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[Pediatrician's experience in announcing bad news]
C Crosnier-Schoedel1, N Trocmé2, R Carbajal1
1Service des urgences pédiatriques, hôpital Armand-Trousseau, 26, avenue du Dr Arnold-Netter, 75012 Paris, France.
Insights
Pediatricians face significant challenges when delivering bad news to children and teenagers, often feeling ill-equipped and emotionally impacted. These difficulties stem from patient, family, and self-related factors, impacting communication effectiveness.
Area of Science:
- Pediatric Medicine
- Clinical Communication
- Psychological Impact in Healthcare
Background:
- Delivering bad news is a critical clinical skill, particularly complex in pediatrics due to the involvement of parents.
- Limited research exists on pediatricians' specific experiences and challenges in this area.
Purpose of the Study:
- To explore hospital pediatricians' experiences and perceived difficulties when announcing bad news to pediatric patients.
- To identify factors contributing to communication challenges in pediatric end-of-life or serious illness discussions.
Main Methods:
- A questionnaire with 30 questions was administered to 20 hospital pediatricians.
- The survey focused on their personal experiences with breaking bad news to children and teenagers.
Main Results:
- Pediatricians reported numerous limitations related to the child, family, and themselves when delivering bad news.
- Key difficulties included timing, location, word choice, and patient/family comprehension issues.
- Pediatricians often doubted patient understanding and experienced personal emotional distress, including loneliness and guilt.
Conclusions:
- Pediatricians face substantial emotional and practical hurdles when communicating bad news to young patients and their families.
- Effective strategies are needed to support pediatricians in navigating these difficult conversations and mitigating personal impact.
Abstract:
Few studies are available on pediatricians' experience with announcing bad news. Announcing bad news is an important component of medical practice and is even more complex in pediatrics because parents must be associated. We had 20 hospital pediatricians complete a questionnaire containing 30 questions about their own experience announcing bad news to a child or a teenager. In spite of their experience and the time they have spent practicing medicine, there are many limitations stemming from different factors concerning children, teenagers, their families, and themselves. The difficulties encountered by pediatricians are mainly related to the timing of the announcement, the location, the choice of the words used, and the poor understanding of children and families, due to intellectual, cultural, or psychological limitations. Pediatricians question their own capacity to make such an announcement, wondering if the information has actually been well understood. They indicate that they are themselves affected. Most of them develop and implement strategies to refute the emotional instability caused by the announcement of bad news. Yet many of them feel weak, even talking about a deep sense of loneliness and guilt.
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