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Relationships between oncohematopediatrics, mothers and children in communicating bad news
Selene Beviláqua Chaves Afonso1, Maria Cecília de Souza Minayo2
1Setor 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.
Insights
Pediatric oncologists navigate complex emotional and ethical challenges when sharing bad news with children and mothers. Effective communication is crucial for treatment and supporting families through end-of-life care.
Area of Science:
- Pediatric Oncology
- Communication in Healthcare
- Bioethics
Background:
- Sharing bad news (BN) in pediatric oncology involves intricate technical and emotional aspects.
- Fatal outcomes are a constant probability in childhood cancer diagnoses, necessitating sensitive communication strategies.
Purpose of the Study:
- To explore the dynamics between pediatric oncologists, mothers, and children in delivering bad news.
- To understand the role of communication, emotional expression, and bioethical considerations in end-of-life care for pediatric cancer patients.
Main Methods:
- Qualitative research approach.
- Participant observation and open interviews with female oncologists and mothers at a public hospital in Rio de Janeiro.
Main Results:
- Professionals engage in frequent discussions regarding bad news delivery.
- Relapse in positively evolving cases presents the most challenging news to convey.
- Continuous updating of bad news is necessary for terminally ill children.
- Communication quality significantly impacts treatment outcomes.
- Oncologists constantly balance proximity and objectivity, playing a vital role in securing family and child well-being.
Conclusions:
- Effective communication, balancing empathy and objectivity, is paramount in pediatric oncology.
- Addressing bioethical issues with sensitivity is essential when discussing end-of-life care.
- The role of healthcare professionals in supporting families during difficult prognoses is irreplaceable.
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.
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