Communication Challenges of Oncologists and Intensivists Caring for Pediatric Oncology Patients: A Qualitative Study

Title

Communication Challenges of Oncologists and Intensivists Caring for Pediatric Oncology Patients: A Qualitative Study

Creator

Odeniyi F; Nathanson PG; Schall TE; Walter JK

Publisher

Journal Of Pain And Symptom Management

Date

2017

Subject

Communication Barriers; Goals Of Care; Interprofessional Communication; Pediatric Ethics; Pediatric Intensive Care; Pediatric Oncology

Description

CONTEXT: The families of oncology patients requiring intensive care often face increasing complexity in communication with their providers, particularly when patients are cared for by providers from different disciplines. OBJECTIVE: To describe experiences and challenges faced by pediatric oncologists and intensivists and how the oncologist-intensivist relationship impacts communication and initiation of goals of care discussions (GCDs). METHODS: We conducted semi-structured interviews with a convenience sample of ten physicians, including pediatric oncology and intensive care attendings and fellows. RESULTS: We identified key themes (3 barriers, 4 facilitators) to having GCDs with families of oncology patients who have received intensive care. Barriers included challenges to communication within teams because of hierarchy and between teams due to incomplete sharing of information and confusion about who should initiate GCDs; provider experiences of internal conflict about how to engage parents in decision making and about the "right thing to do" for patients; and lack of education and training in communication. Facilitators included team preparation for family meetings; skills for partnering with families; the presence of palliative care specialists; and informal education in communication and willingness for further training in communication. Notably, the education theme was identified as both a barrier and a resource. CONCLUSION: We identified barriers to communication with families both within and between teams and for individual physicians. Formal communication training and processes that standardize communication to ensure completeness and role delineation between clinical teams may improve oncologists' and intensivists' ability to initiate GCDs, thereby fulfilling their ethical obligations of decision support.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation List Month

Oncology 2017 List

Collection

Citation

Odeniyi F; Nathanson PG; Schall TE; Walter JK, “Communication Challenges of Oncologists and Intensivists Caring for Pediatric Oncology Patients: A Qualitative Study,” Pediatric Palliative Care Library, accessed October 28, 2021, https://pedpalascnetlibrary.omeka.net/items/show/11151.

Social Bookmarking