Facilitators and barriers to parent-child communication in pediatric palliative care: An integrative review

Objectives: This study aimed to identify facilitators and barriers to parent-child communication in pediatric palliative care, providing insights for medical professionals developing targeted interventions to enhance parent-child communication and improve its effectiveness. Methods: Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in six databases (Medline, Embase, CINAHL Complete, PsycINFO, Web of Science, and Cochrane Library). Peer-reviewer articles published in the English language from inception to December 2023. All of the identified studies were screened, extracted, and analyzed independently by two researchers. Results: Twenty-four articles were included. The findings of the relevant studies were analyzed using thematic analysis. Four themes were identified as facilitators: legacy-making, resilience training programs, guidance from the healthcare team, and positive communication. Seven themes were identified as barriers: denial, being unprepared and evasive, mutual protection, being overwhelmed by painful emotions and overloaded with information, incorrect views of medical professionals and parents, negative communication, and cultural context. Conclusions: Parents and professionals should avoid myths about protecting the child and encourage open communication that respects the child’s wishes. The specialized pediatric palliative care team should carefully monitor parent-child communication, determine if any obstacles exist, and design more interventions to enhance it.