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Language to Support Dignity for Children With Advanced Cancer and Their Families.

Carolyn Humphrey1,2, Shoshana Mehler2, Sarra O'Bryan2

  • 1Department of Psychology, University of Mississippi, Oxford, Mississippi.

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Pediatric oncologists used dignity language in less than 7% of discussions, missing opportunities to affirm dignity in children with cancer. A new model, "Lend an EAR," aims to improve communication and support dignity in pediatric oncology.

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Area of Science:

  • Pediatric Oncology
  • Medical Communication
  • Bioethics

Background:

  • Dignity is crucial for person-centered pediatric care.
  • Language strategies to support dignity in pediatric oncology are understudied.
  • This study addresses the gap in understanding dignity-affirming communication in pediatric cancer.

Purpose of the Study:

  • To identify and characterize language used by pediatric oncologists to recognize and affirm dignity in children with advancing cancer.
  • To analyze communication patterns during disease reevaluation encounters.

Main Methods:

  • Longitudinal prospective study involving audio-recorded encounters between pediatric oncologists, children with cancer, and families.
  • Hybrid deductive-inductive qualitative approach for content analysis of dignity language.
  • Thematic analysis of 91 discussions across 36 patients over 24 months or until death.

Main Results:

  • Dignity language was absent in 45% of "bad news" encounters.
  • Oncologists spent less than 7% of dialogue engaging in dignity language.
  • Key themes upholding dignity included empowerment, autonomy, and respect.

Conclusions:

  • Significant opportunities exist to enhance dignity-based communication in pediatric cancer care.
  • A conceptual model, "Lend an EAR," is proposed to guide dignity communication.
  • Future research should focus on patient/parent perspectives and integrate the model into communication training.