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Sammanfattning

Healthcare personnel tend to avoid asking seriously ill patients about their dependent children (1,2). To shed light on the barriers facing healthcare personnel to engaging in this way, we conducted a qualitative study consisting of 49 semi-structured, in-depth interviews with physicians (N=19) and nurses (N=30) specialised in haematology, gynaecological oncology and neurointensive care, and of 27 days of field work (9 days in each department, over three visits). Inspired by Maturana’s domain theory, focused interviews, field work and analysis of the healthcare personnel’s emotional and structural barriers, and of the interaction between those barriers (2,3). We found that the emotional barriers among healthcare personnel, such as the fear of being overwhelmed emotionally, and the need to maintain professional distance, result in them tending to avoid asking about patients’ children. In addition, a number of structural barriers come into play such as the lack of a designated place in the patient’s medical notes for recording information about dependent children; pressure of time, and lack of training, including clarity surrounding what is expected of healthcare personnel concerning children as next of kin. We found that the emotional barriers prevail when structural barriers fail to be addressed. The article may be of interest to healthcare personnel attending to seriously ill or terminally ill patients with dependent children, and to decision-makers with influence over the structural preconditions for involvement of children by healthcare personnel.

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