Pediatric Liver Transplant Teams’ Coping with Patient Death

Objectives: Coping with patient death among pediatric liver transplant teams has received little attention despite general recognition of the potentially negative emotional consequences associated with such loss. The purpose of this study was to investigate 1) the ways in which members of pediatric liver transplant teams cope with the death of patients on the waitlist and post-transplant and 2) the institutional resources available to facilitate this coping. Methods: Participants included 120 physicians, nurses, and mental health professionals from multiple transplant centers across the United States. Participants completed an online questionnaire that assessed the availability of formal coping resources at their institutions, informal sources of support used to cope with patient death, and as indices of coping, bereavement and emotional exhaustion symptoms experienced. Results: Debriefing, the most commonly offered support, was available to about half (55.8%) of the sample; yet, nearly all respondents (98.3%) indicated that debriefing would be useful. On average, bereavement and emotional exhaustion levels were comparable to normative data, but patterns of coping varied based on participants' position within the transplant team. For participants who reported that debriefing was available at their institutions, emotional exhaustion was lower. Conclusions: Overall, formal supports were inconsistently offered to pediatric transplant team members. Team members expressed high acceptability for debriefing, which has been associated with benefits in other populations, and findings indicated better coping in the transplant setting when it was offered. Address correspondence and reprint requests to Sarah E. Duncan, Department of Psychology, Fordham University, 441 E. Fordham Road, Bronx, NY 10458 (e-mail: sduncan6@fordham.edu). Received 20 July, 2017 Accepted 17 January, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Authorship Statements Sarah E Duncan: Concept/design, statistics, data analysis/interpretation, drafting article, critical revision of article, approval of article Ronen Arnon: Concept/design, data analysis/interpretation, critical revision of article, approval of article Christie DiPietrantonio: Concept/design, data collection, critical revision of article, approval of article Katie Ehrlich: Concept/design, data collection, critical revision of article, approval of article Christopher S Knight: Concept/design, data collection, critical revision of article, approval of article Jaime Chu: Data analysis/interpretation, critical revision of article, approval of article Rachel A Annunziato: Concept/design, data collection, statistics, data analysis/interpretation, drafting article, critical revision of article, approval of article Conflict of Interest and Sources of Funding: The authors of this manuscript have no conflicts of interest or sources of funding to disclose. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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