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Latest News: International Children's

Communication with Children

Nafula KEHPCA 2

“Communication has been a challenge with medical practitioners because we treat patients and communication skills with patients are not emphasised enough. How we communicate and deliver news to patients matters because they are human. We must look beyond the medical condition.” Dr. Esther Nafula We need to discuss and come up with strategies of communicating with children and their parents when offering palliative care especially when breaking bad news. Usually, children are told little if anything about their illness. There are several factors contributing to this and one of them is culture. In many communities, children are shielded and protected not only from harm but from information. We must find a way of working within the cultural contexts we find ourselves in. When we better understand how different communities communicate and relate to children, we are able to approach people with some understanding. It is also assumed that children have limited reasoning. While it may be true that children process information differently compared to adults, we cannot assume that they are not aware of their surroundings and when there are changes in their lives and health. Children are categorized in different stages starting from neonates to adolescence. As children grow, their psychology and understanding of the world grow with them. Every stage requires a different approach wjen communicating with them. Considerations in breaking bad news: Provide a warning shot Encourage a support system for the child and parents The setting or environment where you communicate with them should have some privacy You should not be far from the family when breaking the news. Try to bridge the gap Do not be in a hurry to break the news Have a multidisciplinary team ready to support the family Be specific and use simple language. Avoid medical jargon. Delivering bad news using the SPIKES method. Setting/Set-up Do not wing it. Prepare in advance. Make sure you have the right venue and you have reviewed the medical records. Make sure the multidisciplinary team and family are coordinated. Perception Be knowledgeable about the family and have at least some information about their background and their current emotional state. Invitation Find out how much information the patient and family want to know Knowledge Share the information, summarise the bigger picture, and allow room for reactions Empathy Respond to the thoughts, feelings, and emotions. Put yourself in their shoes. Summarise Discuss the next steps and follow-up plan. Allow them to ask questions and clarify issues. Summarise the decisions that have been made.

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