Peer-reviewed article
Breaking silence: Challenges of non-disclosure directives in paediatric clinical practice.
El Ali M ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how nurses approach truth-telling with seriously ill children when parents request non-disclosure of health information. Through interviews with nurses, researchers identified tensions between traditional practices of withholding information and modern principles of open communication. Nurses often act as advocates for truthful information while navigating parental wishes to conceal diagnoses. The research suggests that partnership between nurses, children, and families can support shared decision-making and better care outcomes.
Key points
- Nurses identified children's absence from health communication conversations as a significant challenge when parents request non-disclosure
- Despite access to online medical information and direct provision of diagnostic results to patients, nurses continue to employ self-regulation strategies upholding traditional disclosure practices
- Nurses struggle to balance supporting parents' non-disclosure wishes with advocating for children's right to health information
- Assessment of child and family understanding is a key step nurses use before communicating health information
- Nurses' partnership with children and families can support policies enabling participation and shared clinical decision-making
Limitations
The study does not identify the specific countries or healthcare systems involved, and does not measure the impact of different communication approaches on child health outcomes or psychological well-being.
Abstract
Nurses caring for children hospitalised with a serious illness are optimally placed to advocate for truthful health information. This study explored the phenomenon of truth-telling as experienced and perceived by nurses caring for seriously ill children when parents are contemplating a non-disclosure directive. Data were collected through semi-structured interviews and analysed using Interpretative Phenomenological Analysis (IPA). The thematic analysis identified four themes, including, Child's absence from the health communication conversation, Child and family's access to health information, Assessment of the child and family's understanding for the purpose of communicating health information and Nurse communication after physician communication. Despite access to online medical information and the provision of diagnostic results directly to patients, nurses continue to employ self-regulation strategies, upholding traditional practices of disclosure, before employing a supportive role for parents and children. Nurses' partnership with the child and family can support the implementation of policies and practices allowing participation and shared clinical decision-making through open and honest communication, ultimately contributing to positive care outcomes.