Differences in end-of-life communication for children with advanced cancer who were referred to a palliative care team

BackgroundThere is a general consensus that involving a specialized palliative care team in the care of children with advanced cancer can help optimize end-of-life communication; however, how this compares to standard oncology care is still unknown. We aimed to determine whether there was an association between specialist palliative care involvement and improved end-of-life communication for children with advanced cancer and their families. ProcedureWe administered questionnaires to 75 bereaved parents (response rate 54%). Outcome measures were presence or absence of 11 elements related to end-of-life communication. ResultsParents were significantly more likely to receive five communication elements if their child was referred to a palliative care team. These elements are: discussion of death and dying with parents by the healthcare team (P<0.01); discussion of death and dying with child by the healthcare team when appropriate (P<0.01); providing parents with guidance on how to talk to their child about death and dying when appropriate (P<0.01); preparing parents for medical aspects surrounding death (P=0.02) and sibling support (P=0.02). Children were less likely to be referred to a palliative care team if they had a hematologic malignancy. ConclusionsChildren who receive standard oncology care are at higher risk of not receiving critical communication elements at end of life. Strategies to optimize end-of-life communication for children who are not referred to a palliative care team are needed. Pediatr Blood Cancer 2015;62:1409-1413. (c) 2015 Wiley Periodicals, Inc.