Physicians' experiences and perspectives regarding follow-up meetings with parents after a child's death in the pediatric intensive care unit.
OBJECTIVE
To investigate critical care physicians' experiences and perspectives regarding follow-up meetings with parents after a child's death in the pediatric intensive care unit. Parents of children who die in the pediatric intensive care unit often desire a follow-up meeting with the physicians who cared for their child.


METHODS
Semistructured, audio-recorded telephone interviews.


METHODS
Six clinical centers affiliated with the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network.


METHODS
Seventy critical care physicians (i.e., attendings and fellows) practicing or training at a Child Health and Human Development Collaborative Pediatric Critical Care Research Network clinical center between February 1, 2008 and June 30, 2008.


RESULTS
Twenty-three (33%) physicians reported never participating in a follow-up meeting with bereaved parents; 22 (31%) participated in one to five meetings; and 25 (36%) participated in more than five meetings. Of those with prior experience, 44 (94%) met with parents at the hospital and 40 (85%) met within 3 months of the death. Meeting content included discussing autopsy, parent questions, hospital course, cause of death, genetic risk, bereavement services, and legal or administrative issues; providing emotional support; and receiving parent feedback. Forty (85%) physicians perceived the meetings to be beneficial to families, and 35 (74%) to physicians. Barriers included time and scheduling, family and physician unwillingness, distance and transportation, language and cultural issues, parent anger, and lack of a system for meeting initiation and planning.


CONCLUSIONS
Critical care physicians have a wide range of experience conducting follow-up meetings with bereaved parents. Although physicians perceive benefits to follow-up meetings, barriers exist that interfere with their implementation in clinical practice.
Meert
Kathleen L
KL
Children's Hospital of Michigan, Detroit, MI, USA. kmeert@med.wayne.edu
Eggly
Susan
S
Berger
John
J
Zimmerman
Jerry
J
Anand
K J S
KJ
Newth
Christopher J L
CJ
Harrison
Rick
R
Carcillo
Joseph
J
Dean
J Michael
JM
Willson
Douglas F
DF
Nicholson
Carol
C
D003142:Communication; D003643:Death; D017052:Hospital Mortality; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007407:Interviews as Topic; D010290:Parents / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011368:Professional-Family Relations