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Am J Hosp Palliat Care · Mar 2018
Speaking a Different Language: A Qualitative Analysis Comparing Language of Palliative Care and Pediatric Intensive Care Unit Physicians.
- Anne G Ciriello, Zoelle B Dizon, and Tessie W October.
- 1 Division of Critical Care Medicine, Children's National Health Systems, Washington, DC, USA.
- Am J Hosp Palliat Care. 2018 Mar 1; 35 (3): 384-389.
BackgroundFamily conferences in the pediatric intensive care unit (ICU) often include palliative care (PC) providers. We do not know how ICU communication differs when the PC team is present.AimTo compare language used by PC team and ICU physicians during family conferences.DesignA retrospective cohort review of ICU family conferences with and without the PC team.SettingForty-four bed pediatric ICU in a tertiary medical center.ParticipantsNine ICU physicians and 4 PC providers who participated in 18 audio-recorded family conferences.ResultsOf the 9 transcripts without the PC team, we identified 526 ICU physician statements, generating 10 thematic categories. The most common themes were giving medical information and discussing medical options. Themes unique to ICU physicians included statements of hopelessness, insensitivity, and "health-care provider challenges." Among the 9 transcripts with the PC team, there were 280 statements, generating 10 thematic categories. Most commonly, the PC team offered statements of support, giving medical information, and quality of life. Both teams promoted family engagement by soliciting questions; however, the PC team was more likely to use open-ended questions, offer support, and discuss quality of life.ConclusionPediatric ICU physicians spend more time giving medical information, whereas the PC team more commonly offers emotional support. The addition of the PC team to ICU family conferences may provide a balanced approach to communication.
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