MeSH: Physician-Patient Relations
Facilitators Associated With Building and Sustaining Therapeutic Alliance in Advanced Pediatric Cancer
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Importance: Therapeutic alliance is a core component of patient- and family-centered care, particularly in the setting of advancing cancer. Communication approaches used by pediatric oncologists to foster therapeutic alliance with children with cancer and their families are not well understood. Objectives: To identify key oncologist-driven facilitators associated with building and sustaining therapeutic alliance in the…
Broaching goals-of-care conversations in advancing pediatric cancer
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Broaching conversations about goals of care can be difficult for clinicians. Presently, the communication strategies used by pediatric oncologists to approach goals of care conversations are not well understood. We recorded disease re-evaluation conversations between pediatric oncologists, patients, and parents, capturing 141 conversations (∼2400 minutes) for 17 patients with advancing illness across the study period.…
Communication around palliative care principles and advance care planning between oncologists, children with advancing cancer and families
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BACKGROUND: In medical oncology, palliative care principles and advance care planning are often discussed later in illness, limiting time for conversations to guide goal-concordant care. In pediatric oncology, the frequency, timing and content of communication about palliative care principles and advance care planning remains understudied. METHODS: We audio-recorded serial disease re-evaluation conversations between oncologists, children…
Community Resource Connection for Pediatric Caregivers with Unmet Social Needs: A Qualitative Study
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OBJECTIVE: Pediatric health systems are increasingly screening caregivers for unmet social needs. However, it remains unclear how best to connect families with unmet needs to available and appropriate community resources. We aimed to explore caregivers’ perceived barriers to and facilitators of community resource connection. METHODS: We conducted semi-structured interviews with caregivers of pediatric patients admitted…