title: A Qualitative Examination of Physician Gender and Parental Status in Pediatric End-of-Life Communication.
abstract: In this study we utilized the framework of patient-centered communication to explore the influence of physician gender and physician parental status on (1) physician-parent communication and (2) care of pediatric patients at the end of life (EOL). The findings presented here emerged from a larger qualitative study that explored physician narratives surrounding pediatric EOL communication. The current study includes 17 pediatric critical care and pediatric emergency medicine physician participants who completed narrative interviews between March and October 2012 to discuss how their backgrounds influenced their approaches to pediatric EOL communication. Between April and June of 2013, participants completed a second round of narrative interviews to discuss topics generated out of the first round of interviews. We used grounded theory to inform the design and analysis of the study. Findings indicated that physician gender is related to pediatric EOL communication and care in two primary ways: (1) the level of physician emotional distress and (2) the way physicians perceive the influence of gender on communication. Additionally, parental status emerged as an important theme as it related to EOL decision-making and communication, emotional distress, and empathy. Although physicians reported experiencing more emotional distress related to interacting with patients at the EOL after they became parents, they also felt that they were better able to show empathy to parents of their patients.
authors.affiliation: a Division of Preventive Medicine , University of Alabama at Birmingham School of Medicine.
authors.forename: Lori Brand
authors.initials: LB
authors.lastname: Bateman
authors.affiliation: b Department of Pediatrics , University of Alabama at Birmingham School of Medicine.
authors.forename: Marjorie Lee
authors.initials: ML
authors.lastname: White
authors.affiliation: b Department of Pediatrics , University of Alabama at Birmingham School of Medicine.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Tofil
authors.affiliation: c Department of Sociology , University of Alabama at Birmingham.
authors.forename: Jeffrey Michael
authors.initials: JM
authors.lastname: Clair
authors.affiliation: d Department of Epidemiology , University of Michigan School of Public Health.
authors.forename: Belinda L
authors.initials: BL
authors.lastname: Needham
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D004645:Empathy; D005260:Female; D066296:Grounded Theory; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D010820:Physicians / Q000523:psychology*; D011368:Professional-Family Relations; D036301:Qualitative Research; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology; D013727:Terminal Care / Q000523:psychology*