Communication of bad news in palliative care within pediatric oncology

Abstract The study aims to understand the process of communicating bad news experienced by families of patients in hospice care from the pediatric oncology reference center in Fortaleza, Ceará, Brazil. This is a qualitative descriptive study using structured interviews with families of children and adolescents in palliative care and guided by thematic and categorical content analysis. It was observed that, in the view of family members, communication brings ambivalent reactions, involving the need to know and the suffering caused by the prospect of the child’s death. Humanizing factors, such as an empathic stance, welcoming attitude and affection related to the others’ suffering experience, resonate in the good relationship between professionals and family members. It is concluded that the communication in palliative care is an imperative in everyday pediatric oncology and causes suffering that requires mental health care. Thus, professional practice needs constant improvement in order to qualify the services of palliative care.

摘要 本研究旨在探明巴西塞阿拉州福塔莱萨市儿科肿瘤转诊中心儿科临终关怀（hospice care）患者家属在接收坏消息过程中的沟通全貌。本研究属于质性描述性研究，采用针对姑息治疗（palliative care）儿童与青少年家属的结构化访谈法，并以主题与类别内容分析作为研究指导框架。研究观察到，从家属视角来看，此类沟通会引发矛盾性反应：一方面存在知晓真相的迫切需求，另一方面又会因得知子女将离世的前景而承受巨大痛苦。共情立场、接纳态度以及对他人苦难经历的共情关怀等人性化因素，能够有效促进医护人员与家属间的良好互动关系。研究结论显示，姑息治疗中的沟通环节是儿科肿瘤临床日常工作的必要组成部分，且其带来的痛苦体验需通过心理健康服务予以干预。因此，为优化姑息照护服务质量，专业临床实践需持续精进完善。