Exploring the experiences of healthcare professionals in South Africa and Uganda around communicating with children about life-threatening conditions: a workshop-based qualitative study to inform the adaptation of communication frameworks for use in these settings
Date
2022-12-15
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Abstract
Objectives This study aimed to explore how published
communication frameworks could be amended to ensure
applicability and cultural appropriateness for professionals
to support family-centred conversations by investigating’
healthcare professionals’ (1) experiences of providing
support to families when a caregiver or a dependent
child (<18 years old) has a life-threatening condition,
(2) perceived challenges for caregivers and healthcare
professionals in communicating with children about
illness, (3) perceptions of how clinicians could be equipped
to facilitate conversations between caregivers and children
about an adult or the child’s own life-threatening condition
and (4) suggestions for amendments to previously
published guidelines to ensure cultural relevance in South
Africa and Uganda.
Design A qualitative study involving two 2-day workshops
with embedded focus group discussions, break out rooms
and consensus discussions.
Setting Health and social care and third sector
organisations in South Africa and Uganda.
Participants Thirty-two professionals providing care to
families affected by life-threatening conditions in South
Africa or Uganda who were aged 18 years or older and
able to converse in English.
Results Participants identified obstacles to having
conversations with caregivers about children and to
telling children about serious illness during consultations.
These included patients’ beliefs about illness, medicine
and death, language barriers between families and the
healthcare team, and emotional and practical challenges
for professionals in having these conversations. Culturally
appropriate adaptations were made to previously published communication frameworks for professionals to
support family-centred conversations.
Conclusions Culturally sensitive communication
frameworks could help healthcare professionals to talk
with families about what children need to know when
they or a caregiver have a serious illness. More broadly,
effective communication could be facilitated by promoting
healthcare professionals’ and communities’ understanding
of the benefits of telling children about illness within the family. Together these strategies may mitigate the psychological impact of
global disease on children and their families