The Communication of Palliative Care Adoption in a Pediatric Intensive Care Unit
Miriam Neis, Cristianne Maria Famer Rocha, and Paulo Roberto Antonacci Carvalho
Since 1990, palliative care has been recommended by the World Health Organization as an alternative treatment for individuals with incurable and advanced diseases. It aims for a longer life with better quality and a process of dying without suffering. In the pediatric universe, palliative care is recommended in cases where no treatment can substantially change the expected disease progression or clinical condition of the child toward death. The decision-making process and communication about the adoption of Palliative Care in the Pediatric Intensive Care Unit (ICU) is a challenge for professionals because of ethical dilemmas and the emotional load this type of situation generates in the child's family and in the health team itself. A descriptive exploratory study sought to understand the development of the interprofessional team’s communication processes when deciding on the adoption of Palliative Care in the Pediatric ICU, analyzing their effectiveness. Eleven family interviews were conducted, 15 questionnaires were completed by physicians, and 20 questionnaires were completed by nurses after meetings for the palliative care decision process. The study was carried out from January to November 2017 at the Pediatric ICU at the Hospital de Clínicas de Porto Alegre, Brazil. The analysis of the collected data showed that in 10 of the 14 cases observed, there was communicative effectiveness. In the four cases considered ineffective, the communication process lacked feedback techniques to check for understanding and agreement of all parties on the issues addressed. Effectiveness is not the only element to confer total adequacy in this type of communicative process. As identified by the analysis of data collected, elements such as better psychological connection, choice of milder words, demonstration of affection, and concern for the families’ feelings lacked in some situations.