The pervasive relevance of COVID-19 within routine paediatric palliative care consultations during the pandemic: A conversation analytic study

Palliat Med. 2020 Oct;34(9):1202-1219. doi: 10.1177/0269216320950089. Epub 2020 Aug 16.

Abstract

Background: The importance of caring for children with complex and serious conditions means that paediatric palliative care must continue during pandemics. The recent pandemic of Coronavirus Disease 2019 (COVID-19) provides a natural experiment to study health communication during pandemic times. However, it is unknown how communication within consultations might change during pandemics.

Aim: This study, a sub-study of a larger project, aimed to examine real-world instances of communication in paediatric palliative care consultations prior to and during the COVID-19 pandemic to understand how clinicians and families talk about the pandemic.

Design: Paediatric palliative care consultations prior to, during, and immediately following the initial peak of COVID-19 cases in Australia were video recorded and analysed using Conversation Analysis methods.

Setting/participants: Twenty-five paediatric palliative care consultations (including face-to-face outpatient, telehealth outpatient and inpatient consultations) were video recorded within a public children's hospital in Australia. Participants included 14 health professionals, 15 child patients, 23 adult family members and 5 child siblings.

Results: There was a pervasive relevance of both serious and non-serious talk about COVID-19 within the consultations recorded during the pandemic. Topics typical of a standard paediatric palliative care consultation often led to discussion of the pandemic. Clinicians (55%) and parents (45%) initiated talk about the pandemic.

Conclusions: Clinicians should not be surprised by the pervasiveness of COVID-19 or other pandemic talk within standard paediatric palliative care consultations. This awareness will enable clinicians to flexibly address family needs and concerns about pandemic-related matters that may impact health and wellbeing.

Keywords: COVID-19; Palliative care; child; communication; pandemics.

MeSH terms

  • Adolescent
  • Australia
  • COVID-19
  • Child
  • Child, Preschool
  • Coronavirus Infections / nursing*
  • Female
  • Hospice and Palliative Care Nursing / organization & administration*
  • Hospice and Palliative Care Nursing / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pandemics / statistics & numerical data*
  • Pediatric Nursing / organization & administration*
  • Pediatric Nursing / statistics & numerical data
  • Pneumonia, Viral / nursing*
  • Remote Consultation / statistics & numerical data*
  • Telemedicine / organization & administration*
  • Telemedicine / statistics & numerical data