Communicating after the Death of a Child: Bereaved Parent Insights on the GRIEV_ING Framework.

Abstract

Background: Communicating with a parent or guardian after their child's death is considered one of the most difficult tasks in medicine. While several frameworks have been developed to aid clinicians when delivering bad news, they are incomplete without the perspectives of bereaved family members. The GRIEV_ING Educational Intervention is one well-established framework for death notification that currently lacks feedback from bereaved family members. Objective: Bereaved parents have valuable insights for trainees learning to communicate with grieving families. Our aim was to elicit and analyze bereaved parent feedback on the GRIEV_ING framework. Design: Pediatric Critical Care Medicine and Pediatric Emergency Medicine fellows completed simulated conversations with standardized actors using the GRIE_VING framework. Conversations were audiovisually recorded for analysis by bereaved parent volunteers. Parent volunteers reviewed recordings of selected sessions and provided feedback on participants' performances and the GRIEV_ING framework via semistructured interviews. These interviews were then qualitatively analyzed for common themes. Setting: A pediatric tertiary hospital in the United States. Results: Five bereaved parents provided feedback on the GRIEV_ING framework. From this feedback, we identified five themes that were important to bereave parents and were absent from the GRIE_VING framework: (1) Reassurance, (2) Avoiding False Hope, (3) Preparing for the Child's Appearance, (4) Sacred Space, and (5) Offering Guidance. Conclusions: The five themes that emerged from interviews with bereaved parents demonstrate the importance of including family members when developing communication curricula. Eliciting feedback from bereaved parents added more nuance to the already well-established GRIEV_ING framework.