Interaction of Health-care Professionals with Critically III Children and Their Parents

Abstract

The stresses imposed on the emotional equilibrium of a team of health-care professionals by the serious illness of a child can disrupt communication among the team, the child, and the parents. Such stresses may be so severe as to interfere with the ability of the adults to meet the child's needs. Although the feelings and attitudes of critically ill children and their parents are well described in the medical literature, very little has been written about the psychosocial interaction among those responsible for the patient's care. Patterns of interaction which would be most beneficial to the child are still in doubt.

The purpose of this article is to review available information, as well as experience at St. Jude Children's Research Hospital, on the psychosocial interaction of the health-care team with crit ically ill children and their parents. An awareness of the difficulties of caring for such patients is essential in overcoming communication barriers, in reducing any interprofessional tensions that might arise during treatment, and in ensuring high-quality medical care.

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References

Spinetta JJ , Rigler D. , Karon M. Anxiety in the dying child. Pediatrics 1973 ;52:841-5.

Spinetta JJ , Maloney LJ Death anxiety in the outpatient leukemic child. Pediatrics 1975;56:1034-9.

Koocher GP , O'Malley JE The Damocles Syndrome. New York: McGraw-Hill, 1981:xviii.

Eason WM Management of the child or adolescent who is dying. Springfield, IL: Charles C Thomas, 1970:83-7.

Binger CM , Ablin AR , Feuerstein RC , et al. Childhood leukemia, emotional impact on patient and family. N Engl J Med 1969;280:414-6.

O'Malley JE , Koocher GP Psychological consultation to a pediatric oncology unit: obstacles of effective intervention. J Pediatr Psychol 1976;2:54-60.

Powazek M. , Goff JR , Schyving J. , et al. Emotional reactions of children to isolation in a cancer hospital . Pediatrics 1978;92:834-9.

Schoenberg A. Management of the dying patient. In: Schoenberg, Car , Peretz , et al, eds. Loss and grief: psychological management in medical practice . New York: Columbia University Press, 1970:238-60.

Alby N. , Alby JM Doctor and dying child. In: Anthony JE , Koupernik C , eds. The child in his family, vol. II; The impact of disease and death. New York: John Wiley & Sons, 1977:145-51.

10.

Alby N. Ending the chemotherapy of acute leukemia, a period of difficult weaning. In: Schulman TL , Kupst MJ , eds. The child with cancer. Springfield, IL: Charles C Thomas, 1980:175-7.

11.

Eissler KR Psychiatrists and the dying patient. New York: International University Press, 1955:119-22.

12.

Fialkov MJ , Miller JA Severe psychosomatic illness in children: effect on a pediatric ward's staff . Clin Pediatr 1981;20:792-6.

13.

Goggin EL , Lansky SB , Hassanein K. Psychological reactions of children with malignancies. J Am Acad Child Psychiatry 1976;15:314-7.

14.

Goldfogel J. Working with the parent of a dying child. Am J Nurs 1975;70:205-7.

15.

Green M. Care of the child with a long-term life-threatening illness: some principles of management. Pediatrics 1961;39:441-5.

16.

Kellerman J. , Rigler D. , Siegel SE , et al. Disease-related communication and depression in pediatric cancer patients. J Pediatr Psychol 1977;2:52-8.

17.

Moore DC , Holton CP , Marten GW Psychologic problems in management of adolescents with malignancy . Clin Pediatr 1969;8:464-73.