title: Evaluation of Physician and Nurse Dyad Training Procedures to Deliver a Palliative and End-of-Life Communication Intervention to Parents of Children with a Brain Tumor.
abstract: When a child's prognosis is poor, physicians and nurses (MDs/RNs) often struggle with initiating discussions about palliative and end-of-life care (PC/EOL) early in the course of illness trajectory. We describe evaluation of training procedures used to prepare MD/RN dyads to deliver an intervention entitled: Communication Plan: Early Through End of Life (COMPLETE) intervention. Our training was delivered to 5 pediatric neuro-oncologists and 8 pediatric nurses by a team of expert consultants (i.e., in medical ethics, communication, and PC/EOL) and parent advisors. Although half of the group received training in a 1-day program and half in a 2-day program, content for all participants included 4 modules: family assessment, goal-directed treatment planning, anticipatory guidance, and staff communication and follow-up. Evaluations included dichotomous ratings and qualitative comments on content, reflection, and skills practice for each module. Positive aspects of our training included parent advisers' insights, emphasis on hope and non-abandonment messages, written materials to facilitate PC/EOL communication, and an MD/RN dyad approach. Lessons learned and challenges related to our training procedures will be described. Overall, the MDs and RNs reported that our PC/EOL communication-training procedures were helpful and useful. Future investigators should carefully plan training procedures for PC/EOL communication interventions.
authors.affiliation: Saint Louis University School of Nursing, St. Louis, MO, USA hendrivl@slu.edu.
authors.forename: Verna L
authors.initials: VL
authors.lastname: Hendricks-Ferguson
authors.affiliation: Texas A&M College of Medicine, Temple, TX, USA.
authors.forename: Javier R
authors.initials: JR
authors.lastname: Kane
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Kamnesh R
authors.initials: KR
authors.lastname: Pradhan
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Chie-Schin
authors.initials: CS
authors.lastname: Shih
authors.affiliation: Washington University School of Medicine, St Louis, MO, USA.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Gauvain
authors.affiliation: St Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Justin N
authors.initials: JN
authors.lastname: Baker
authors.affiliation: Indiana University School of Nursing, Indianapolis, IN, USA.
authors.forename: Joan E
authors.initials: JE
authors.lastname: Haase
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000451:nursing* / Q000523:psychology; D002648:Child; D003142:Communication; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000379:methods; D008297:Male; D010166:Palliative Care / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010348:Patient Care Team; D057184:Practice Patterns, Nurses'; D010818:Practice Patterns, Physicians'
keywords: end-of-life care; palliative and end-of-life communication training; palliative care; parents of children with a brain tumor