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. 2025 Apr 14;24(1):103.
doi: 10.1186/s12904-025-01709-2.

The blue tick: WhatsApp as a care tool in pediatric palliative care

Mariangela Rosa  1 , Anna Santini  2 , Valentina De Tommasi  2 , Caterina Agosto  2 , Luca Giacomelli  3 , Simonetta Papa  3 , Lara Vecchi  3 , Franca Benini  4   5
Affiliations

The blue tick: WhatsApp as a care tool in pediatric palliative care

Mariangela Rosa et al. BMC Palliat Care. .

Abstract

Background: Comprehensive care, which includes psychological support for pediatric palliative care (PPC) patients, addresses all aspects of the patient's life. It focuses on managing disease-related challenges and identifying strategies for personal, relational, and social dynamics. Effective communication between patients and healthcare providers is essential in the PPC setting. While various assistive communication tools have been explored in literature, using instant messaging within PPC remains relatively unexamined. Therefore, this study aims to evaluate the role of this technology in supporting patient care.

Methods: Virtual messages exchanged between psychologists and PPC patients via WhatsApp were analyzed retrospectively. The content of these messages was examined qualitatively through thematic analysis using ATLAS.ti software, and sociodemographic characteristics were also collected.

Results: A total of 25 patients receiving PPC services were recruited, with 5,623 messages evaluated across 766 interaction threads between patients and psychologists. On average, there were 7.34 messages per thread, ranging from 1 to 116 messages per thread. The qualitative thematic analysis revealed that the message content primarily fell into two areas: informative and psychological. The informative area included exchanges about symptomatology, procedures performed, visits, and general health. The psychological area consisted of messages reflecting negative and positive thoughts and emotions related to personal experiences, peer relationships, and family dynamics. Notably, 8.2% of the messages were significant enough to be shared within the team, which helped redirect or modify the care plan for the child and family. Additionally, 8.9% of the messages prompted medical, nursing, or psychological emergency consultations.

Conclusions: This communication tool appears more accessible for adolescent patients who regularly use instant messaging applications. Its immediacy and ease of use make such communication strategies effective and efficient for organizing, coordinating, and implementing care for a sizable portion of PPC patients.

Keywords: Communication; Instant messaging; Pediatric palliative care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This is a non-interventional study using de-identified retrospective data from the patient database. Internal data protection regulations and the General Data Protection Regulation (GDPR) (EU) 2016/679 assure the confidentiality and privacy of patient data. The review of patients’ data did not require ethical approval by national guidelines (DECRETO LEGISLATIVO n. 211, 24/ 06/2003). The PI notified the local Ethics Committee of the University Hospital of Padua according to national law. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Codes emerged from thematic analysis
Fig. 2
Fig. 2
Output of code frequency in care communication between psychologist and patient (D = “density”; G = “groundedness”)
Fig. 3
Fig. 3
Output of code category co-occurrence and sex
See this image and copyright information in PMC

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