Empathic Communication in Pediatric Palliative Care: A Mixed-Methods Systematic Review

Area of Science:

• Pediatric Palliative Care
• Communication Studies
• Psychosocial Outcomes

Background:

• Effective communication between healthcare providers and parents is crucial but complex during a child's end-of-life care.
• A synthesis of empathic communication's impact on clinical and bereavement outcomes in pediatric palliative care is needed.

Purpose of the Study:

• To synthesize evidence on parent-provider empathic communication in pediatric palliative care.
• To develop an integrative theoretical-conceptual model of its mediating role in symptom management and family bereavement.

Main Methods:

• A mixed-methods systematic review following Joanna Briggs Institute (JBI) methodology.
• Searched multiple databases (PubMed/MEDLINE, Scopus, CINAHL, PsycINFO, LILACS) for studies on parental experiences of empathic communication.
• Synthesized qualitative findings via meta-aggregation and quantitative data through narrative synthesis.

Main Results:

• Fifty-four studies involving 3,567 participants were included.
• Empathic communication fosters relational trust, enhances prognostic understanding, supports meaning-making, and prevents complicated grief.
• Better communication and continuity of care correlated with lower parental grief; late information increased unresolved grief risk.

Conclusions:

• Empathic communication in pediatric palliative care functions via specific psychosocial mechanisms, not just as a communication style.
• The "Relational Layered Care Model" offers a framework for clinical practice, education, and interventions.
• This model highlights how empathic communication influences bereavement adaptation and symptom outcomes.