Balancing Parent/Child/Healthcare Provider Talks



Communicating With Young People Who Are Seriously Ill Is Difficult

Young people who are seriously ill can feel unable to participate in consultations and parents may be reluctant to communicate openly with their children.

Health professionals must try to balance the different priorities of young people and parents, suggest researchers in this week's BMJ.

Thirteen cancer patients aged 8-17 years, and their parents, gave accounts of communication about their illness.

Most parents described acting in an executive-like role, managing what and how their children were told about their illness, particularly at the time of diagnosis when parents faced the difficult job of dealing with their own emotional responses.

Their accounts were shaped by concerns to manage their identity as strong and optimistic parents and to protect their child's wellbeing.

While the young people welcomed their parents' involvement, some felt that communication was constrained by their parents' role.

One patient aged 15 said: " I still didn't feel that they were telling me everything." Some young people described feeling marginalised in consultations and pointed to difficulties they experienced in encounters with some doctors.

The young people in our study clearly wanted their parents to be involved in communication but were not always satisfied with how communication was managed, say the authors.

Professionals need to remain aware of how the power relations of professional-parent-child encounters can be an obstacle in forging successful relationships between health professionals and young people.

These issues will be of crucial importance in implementing the new children's national service framework, they conclude.

British Medical Journal, 2/03

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