The Pediatrician and the Dying Child

Behnke, Marylou; Nackashi, John A.; Raulerson, Marsha Dendler; Schuler, Pamela; Mehta, Paulette

doi:10.3109/01460868509006355

Cited by 4 publications

(12 citation statements)

References 20 publications

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“…Most of the articles noted that grief from singular or cumulative losses may lead to mental health disruptions, including adjustment problems, anxiety (e.g., separation anxiety, procedural anxiety, medically-associated traumatization, social anxiety, generalized anxiety, panic attacks, obsessive-compulsive disorder), depression with occasional suicidality and conversion/somatic symptom disorders [37,38]. A few of the articles also reported that physicians experience overwhelming emotional reactions and stress responses to patient deaths, yet often feel a lack of collegial support that would help them cope [36,39,40].…”

Section: Resultsmentioning

confidence: 99%

Being there: A scoping review of grief support training in medical education

Sikstrom

Saikaly²,

Ferguson

et al. 2019

PLoS ONE

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IntroductionMedical education experts argue that grief support training for physicians would improve physician and patient and family wellness, and should therefore be mandatory. However, there is little evidence about the range of curricula interventions or the impact of grief training. The aim of this scoping review was to describe the current landscape of grief training worldwide in medical school, postgraduate residency and continuing professional development in the disciplines of pediatrics, family medicine and psychiatry.MethodsUsing Arksey and O’Malley’s scoping review principles, MEDLINE, EMBASE, ERIC, PsychInfo and Web of Science were searched by a librarian. Two levels of screening took place: a title and abstract review for articles that fit a predefined criteria and a full-text review of articles that met those criteria. Three investigators reviewed the articles and extracted data for analysis. To supplement the search, we also scanned the reference lists of included studies for possible inclusion.ResultsThirty-seven articles published between 1979 and 2019 were analyzed. Most articles described short voluntary grief training workshops. At all training levels, the majority of these workshops focused on transmitting knowledge about the ethical and legal dimensions of death, dying and bereavement in medicine. The grief trainings described were characterized by the use of diverse pedagogical tools, including lectures, debriefing sessions, reflective writing exercises and simulation/role-play.DiscussionGrief training was associated with increased self-assessed knowledge and expertise; however, few of the studies analyzed the impact of grief training on physician and patient and family wellness. Our synthesis of the literature indicates key gaps exist, specifically regarding the limited emphasis on improving physicians’ communication skills around death and dying and the limited use of interactive and self-reflexive learning tools. Most trainings also had an overly narrow focus on bereavement grief, rather than a more broadly defined definition of loss.

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Section: Resultsmentioning

confidence: 99%

Being there: A scoping review of grief support training in medical education

Sikstrom

Saikaly²,

Ferguson

et al. 2019

PLoS ONE

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“…They " . The relationships formed with dying patients are often meaningful and intense in nature, and yet researchers state that our society does not generally acknowledge the right of these caregivers to grieve or process the impact the death has had on them (Bertman, 1991;Kastenbaum, 1995;Rando, 1984). .…”

Section: Literature Reviewmentioning

confidence: 99%

Toward a Model of Caregiver Grief: Nurses' Experiences of Treating Dying Children

Kaplan¹

2000

Omega (Westport)

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This study explored the emotional experiences of fifteen American nurses who work with terminally ill children. Structured interviews were conducted which considered the relationships and the emotional experiences of one who works with dying children. Specific questions that addressed attitudes and reactions to the dying process were asked, and the notion of a grief reaction was explored. Results from this study indicate that participants experience a form of "emotional tension" in their struggle to balance the intense emotional feelings that exist when treating dying children with their desire and need to be competent care providers. Their emotional experiences are influenced by the relationship that is established with their patient and by the child's dying process. It was concluded that when caregivers recognize the need to grieve and express their feelings while acknowledging that this is a natural, normal, and appropriate manner in which to respond to the death of a patient, they then become better able to take care of themselves, and thus their patients. A proposed model of caregivers' grief is presented.

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“…16 Because the death of a child is contrary to everything for which a pediatrician strives, patient deaths can cause grief reactions in physicians that are comparable to personal or family illnesses or the death of a loved one. 17,18 To interact well with bereaved families and support a family through the dying process requires experience, knowledge, self-reflection, and understanding of one's responses in order to best integrate the experience. 2,3,11,19 The pediatrician's ability to integrate the death of a child is the culmination of multiple factors.…”

Section: Introductionmentioning

confidence: 99%

“…20 Work by Behnke and colleagues emphasizes the psychophysiologic responses including guilt, blaming self, and recurrent thoughts of the child who has died, identifying factors in the grief process that might affect the doctor-patient relationship, importance of dealing with own grief in order to be able to help families with theirs and behavioral re- sponses such as talking with others and attending the funeral. 17 Responding to patients' and families' spiritual beliefs can help in comforting them as they near the end of life. 21 Spirituality has to do with one's search for a meaning and purpose in life, [22][23][24] while religion is a specific system of belief and worship that involves a philosophy.…”

Section: Introductionmentioning

confidence: 99%

“…Figure 1 demonstrates a conceptual framework developed by the authors prior to initiating the study to understand the relationship of these factors. This conceptual framework was developed from prior works from Papadatou 20 and Behnke et al 17 Papadatou proposes the importance of: acknowledging the impact of major loss related experiences in the personal and professional lives of health care professionals, exploring the personal feelings engendered by the death to avoid burnout, experiencing the normal grieving process and intensity of emotions such as guilt, avoiding repressing grief reactions, attending the funeral as a symbolic closure to the relationship with the patient and family, and participating in debriefing sessions. 20 Work by Behnke and colleagues emphasizes the psychophysiologic responses including guilt, blaming self, and recurrent thoughts of the child who has died, identifying factors in the grief process that might affect the doctor-patient relationship, importance of dealing with own grief in order to be able to help families with theirs and behavioral re- sponses such as talking with others and attending the funeral.…”

Section: Introductionmentioning

confidence: 99%

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