Communicating with the child dying of cancer: Professionals' attitudes, practices, and observations

This descriptive study explored what is current clinical practice in pediatric oncology regarding open communication with children dying of cancer. Pediatric oncology professionals (N = 180) including mental health professionals (N = 91), nurses (N = 53), and physicians (N = 36) completed a questionnaire about their attitudes, practices, observations and perceived risks and benefits of open communication. Professionals stated that they believe in the benefits of open communication and practice it when they are able. Although professionals endorse open communication, they reported that they observe this occurring between parents and children intermittently. Professionals stated that the greatest obstacle is disagreement on the advisability of open communication between health care professionals and parents. Health care professionals also described the emotional challenges and lack of training in this area of care. These challenges appear to impact the frequency in which open communication occurs with children who are dying. Respondents agreed that there are risks involved in open communication but that these risks are outweighed by the benefits. A single analysis of variance demonstrated between group differences on the observation measure as well as on four individual questions. These significant differences as well as results that approached significance are described further in this study.