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Parental perspectives on the clinician’s approach to serious illness communication: A qualitative study

Published online by Cambridge University Press:  01 August 2023

Nicholas Mills Open the ORCID record for Nicholas Mills [Opens in a new window] ,
Megan Chapman Open the ORCID record for Megan Chapman [Opens in a new window] ,
Ingrid Sutherland Open the ORCID record for Ingrid Sutherland [Opens in a new window] ,
Lynn Gillam Open the ORCID record for Lynn Gillam [Opens in a new window]  and
Anna Collins Open the ORCID record for Anna Collins [Opens in a new window]
Nicholas Mills*
Affiliation:
Department of Neurodevelopment and Disability, The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia Paediatric Palliative Care Service, The Women’s and Children’s Hospital, North Adelaide, SA, Australia
Megan Chapman
Affiliation:
Department of Mental Health, The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
Ingrid Sutherland
Affiliation:
Department of Neurodevelopment and Disability, The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
Lynn Gillam
Affiliation:
The Children’s Bioethics Centre, The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
Anna Collins
Affiliation:
Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia
*
Corresponding author: Nicholas Mills; Email: drnicholasmills@icloud.com
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Abstract

Objectives

To explore the perceptions of parents caring for a child with a life-limiting condition on approaches to communication used by clinicians engaging in routine serious illness communication.

Methods

An exploratory qualitative design was used, employing a thematic analysis of data derived through semi-structured interviews which presented hypothetical vignettes of serious illness conversations to elicit parental perspectives. Adult parents of children with a life-limiting condition, in a stable phase of care, known to the Neurodevelopment and Disability Department of a tertiary Children’s Hospital in Melbourne, Australia, were purposively sampled to achieve a broad representation of relevant clinical and sociodemographic factors.

Results

Eleven parents (72% female) of children aged 7 months to 18 years participated. Two major themes characterized parental perspectives on serious illness communication: “Approaches clinicians can use to lay the foundation for quality communication” including checking in, validation, aligning with hopes and a commitment to listening and being present; and “Approaches clinicians can use to aid the delivery of information” including honesty and compassion, presenting possibilities, providing a plan, and conveying the clinician’s experience.

Significance of results

This study provides novel insights into the perspectives of parents of children with life-limiting conditions that inform how clinicians may best approach serious illness communication. The findings highlight the need for clinicians working in pediatric health care to be cognizant of parents’ needs before and during conversations. Laying the foundation for quality communication is important alongside the approaches outlined that aid in the delivery of information.

Keywords

Palliative careChildrenParentsCommunicationSerious illnessQualitative research
Type
Original Article
Information
Palliative & Supportive Care , Volume 22 , Issue 2 , April 2024 , pp. 354 - 359
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Copyright
© The Author(s), 2023. Published by Cambridge University Press.

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