Laura L Drach1, Debra A Hansen2, Tracy M King3, Erica M S Sibinga4. 1. Division of Pediatric Palliative Care, Johns Hopkins All Children's Hospital, St. Petersburg FL, 501 6th Ave So, St. Petersburg, FL, 33701, USA. Ldrach1@jhmi.edu. 2. Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 100 Hitchcock Way, Manchester, NH, 03104, USA. 3. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr. Room 2227D, MSC 7002, Bethesda, MD, 20892-7002, USA. 4. Division of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Suite 4200 Mason F. Lord Center Tower, 5200 Eastern Ave., Baltimore, MD, 21224, USA.
Abstract
OBJECTIVE: When an infant's prognosis is uncertain, communication between neonatologists and parents surrounding goals of care and decision-making can be challenging. This qualitative study explored communication between neonatologists and parents to discover qualities which may enhance or impede parent-clinician partnership under such difficult circumstances. STUDY DESIGN: Guided by the National Cancer Institute (NCI) Patient Centered Communication framework, semi-structured individual interviews were conducted and analyzed regarding neonatologist and parent perceptions of their communication. Subjects consisted of nine dyads of neonatologists and English-speaking parents whose infant had an uncertain prognosis. RESULTS: Parents were overall satisfied with neonatologists' communications concerning their infant's uncertain trajectory. Nonetheless, both experienced challenges and distress during communication, impeding collaboration and engagement. CONCLUSIONS: Families and neonatologists value principles of patient centered communication but report challenges implementing this practice. Incorporating a multidisciplinary approach in settings of prognostic uncertainty to foster patient centered communication, may enhance communication surrounding NICU care.
OBJECTIVE: When an infant's prognosis is uncertain, communication between neonatologists and parents surrounding goals of care and decision-making can be challenging. This qualitative study explored communication between neonatologists and parents to discover qualities which may enhance or impede parent-clinician partnership under such difficult circumstances. STUDY DESIGN: Guided by the National Cancer Institute (NCI) Patient Centered Communication framework, semi-structured individual interviews were conducted and analyzed regarding neonatologist and parent perceptions of their communication. Subjects consisted of nine dyads of neonatologists and English-speaking parents whose infant had an uncertain prognosis. RESULTS: Parents were overall satisfied with neonatologists' communications concerning their infant's uncertain trajectory. Nonetheless, both experienced challenges and distress during communication, impeding collaboration and engagement. CONCLUSIONS: Families and neonatologists value principles of patient centered communication but report challenges implementing this practice. Incorporating a multidisciplinary approach in settings of prognostic uncertainty to foster patient centered communication, may enhance communication surrounding NICU care.
Authors: Wenbo Zheng; Lan Yan; Chao Gou; Zhi-Cheng Zhang; Jun Jason Zhang; Ming Hu; Fei-Yue Wang Journal: Inf Fusion Date: 2021-06-01 Impact factor: 12.975