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Understanding communication among health care professionals regarding death and dying in pediatrics

  • Julianne Harrison (a1), Elana Evan (a2), Amy Hughes (a2), Shahram Yazdani (a3), Myke Federman (a1) and Rick Harrison (a1)...



Effective communication regarding death and dying in pediatrics is a vital component of any quality palliative care service. The goal of the current study is to understand communication among health care professionals regarding death and dying in children. The three hypotheses tested were: (1) hospital staff (physicians of all disciplines, nurses, and psychosocial clinicians) that utilize consultation services are more comfortable communicating about death and dying than those who do not use such services, (2) different disciplines of health care providers demonstrate varying levels of comfort communicating about a range of areas pertaining to death and dying, and (3) health care staff that have had some type of formal training in death and dying are more comfortable communicating about these issues.


A primary analysis of a survey conducted in a tertiary care teaching children's hospital.


Health care professionals who felt comfortable discussing options for end of life care with colleagues also felt more comfortable: initiating a discussion regarding a child's impending death with his/her family (r = 0.42), discussing options for terminal care with a family (r = 0.58), discussing death with families from a variety of ethnic/cultural backgrounds (r = 0.51), guiding parents in developmentally age-appropriate discussions of death with their children (r = 0.43), identifying and seeking advice from a professional role model regarding management concerns (r = 0.40), or interacting with a family following the death of a child (r = 0.51). Among all three disciplines, physicians were more likely to initiate discussions with regards to a child's impending death (F = 13.07; p = 0.007). Health care professionals that received formal grief and bereavement training were more comfortable discussing death.

Significance of the results:

The results demonstrated that consultation practices are associated with a higher level of comfort in discussing death and dying in pediatrics.


Corresponding author

Address correspondence and reprint requests to: Julianne Harrison, 8926 West 25th Street, Los Angeles, CA 90034. E-mail: 718-208-7994


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American Academy of Pediatrics. (2000). Committee on bioethics and committee on hospital care. Palliative care for children. Pediatrics, 106, 351357.
Bagatell, R., Meyer, R., et al. (2002). When children die: A seminar series for pediatric residents. Pediatrics, 110, 348353.
Contro, N., Larson, J., et al. (2004). Hospital staff and family perspectives regarding quality of pediatric palliative care. Pediatrics, 114, 12481252.
Curtis, J., Engelberg, R. et al. (2005). Missed opportunities during family conferences about end-of-life care in the intensive care unit. American Journal Respiratory Critical Care Medicine, 171, 844849.
Himelstein, B., Hilden, J.M., et al. (2004). Pediatric palliative care. New England Journal of Medicine, 250, 17521762.
Hsiao, J., Evan, E., et al. (2007). Parent and child perspectives on physician communication in pediatric palliative care. Palliative and Supportive Care, 5, 355365.
Meert, K., Eggly, S., et al. (2008). Parents' perspectives on physician-parent communication near the time of a child's death in the pediatric intensive care unit. Pediatric Critical Care Medicine, 151, 5055.
Meyer, E., Ritholz, M., et al. (2006). Improving the quality of end of life care in the pediatric intensive care unit: parents' priorities and recommendations. Pediatrics, 117, 649657.
Pierucci, R.L., Kirby, R.S. & Leuthner, S.R. (2001). End-of-life care for neonates and infants: The experience and effects of a palliative care consultation service. Pediatrics, 108, 653660.
Sulmasy, D.P., He, K., et al. (2008). Beliefs and attitudes of nurses and physicians about do not resuscitate orders and who should speak to patients and families about them. Critical Care Medicine, 36, 18171822.
Yazdani, S., Evan, E., et al. (2010). A longitudinal method of teaching pediatric palliative care to interns: Preliminary findings regarding changes in interns' comfort level. Palliative and Supportive Care, 8, 3540.


Understanding communication among health care professionals regarding death and dying in pediatrics

  • Julianne Harrison (a1), Elana Evan (a2), Amy Hughes (a2), Shahram Yazdani (a3), Myke Federman (a1) and Rick Harrison (a1)...


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