[Attitudes and needs of pediatric intensivists in relation to the death of their patients].
BACKGROUND
Most deaths in infants and children occur in hospitals and especially in pediatric and neonatal intensive care units.


OBJECTIVE
To determine 1) how often pediatric intensivists have to manage dying patients, 2) their approach to these patients, and 3) their knowledge of this field and their needs.


METHODS
A 28-item questionnaire was sent by surface mail to each physician, as well as another questionnaire with general questions on the work of the pediatric intensive care unit (PICU) in 2000.


RESULTS
Responses were obtained from 20 PICUs (54 %) from different parts of Spain. There where 373 deaths. More of the half of the deaths (62 %) were due to acute events or occurred during the neonatal period. Ninety-four physicians completed the questionnaire. Each physician attended four deaths (SD = 3.1; range 0-20). Sixty-eight percent of the physicians believed that families were helped by knowing the possibility that the child might die. Intensivists believed that pediatric patients should not be informed that they were dying. In 64 % of deaths, the physicians were with their patients at the moment of death. More than half of the patients died without physical contact with their parents. Forty-six percent of the physicians interpreted death among their patients as a personal or professional failure and most (92 %) wanted training. Only three PICUs allowed parents to stay all day with their children.


CONCLUSIONS
Almost half the physicians experienced death as a personal or professional failure and most wanted training to help them deal with death in their professional work. Most PICUs restrict the time parents are allowed to stay with their children.
Martino Alba
R
R
Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, España. rmartino.hupa@salud.madrid.org
Casado Flores
J
J
Ruiz Díaz
M A
MA
D000293:Adolescent; D001293:Attitude to Death; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education*; D010817:Physician-Patient Relations; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires