title: Relationships between oncohematopediatrics, mothers and children in communicating bad news.
abstract: We present a study about the relations between pediatric oncological haematologists, mothers, and children in sharing bad news (BN) in a public hospital in Rio de Janeiro. The text emphasizes the intertwining of technique and emotions for the treatment of children with diagnoses in which the fatal outcome is always a probability. We used a qualitative approach, privileging participant observation and open interviews with oncologists (at this service all professionals were female) and mothers. We sought to understand the importance of communication which includes expressions and control of emotions; bioethical issues that require sensitivity, serenity, and truth about approaching the end of life; and how the professionals balance proximity to children and families and objectivity in their activity. The main results showed: intense exchanges on BN among professionals; relapse of children who were evolving positively as the most difficult news; constant update of BN facing terminally ill children; quality of communication influencing the treatment; professionals permanently balancing between closeness and distance from patients and evidence of the their irreplaceable role to secure the family and the child.
authors.affiliation: Setor de Psicologia Médica, Instituto Nacional da Saúde da Criança, da Mulher e do Adolescente Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil. selene.zero@gmail.com.
authors.forename: Selene Beviláqua Chaves
authors.initials: SB
authors.lastname: Afonso
authors.affiliation: Departamento de Estudos sobre Violência e Saúde Jorge Careli(Claves), Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro RJ Brasil.
authors.forename: Maria Cecília de Souza
authors.initials: MC
authors.lastname: Minayo
mesh_terms: D026688:Bioethical Issues; D002648:Child; D003142:Communication; D005260:Female; D019337:Hematologic Neoplasms / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008495:Medical Oncology / Q000941:ethics / Q000379:methods; D009035:Mothers / Q000523:psychology*; D010817:Physician-Patient Relations; D012008:Recurrence; D019452:Terminally Ill / Q000523:psychology; D014342:Truth Disclosure / Q000941:ethics