Study Identifies Barriers to Conducting Advanced Care Discussions for Pediatric Patients

Clinicians perceive that parents’ attitudes and their ability to understand their child’s prognosis are the most common barriers to providing optimal pediatric palliative care, according to the results of a study published in the April 2012 issue of Pediatrics. The study, which used a survey of 266 providers (107 physicians and 159 nurses) to identify barriers to conducting advanced care discussions for children with life-threatening conditions, found that 71% of all clinicians believed that pediatric advanced care discussions happen too late in the patient’s clinical course. The top three barriers identified by the study’s participants were unrealistic parental expectations, differences between clinician and patient/parent understanding of prognosis, and lack of parent readiness to have the discussion. Nurses identified lack of importance to clinicians and ethical considerations as impediments more often than physicians.