When a child dies: pediatric oncologists' follow-up practices with families after the death of their child
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OBJECTIVES: Follow-up practices with bereaved families are considered a part of good medical care, yet little is known about pediatric oncologists' protocol with families when their patients die. The objective of this study was to examine follow-up practices employed by pediatric oncologists after patient death using an in-depth qualitative analysis. METHODS: The Grounded Theory method of data collection and analysis was used. Twenty-one pediatric oncologists at two Canadian pediatric hospitals were interviewed about their follow-up practices with bereaved families after patients died. Line-by-line coding was used to establish codes and themes, and constant comparison was used to establish relationships among emerging codes and themes. RESULTS: Pediatric oncologists actively engage in follow-up practices that include making phone calls, sending an email or condolence card, attending funerals or visitations, having long-term and short-term meetings with parents, and attending hospital or departmental memorials for the deceased child. Attending funerals or visitations was less frequent and varied widely across pediatric oncologists. Reasons for not participating in bereavement follow-up practices included logistical, emotional, and practical considerations. CONCLUSIONS: While the majority of pediatric oncologists at two Canadian centers engage in some follow-up practices with bereaved families, these practices are complex and challenging because of the emotional nature of these interactions. Medical institutions should provide both structured time for this follow-up work with families, as well as medical education and financial and emotional support to pediatric oncologists who continue caring for these families long after their child has died.
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