Barriers identified to pediatric advance care discussions

Barriers identified to pediatric advance care discussions

(HealthDay) -- Prognostic understanding and parental attitude are significant barriers to advance care discussions (ACD) for children with life-threatening conditions, according to a study published online March 5 in Pediatrics.

Amy Durall, M.D., of Children's Hospital Boston, and colleagues analyzed survey results (54 percent response rate) from physicians (107) and nurses (159) involved in pediatric clinical care in practice settings where advance care planning takes place.

The researchers found that the top three barriers were unrealistic parent expectations, differences between clinician and patient/parent understanding of prognosis, and lack of parent readiness to have the discussion. Some differences existed between physician and nurse responses, with nurses significantly more likely than physicians to identify lack of importance to clinicians and ethical considerations as impediments. Physicians were significantly more likely to respond that not knowing the right thing to say was more often a barrier. Response differences also existed by specialty, with unit providers more likely to report unrealistic clinician expectations and differences between clinician and patient/parent understanding of as common barriers to conducting ACD. Most clinicians (71 percent) believed that ACD happen too late in the patient's clinical course.

" perceive parent prognostic understanding and attitudes as the most common barriers to conducting ACD," the authors write.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Perception of inappropriate care frequent among ICU workers

Dec 27, 2011

A survey of nurses and physicians in intensive care units (ICUs) in Europe and Israel indicated that the perception of inappropriate care, such as excess intensity of care for a patient, was common, and that these perceptions ...

Recommended for you

Schumacher's doctor sees progress after injury

3 hours ago

A French physician who treated Michael Schumacher for nearly six months after the Formula One champion struck his head in a ski accident says he is no longer in a coma and predicted a possible recovery within three years.

New MCAT shifts focus, will include humanities

Oct 20, 2014

(HealthDay)—The Medical College Admission Test (MCAT) has been revised, and the latest changes, including more humanities such as social sciences, are due to be implemented next April, according to a report ...

User comments