家长与临床医生的沟通对于癌症儿童的高质量临终 (EOL) 护理至关重要。然而，目前尚不清楚父母与临床医生的沟通如何影响父母在孩子去世后头两年的经历。研究孩子死于癌症的父母之间的沟通与长期悲伤之间的关系，并探讨为EOL做好准备的中介作用我们分析了对过去 6-24 个月内死于癌症的儿童父母进行的横断面调查的数据。我们使用多元线性回归来检查沟通变量与长期悲伤症状之间的关联。我们还研究了 EOL 准备如何介导这些关联。在 N=124 名父母中，平均年龄为 46 岁，82% 是白人，64% 是母亲。平均 PG-13 总分为 32.7 ± 10.6（范围 11-55，分数越高表明症状越严重）。大多数家长表示与临床医生的沟通“非常好/优秀”（80%）、充足的预后信息（64%）和高度信任（90%）。近 39% 的家长表示，他们对孩子的生命终止感到“完全没有准备好”。与想要更多预后信息的父母相比，认为预后信息充分的父母的 PG-13 总分显着较低（36.4 ± 10.8 vs. 30.5 ± 10.1，F=9.26，p=0.003）。 EOL 的准备充分调节了这种关联。早期失去亲人的父母报告了严重的长期悲伤症状。专注于提供足够的预后信息和改善 EOL 准备的干预措施可能会减轻父母在丧亲之痛的头两年内的长期悲伤症状。版权所有 © 2024。由 Elsevier Inc. 出版。

Parent-clinician communication is essential for high-quality end-of-life (EOL) care in children with cancer. However, it is unknown how parent-clinician communication affects parents' experience in the first two years after their child's death.To examine the association between communication and prolonged grief among parents whose child died from cancer and to explore the mediation effect of preparation for EOL care.We analyzed data from a cross-sectional survey of parents of children who died from cancer in the prior 6-24 months. We used multiple linear regression to examine the association between communication variables and prolonged grief symptoms. We also examined how preparation for EOL mediates these associations.Across N=124 parents, the mean age was 46 years, 82% were White, and 64% were mothers. The average PG-13 sum score was 32.7 ± 10.6 (range 11-55, with higher scores indicating greater symptom severity). Most parents reported "very good/excellent" communication with clinicians (80%), adequate prognostic information (64%), and high levels of trust (90%). Nearly 39% of parents reported feeling "not at all prepared" for their child's EOL. Compared to parents who wanted more prognostic information, parents who perceived prognostic information to be adequate had significantly lower PG-13 sum scores (36.4 ± 10.8 vs. 30.5 ± 10.1, F=9.26, p=0.003). Preparation for EOL fully mediated this association.Early bereaved parents report severe prolonged grief symptoms. Interventions focused on providing adequate prognostic information and improving preparation for EOL may mitigate parental prolonged grief symptoms in the first two years of their bereavement.Copyright © 2024. Published by Elsevier Inc.