Facilitators and barriers to parent-child communication in pediatric palliative care: An integrative review

Objectives

This study aimed to identify facilitators and barriers to parent-child communication in pediatric palliative care, providing insights for medical professionals developing targeted interventions to enhance parent-child communication and improve its effectiveness.

Methods

Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in six databases (Medline, Embase, CINAHL Complete, PsycINFO, Web of Science, and Cochrane Library). Peer-reviewer articles published in the English language from inception to December 2023. All of the identified studies were screened, extracted, and analyzed independently by two researchers.

Results

Twenty-four articles were included. The findings of the relevant studies were analyzed using thematic analysis. Four themes were identified as facilitators: legacy-making, resilience training programs, guidance from the healthcare team, and positive communication. Seven themes were identified as barriers: denial, being unprepared and evasive, mutual protection, being overwhelmed by painful emotions and overloaded with information, incorrect views of medical professionals and parents, negative communication, and cultural context.

Conclusions

Parents and professionals should avoid myths about protecting the child and encourage open communication that respects the child’s wishes. The specialized pediatric palliative care team should carefully monitor parent-child communication, determine if any obstacles exist, and design more interventions to enhance it.