Bringing Children into Focus in Adult Palliative Care: Pilot Evaluation of a Family Communication Educational Intervention.
TL;DR
Brief, interdisciplinary training was associated with meaningful short-term confidence gains and sustained practice change and family outcomes, and larger studies should assess sustained practice change and family outcomes.
Abstract
Background
Dependent children's support needs may be overlooked in adult palliative care, and clinicians report limited preparation for family communication.
Objective
To develop and pilot an educational intervention to increase clinician self-efficacy in supporting families' serious illness communication with dependent children.
Methods
Interdisciplinary palliative care clinicians in one health system completed a 1-hour workshop and matched pre/postsurveys assessing four confidence domains. Changes among 20 matched respondents were analyzed with paired t-tests and Wilcoxon sensitivity tests.
Results
Mean composite confidence increased from 5.2 to 6.6 (10-point scale). Confidence improved in identifying children's needs (d = 1.36), exploring family concerns (d = 0.92), advising parents what to tell a child (d = 1.10), and preparing caregivers (d = 0.86; all p ≤ 0.001). Most respondents intended to intervene (85%) and communicate with families (90%).
Conclusion
Brief, interdisciplinary training was associated with meaningful short-term confidence gains. Larger studies should assess sustained practice change and family outcomes.