Published online November 17, 2008
PEDIATRICS Vol. 122 No. 6 December 2008, pp. e1174-e1178 (doi:10.1542/peds.2008-0952)

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ARTICLE

Physicians' Contact With Families After the Death of Pediatric Patients: A Survey of Pediatric Critical Care Practitioners' Beliefs and Self-Reported Practices

Santiago Borasino, MD, MPH^a, Wynne Morrison, MD^b, Jordan Silberman, MAPP, BA^c, Robert M. Nelson, MD, PhD^b,d and Chris Feudtner, MD, PhD, MPH^e

^a Pediatric Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama
^b Department of Anesthesiology and Critical Care
^d Center for Research Integrity
^e Pediatric Advanced Care Team, Department of Medical Ethics, and General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
^c School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York

OBJECTIVES. Although research with bereaved families has shown that they appreciate contact with clinicians after the child's death, this realm of clinical practice remains empirically uncharted. The objective of this study was to describe pediatric critical care practitioners' attitudes and self-reported practices regarding contacting families after a patient's death.

METHODS. A total of 376 board-certified members of the American Academy of Pediatrics Section of Critical Care received e-mail invitations to complete a Web-based questionnaire; 204 members responded (effective response rate: 54.3%).

RESULTS. Most (95%) participants reported 0 to 1 patient deaths per week. A total of 79% of the respondents reported contacting families at least sometimes, 71.9% had attended funerals, and only 2.5% thought that it was inappropriate for clinicians to attend funerals. A total of 75.9% agreed that follow-up contact helps the family, whereas 47.3% agreed that follow-up contact helps the physicians. The most common methods of follow-up contact included the passive measures of providing contact information; active methods such as meeting with the family, calling them by telephone, or writing a letter or note were used less often. In multivariable analysis, respondents were more likely to report contact with a family after the death of a child when they affirmed the belief that such contact was useful to the family or to the physician or when they were female physicians. Regarding reported funeral attendance after the death of a patient, multivariable analysis revealed similar patterns of association but to an attenuated and nonstatistically significant degree.

CONCLUSIONS. A high proportion of pediatric critical care physicians have contacted bereaved families and attended funerals after the death of a child patient. These practices were consistently associated with the belief that such follow-up contact helps the family or the practitioner.

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Key Words: bereavement • communication • critical care

Abbreviations: OR—odds ratio • CI—confidence interval

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Accepted Sep 2, 2008.

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