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  • ‘I’m praying for a miracle’: characteristics of spiritual statements in paediatric intensive care unit care conferences

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Original research
‘I’m praying for a miracle’: characteristics of spiritual statements in paediatric intensive care unit care conferences
  1. Katie Gradick1,2,
  2. Tessie October3,4,
  3. David Pascoe2,
  4. Jeff Fleming2 and
  5. Dominic Moore1,2
  1. 1 Pediatrics, University of Utah Health Care, Salt Lake City, Utah, USA
  2. 2 Pediatrics, Primary Children's Hospital, Salt Lake City, Utah, USA
  3. 3 Division of Critical Care Medicine, Children's National Health System, Washington, DC, USA
  4. 4 Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
  1. Correspondence to Dr Katie Gradick, Pediatrics, University of Utah Health Care, Salt Lake City, UT 84113, USA; katie.gradick{at}hsc.utah.edu

Abstract

Context Supporting spiritual needs is a well-established aspect of palliative care, but no data exist regarding how physicians engage with patients and families around spirituality during care conferences in paediatric intensive care units (PICU).

Objectives To assess the frequency and characteristics of family and physician spiritual statements in PICU care conferences.

Methods We performed qualitative analysis of 71 transcripts from PICU conferences, audio-recorded at an urban, quaternary medical centre. Transcripts were derived from a single-centre, cross-sectional, qualitative study.

Results We identified spiritual language in 46% (33/71) of PICU care conferences. Spiritual statements were divided relatively evenly between family member (51%, 67/131) and physician statements (49%, 64/131). Physician responses to families’ spiritual statements were coded as supportive (46%, 31/67), deferred (30%, 20/67), indifferent (24%, 16/67) or exploratory (0/67).

Conclusions In this single-centre PICU, spiritual statements were present 46% of the time during high stakes decision-making conferences, but there was little evidence of spiritual care best practices, such as offering chaplain support and performing open-ended spiritual assessments. PICU clinicians should expect spiritual statements in care conferences and be prepared to respond.

  • communication
  • paediatrics
  • spiritual care
  • family management
  • hospital care

Data availability statement

Data are available upon reasonable request. Our data are 71 deidentified transcripts, available from Dr Tessie October (ORCID 0000-0003-0664-3472) for additional research, upon request.

https://doi.org/10.1136/bmjspcare-2020-002436

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    Data availability statement

    Data are available upon reasonable request. Our data are 71 deidentified transcripts, available from Dr Tessie October (ORCID 0000-0003-0664-3472) for additional research, upon request.

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    Footnotes

    • Contributors KG drafted the initial manuscript. DM and TO conceptualised the work. TO and DM revised and critically reviewed the manuscript for important intellectual content. KG, DM, TO, JF and DP coded and analysed transcripts. KG, DM and TO approved the final manuscript. KG is responsible for the overall content as guarantor.

    • Funding This work was supported by the National Institutes of Health (NIH), under grant number 1K23HD080902.

    • Disclaimer The funding sources have had no involvement in the study design, collection, analysis and interpretation of the data, the writing of the report, or in the decision to submit this article for publication.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.