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Pediatric Palliative Care for Non-palliative Care Specialists

MAY 04, 2017
Anthony Herbert, M.D.


Communication is fundamental for delivering quality medical care. That is also true when talking to a family about palliative care and end-of-life decisions for a terminally-ill child.  Unfortunately, not all health professionals are properly trained to have those difficult conversations.
 
 Dr. Anthony Herbert, staff specialist in pediatric palliative care at Lady Cilento Children’s Hospital in Brisbane, Australia talks about a pilot project they performed in which they videotaped 9 conversations with families by a pediatric palliative care specialist. 
 
The study identified 2 communicative practices used by a pediatric palliative care specialist that afforded opportunities to discuss deterioration: 1) soliciting the family’s agenda for the consultation; 2) initiating and maintaining topics where discussing deterioration is a relevant possibility. 
 
Dr. Herbert noted that in most cases, these conversations can be approached by ‘knocking on the door’ of the subject by providing cues for the family to bring up the topic on their own. 

Reference

Herbert A, Danby S, Bradford N, et al. Affording opportunities to discuss deterioration in paediatric palliative care consultations: a conversation analytic study. Presented at the ASPHO Annual Meeting; Montreal, Canada; April 26-29, 2017.


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