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Evaluation of Interdisciplinary Training for a Palliative Care/End-of-Life Communication Intervention for Parents of Children with Brain Tumors

Thursday, July 14, 2011

Verna L. Hendricks-Ferguson, PhD, RN1
Joan E. Haase, RN, PhD, FAAN2
Kamnesh R. Pradhan, MD3
Javier R. Kane, MD4
Chie-Schin Shih, MD5
Karen M. Gauvain, MD6
Molly A. Donovan Stickler, MPH2
(1)Goldfarb School of Nursing, Barnes-Jewish College, St. Louis, MO
(2)School of Nursing, Indiana University, Indianapolis, IN
(3)Pediatric Hematology-Oncology, Riley Children's Hospital, Indianapolis, IN
(4)Pediatrics; and the Division of Palliative and End-of-Life Care, St. Jude Children's Research Hospital, Memphis, TN
(5)Pediatrics; Hematology-Oncology, Indiana University School of Medicine, Indianapolis, IN
(6)Pediatrics, St. Louis University, St. Louis, MO

Learning Objective 1: To identify training factors for an interdisciplinary team to deliver palliative and end-of-life care communication to parents of a child with a poor prognosis.

Learning Objective 2: To describe the role of expert consultants and of bereaved parent advisors who participated in the training activities (e.g. role-playing) of the physician-nurse interveners.

Purpose:  The aim of this NIH funded study was to develop and evaluate training strategies for physicians and nurses (MD/RN dyads) to collaboratively deliver an early palliative and end-of-life (PC/EOL) communication intervention called, Communication Plan: Early through End of Life (COMPLETE), to 24 parents of children with a brain tumor. The purpose of this presentation is to describe the training activities and evaluation responses of the MD/RN dyads who participated in our training activities.  

Methods:  Training strategies were based on principles from a Relationship Centered Care perspective. The training was delivered to 3 pediatric neuro-oncologists and 5 oncology nurses by a team of parent advisors and a team of expert consultants (i.e., medical ethics, communication, and PC/EOL). Our 2-day training included 4 modules: family assessment, goal directed treatment planning, anticipatory guidance, and staff communication and follow-up. Each module included: didactic content, small group reflective sessions, and communication skills practice with bereaved parent. Evaluations included dichotomous (agree/disagree) ratings and qualitative comments on didactic content, small group reflection, and skills practice for each module.

Results:  Helpful aspects of our training strategies included: parent advisers’ insights, emotional presence, emphasis on hope and non-abandonment messages, written materials to facilitate PC/EOL communication, and a team approach. For this presentation we will discuss insights gained regarding use of a parent advisory panel, strategies to help the MD/RN dyads feel comfortable working as a team to communicate with parents, and ways to improve training procedures and our intervention.

Conclusion: Pediatric oncology physicians and nurses found PC/EOL care communication training strategies and content as helpful and useful. Implications for research, policy or practice: Our PC/EOL care communication intervention will be implemented and evaluated with enrolled parents. If effective, this intervention will facilitate integration of quality PC care practices into the care of children with brain tumors.   

 

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