Megan Moore1, Gabrielle Robinson, Richard Mink, Kimberly Hudson, Danae Dotolo, Tracy Gooding, Alma Ramirez, Douglas Zatzick, Jessica Giordano, Deborah Crawley, Monica S Vavilala. 1. 1Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA. 2School of Social Work, University of Washington, Seattle, WA. 3Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. 4Harbor-UCLA Medical Center, Torrance, CA. 5Los Angeles BioMedical Research Institute, Torrance, CA. 6Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA. 7Brain Injury Alliance of Washington, Seattle, WA.
Abstract
OBJECTIVES: This study examined the family experience of critical care after pediatric traumatic brain injury in order to develop a model of specific factors associated with family-centered care. DESIGN: Qualitative methods with semi-structured interviews were used. SETTING: Two level 1 trauma centers. PARTICIPANTS: Fifteen mothers of children who had an acute hospital stay after traumatic brain injury within the last 5 years were interviewed about their experience of critical care and discharge planning. Participants who were primarily English, Spanish, or Cantonese speaking were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Content analysis was used to code the transcribed interviews and develop the family-centered care model. Three major themes emerged: 1) thorough, timely, compassionate communication, 2) capacity building for families, providers, and facilities, and 3) coordination of care transitions. Participants reported valuing detailed, frequent communication that set realistic expectations and prepared them for decision making and outcomes. Areas for capacity building included strategies to increase provider cultural humility, parent participation in care, and institutional flexibility. Coordinated care transitions, including continuity of information and maintenance of partnerships with families and care teams, were highlighted. Participants who were not primarily English speaking reported particular difficulty with communication, cultural understanding, and coordinated transitions. CONCLUSIONS: This study presents a family-centered traumatic brain injury care model based on family perspectives. In addition to communication and coordination strategies, the model offers methods to address cultural and structural barriers to meeting the needs of non-English-speaking families. Given the stress experienced by families of children with traumatic brain injury, careful consideration of the model themes identified here may assist in improving overall quality of care to families of hospitalized children with traumatic brain injury.
OBJECTIVES: This study examined the family experience of critical care after pediatric traumatic brain injury in order to develop a model of specific factors associated with family-centered care. DESIGN: Qualitative methods with semi-structured interviews were used. SETTING: Two level 1 trauma centers. PARTICIPANTS: Fifteen mothers of children who had an acute hospital stay after traumatic brain injury within the last 5 years were interviewed about their experience of critical care and discharge planning. Participants who were primarily English, Spanish, or Cantonese speaking were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Content analysis was used to code the transcribed interviews and develop the family-centered care model. Three major themes emerged: 1) thorough, timely, compassionate communication, 2) capacity building for families, providers, and facilities, and 3) coordination of care transitions. Participants reported valuing detailed, frequent communication that set realistic expectations and prepared them for decision making and outcomes. Areas for capacity building included strategies to increase provider cultural humility, parent participation in care, and institutional flexibility. Coordinated care transitions, including continuity of information and maintenance of partnerships with families and care teams, were highlighted. Participants who were not primarily English speaking reported particular difficulty with communication, cultural understanding, and coordinated transitions. CONCLUSIONS: This study presents a family-centered traumatic brain injury care model based on family perspectives. In addition to communication and coordination strategies, the model offers methods to address cultural and structural barriers to meeting the needs of non-English-speaking families. Given the stress experienced by families of children with traumatic brain injury, careful consideration of the model themes identified here may assist in improving overall quality of care to families of hospitalized children with traumatic brain injury.
Authors: Judy E Davidson; Karen Powers; Kamyar M Hedayat; Mark Tieszen; Alexander A Kon; Eric Shepard; Vicki Spuhler; I David Todres; Mitchell Levy; Juliana Barr; Raj Ghandi; Gregory Hirsch; Deborah Armstrong Journal: Crit Care Med Date: 2007-02 Impact factor: 7.598
Authors: Monica S Vavilala; Mary A King; Jen-Ting Yang; Scott L Erickson; Brianna Mills; Rosemary M Grant; Carolyn Blayney; Qian Qiu; Randall M Chesnut; Kenneth M Jaffe; Bryan J Weiner; Brian D Johnston Journal: Lancet Child Adolesc Health Date: 2018-11-23
Authors: Elizabeth Ann Sturgiss; Annette Peart; Lauralie Richard; Lauren Ball; Liesbeth Hunik; Tze Lin Chai; Steven Lau; Danny Vadasz; Grant Russell; Moira Stewart Journal: BMJ Open Date: 2022-05-02 Impact factor: 3.006
Authors: Florian Allonsius; Arend de Kloet; Gary Bedell; Frederike van Markus-Doornbosch; Stefanie Rosema; Jorit Meesters; Thea Vliet Vlieland; Menno van der Holst Journal: Int J Environ Res Public Health Date: 2021-02-08 Impact factor: 3.390
Authors: Mariah R Erlick; Monica S Vavilala; Kenneth M Jaffe; Carolyn B Blayney; Megan Moore Journal: J Neurotrauma Date: 2020-11-09 Impact factor: 5.269