, transcribed verbatim, and analyzed using deductive and inductive content analyses. Five overarching themes emerged: (1) high emotional intensity, (2) PICU-related sources of stress, (3) evolving family needs, (4) multi-faceted family functioning, and (5) implemented coping strategies. Our study highlighted the importance of caring for families with CCI children. Parents reported high negative emotional responses that affect their family functioning. Families experience was highly dependent on how HCPs were able to meet the parental needs, provide emotional support, reinforce parental empowerment, and allow high quality of care coordination.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sources of Stress, Family Functioning, and Needs of Families With a Chronic Critically Ill Child: A Qualitative Study

Grandjean

Ullmann²,

Marston

et al. 2021

Front. Pediatr.

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“…The communication skills of health care professionals delivering the bad news 1 and the emotional distress of patients and families, especially parents of children with severe pediatric illnesses, 2 both play an important role in the coping and bereavement abilities of patients and their families, and the risk of burnout among medical professionals. Existing evidence shows that interprofessional education and communication skills training 3,4 are valuable for helping health care students and clinicians when breaking bad news to their patients.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a Computer Role-Playing Game to Promote Empathy in Nursing Students: The Role of Immersiveness and Perspective

Huang

Yao

2021

Cyberpsychology, Behavior, and Social Networking

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Empathy is considered a cornerstone of high-quality health care and a required element of nursing education. Although computer role-playing games (CRPGs) are a promising tool to promote clinical empathy, little is known about how and why it is effective at improving empathy. The goal of the current study is to investigate the feasibility and effectiveness of a CRPG on nursing students' empathy with a focus on immersiveness and perspective. Results from a 2 • 2 (virtual reality [VR] vs. non-VR • patient's family's perspective vs. health care provider's perspective) between-subjects experiment (N = 69) showed that playing the game in VR (vs. non-VR) led to greater spatial presence and empathy. Moreover, playing from the health care provider's (vs. patient's family's) perspective elicited greater empathy. A moderated mediation effect was found, suggesting that users' attention allocation significantly mediated the effect of immersiveness on empathy in the patient's family's perspective condition. These findings show the feasibility of using a role-playing game for nursing education. Both theoretical and practical implications involving empathy training were discussed, along with suggestions for further research.

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“…26,27 When possible, systematic, interdisciplinary team meetings to explore the risks and benefits of each treatment option for any child with chronic respiratory failure are one way to promote consistent and fair counseling in this area. 28,29 Additionally, greater understanding of the lived experiences of children with SNI and families who make different decisions about HMV are needed so that clinicians can better represent these perspectives, and so that parents can hear from other families about their experiences. 30 Ultimately, further attention and emphasis on clinician-parent communication in these lifechanging situations is essential to improving the support and care children with SNI and their families receive.…”

Section: Discussionmentioning

confidence: 99%

Home mechanical ventilation for children with severe neurological impairment: Parents' perspectives on clinician counselling

Bogetz

Munjapara

Henderson

et al. 2022

Develop Med Child Neuro

Self Cite

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Children with severe neurological impairment (SNI) have central nervous system disorders that arise in childhood and result in motor and cognitive impairment as well as complex developmental disability that requires much assistance with activities of daily living. 1 Some children with SNI receive home mechanical ventilation (HMV), defined as invasive ventilatory support with a tracheostomy and therefore clinician counseling must include relevant information about its known risks and benefits. 2,3 Counseling about HMV for children with SNI depends on many factors and is challenging for both parents and clinicians. 4,5 Children with SNI often have overlapping chronic

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Pediatric Chronic Critical Illness: Training Teams to Address the Communication Challenges of Patients With Repeated and Prolonged Hospitalizations

Cited by 12 publications

References 25 publications

Sources of Stress, Family Functioning, and Needs of Families With a Chronic Critically Ill Child: A Qualitative Study

Sources of Stress, Family Functioning, and Needs of Families With a Chronic Critically Ill Child: A Qualitative Study

Feasibility of a Computer Role-Playing Game to Promote Empathy in Nursing Students: The Role of Immersiveness and Perspective

Home mechanical ventilation for children with severe neurological impairment: Parents' perspectives on clinician counselling

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