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One method of coping: Resident debriefing after the death of a patient

2004; Elsevier BV; Volume: 145; Issue: 2 Linguagem: Inglês

10.1016/j.jpeds.2004.04.055

1097-6833

Janet R. Serwint,

Childhood Cancer Survivors' Quality of Life

To describe residents' exposure and reactions to pediatric deaths, their debriefing experiences, and factors associated with debriefing.Cross-sectional survey completed at the end of residency. The survey reflected experiences from the prior 18 months concerning number, type, and setting of deaths; resident reactions; whether resident debriefed and with whom after a patient's death.Seventy-four residents (84%) completed the survey over 4 academic years accounting for 363 deaths; 59% were inpatient deaths of patients with chronic diseases, 22% were inpatient, 18% were emergency department (ED) deaths of previously healthy patients, and 1% were deaths of patients with chronic diseases who died in the ED or in their home. Mean number of deaths experienced per resident was 4.6 (range, 0-19). Thirty-one percent of residents expressed guilt, and 74% stated they had debriefed at least one time, but debriefings took place after only 30% of deaths. Resident debriefing was associated with an inpatient death of a previously healthy child, OR 5.3 (95% CI: 1.31, 22.3), P=.01, whereas there was not an association with number of previous deaths, acute outpatient or chronic inpatient deaths, or resident guilt.Pediatric residents were involved in a small number but varying types of death experiences. Debriefing took place after a minority of deaths. Future research needs to investigate the potential benefits of debriefing.