title: Understanding communication among health care professionals regarding death and dying in pediatrics.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  A primary analysis of a survey conducted in a tertiary care teaching children's hospital.
  
  
  RESULTS
  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.
authors.affiliation: Pediatric Critical Care Mattel Children's Hospital UCLA.
authors.forename: Julianne
authors.initials: J
authors.lastname: Harrison
authors.affiliation: UCLA Children's Comfort Care Program.
authors.forename: Elana
authors.initials: E
authors.lastname: Evan
authors.affiliation: UCLA Children's Comfort Care Program.
authors.forename: Amy
authors.initials: A
authors.lastname: Hughes
authors.affiliation: UCLA Division of General Pediatrics.
authors.forename: Shahram
authors.initials: S
authors.lastname: Yazdani
authors.affiliation: Pediatric Critical Care Mattel Children's Hospital UCLA.
authors.forename: Myke
authors.initials: M
authors.lastname: Federman
authors.affiliation: Pediatric Critical Care Mattel Children's Hospital UCLA.
authors.forename: Rick
authors.initials: R
authors.lastname: Harrison
mesh_terms: D000328:Adult; D002648:Child; D003142:Communication; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel / Q000193:education / Q000523:psychology*; D006776:Hospitals, Pediatric; D006784:Hospitals, Teaching; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010372:Pediatrics / Q000193:education* / Q000379:methods; D011368:Professional-Family Relations; D019452:Terminally Ill / Q000523:psychology*