Agathe Béranger1,2, Charlotte Pierron3, Laure de Saint Blanquat4, Naïm Bouazza5,6, Sandrine Jean7, Hélène Chappuy5,8. 1. Laboratoire d'éthique médicale et de bioéthique, Université Paris Descartes, Sorbonne-Paris Cité, 45 rue des Saint-Pères, 75006, Paris, France. agathe.beranger@gmail.com. 2. Unité de recherche clinique, AP-HP hôpital Cochin-Necker, Université Paris Descartes, Sorbonne-Paris Cité, 89 rue d'Assas, 75006, Paris, France. agathe.beranger@gmail.com. 3. Service de réanimation et surveillance continue pédiatriques, Hôpital Robert Debré, Université Diderot-Paris 7, 48 boulevard Sérurier, 75019, Paris, France. 4. Réanimation et surveillance continue médico-chirurgicale pédiatriques, Hôpital Necker Enfants-Malades, Université Paris Descartes, Sorbonne-Paris Cité, 149 rue de Sèvres, 75015, Paris, France. 5. Unité de recherche clinique, AP-HP hôpital Cochin-Necker, Université Paris Descartes, Sorbonne-Paris Cité, 89 rue d'Assas, 75006, Paris, France. 6. EA 7323, Evaluation des thérapeutiques et pharmacologie périnatale et pédiatrique, Université Paris Descartes, Sorbonne-Paris Cité, 27 rue du faubourg Saint-Jacques, 75014, Paris, France. 7. Réanimation néonatale et pédiatrique, Hôpital Armand Trousseau, Université Pierre et Marie Curie, 26 avenue du Dr Arnold Netter, 75012, Paris, France. 8. Urgences pédiatriques, Hôpital Armand Trousseau, Université Pierre et Marie Curie, 26 avenue du Dr Arnold Netter, 75012, Paris, France.
Abstract
This study evaluated the first interaction (FI) between parents and health care providers at the time of admission of a child in pediatric intensive care unit (PICU), and explored the extent to which parents understood the medical information. This prospective study took place in three French university-affiliated PICUs. Forty-two parents of 30 children were interviewed. The physician and nurse who took care of the child completed a questionnaire. We evaluated parents' comprehension (excellent, fair, or poor) by comparing parents' and physicians' responses to six items: diagnosis, affected organ, reason for hospitalization, prognosis, treatments, and further investigations. Parent-physician FI occurred within 24 h of child's admission. Two thirds of the parents were dissatisfied to wait before receiving information. Most of the parents had an excellent comprehension of the affected organ (n = 25/28, 89.3%) and prognosis (n = 26/30, 86.7%). Two thirds of the parents understood the reason for hospitalization (n = 18/28, 64.3%) and diagnosis (n = 19/30, 63.3%). Less than half the parents understood child's treatments (n = 10/30, 33.3%) and further investigations (n = 8/21, 38.1%). When a nurse delivered information on treatment, parental comprehension improved (p = 0.053). CONCLUSION: Parents complained of their wait time before receiving information. Most of them had an excellent comprehension. An improved communication between nurses and physicians is mandatory, and the active participation of nurses to give information to the parents should be encouraged. What is known: • In pediatric intensive care unit, health care providers deliver information to parents on their child's condition, which fosters the trust between them to build a partnership. • Various guidelines exist to help health care providers communicate with parents in PICU, but never mention the specific time of admission. What is new: • Even though parents could wait before entering the unit, they all received information on their child's condition within 24 hours after admission. • Parents understood the information well, and nurses improved the parental comprehension of the treatments by reformulating.
This study evaluated the first interaction (FI) between parents and health care providers at the time of admission of a child in pediatric intensive care unit (PICU), and explored the extent to which parents understood the medical information. This prospective study took place in three French university-affiliated PICUs. Forty-two parents of 30 children were interviewed. The physician and nurse who took care of the child completed a questionnaire. We evaluated parents' comprehension (excellent, fair, or poor) by comparing parents' and physicians' responses to six items: diagnosis, affected organ, reason for hospitalization, prognosis, treatments, and further investigations. Parent-physician FI occurred within 24 h of child's admission. Two thirds of the parents were dissatisfied to wait before receiving information. Most of the parents had an excellent comprehension of the affected organ (n = 25/28, 89.3%) and prognosis (n = 26/30, 86.7%). Two thirds of the parents understood the reason for hospitalization (n = 18/28, 64.3%) and diagnosis (n = 19/30, 63.3%). Less than half the parents understood child's treatments (n = 10/30, 33.3%) and further investigations (n = 8/21, 38.1%). When a nurse delivered information on treatment, parental comprehension improved (p = 0.053). CONCLUSION: Parents complained of their wait time before receiving information. Most of them had an excellent comprehension. An improved communication between nurses and physicians is mandatory, and the active participation of nurses to give information to the parents should be encouraged. What is known: • In pediatric intensive care unit, health care providers deliver information to parents on their child's condition, which fosters the trust between them to build a partnership. • Various guidelines exist to help health care providers communicate with parents in PICU, but never mention the specific time of admission. What is new: • Even though parents could wait before entering the unit, they all received information on their child's condition within 24 hours after admission. • Parents understood the information well, and nurses improved the parental comprehension of the treatments by reformulating.
Authors: Kathleen L Meert; Susan Eggly; Murray Pollack; K J S Anand; Jerry Zimmerman; Joseph Carcillo; Christopher J L Newth; J Michael Dean; Douglas F Willson; Carol Nicholson Journal: Pediatr Crit Care Med Date: 2008-01 Impact factor: 3.624