Characteristics of uncertainty in advanced pediatric cancer conversations.
Bryan A Sisk, Annie B Friedrich, James DuBois and 1 others
PMID 33109428WHAT IT FOUND
Parents and physicians in advanced pediatric cancer visits raised many uncertainties and mostly kept talks open.
Children rarely spoke, and nurses and psychologists had little part.
Key findings
01Across 489 uncertainty statements, physicians initiated 63%, parents initiated 33%, children initiated 2%, and others initiated 2%.
02Most responses to uncertainty kept discussion open, with physicians most often providing additional information and parents most often using short continuing statements.
03Children seldom responded, and nurses, psychologists, and other family members were minimally involved in responses to uncertainty.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study looked only at what families and clinicians said aloud, so it cannot show what they were thinking or feeling inside. Knowing they were recorded may have changed how people spoke. Only 56% of eligible parents agreed to participate, so families who chose to be recorded may differ from those who did not. Audio recordings did not capture facial expressions, pauses, touch, or other nonverbal cues. Each child had one conversation analysed, so uncertainty may have continued in later visits. Most parents were white and female, and the study was from two Boston hospitals, so it may not apply to other settings. The coding method may have missed subtle ways clinicians closed down uncertainty.
Declared interests
No conflict-of-interest declaration is included in the supplied text. The article is labelled as research supported by NIH extramural funding.
The easy way to misread this
Do not read the high proportion of open responses as evidence that these conversations reduced family distress or improved decisions. The study described communication patterns only. It did not measure outcomes, and it did not test whether any response was better.