TY - JOUR
T1 - Communication During Pediatric Intensive Care Unit Family Conferences
T2 - A Pilot Study of Content, Communication, and Parent Perceptions
AU - Michelson, Kelly
AU - Clayman, Marla L.
AU - Ryan, Claire
AU - Emanuel, Linda
AU - Frader, Joel
PY - 2017/10/3
Y1 - 2017/10/3
N2 - While there is a robust literature describing family conferences (FCs) in adult intensive care units (ICUs), less information exists about FCs in pediatric ICUs (PICUs). We conducted a pilot study to describe the focus of discussion, communication patterns of health care team members (HTMs) and parents, and parents’ perspectives about clinician communication during PICU FCs. We analyzed data from 22 video- or audiorecorded PICU FCs and post-FC questionnaire responses from 27 parents involved in 18 FCs. We used the Roter Interaction Analysis System (RIAS) to describe FC dialogue content. Our questionnaire included the validated Communication Assessment Tool (CAT). FCs were focused on care planning (n = 5), decision making (n = 6), and updates (n = 11). Most speech came from HTMs (mean 85%; range, 65–94%). Most HTM utterances involved medical information. Most parent utterances involved asking for explanations. The mean overall CAT score was 4.62 (using a 1–5 scale where 5 represents excellent and 1 poor) with a mean of 73.02% “excellent” responses. Update and care-planning FCs had lower CAT scores compared to decision-making FCs. The lowest scoring CAT items were “Involved me in decisions as much as I wanted,” “Talked in terms I could understand,” and “Gave me as much information as I wanted.” These findings suggest that while health care providers spend most of their time during FCs relaying medical information, more attention should be directed at providing information in an understandable manner. More work is needed to improve communication when decision making is not the main focus of the FC.
AB - While there is a robust literature describing family conferences (FCs) in adult intensive care units (ICUs), less information exists about FCs in pediatric ICUs (PICUs). We conducted a pilot study to describe the focus of discussion, communication patterns of health care team members (HTMs) and parents, and parents’ perspectives about clinician communication during PICU FCs. We analyzed data from 22 video- or audiorecorded PICU FCs and post-FC questionnaire responses from 27 parents involved in 18 FCs. We used the Roter Interaction Analysis System (RIAS) to describe FC dialogue content. Our questionnaire included the validated Communication Assessment Tool (CAT). FCs were focused on care planning (n = 5), decision making (n = 6), and updates (n = 11). Most speech came from HTMs (mean 85%; range, 65–94%). Most HTM utterances involved medical information. Most parent utterances involved asking for explanations. The mean overall CAT score was 4.62 (using a 1–5 scale where 5 represents excellent and 1 poor) with a mean of 73.02% “excellent” responses. Update and care-planning FCs had lower CAT scores compared to decision-making FCs. The lowest scoring CAT items were “Involved me in decisions as much as I wanted,” “Talked in terms I could understand,” and “Gave me as much information as I wanted.” These findings suggest that while health care providers spend most of their time during FCs relaying medical information, more attention should be directed at providing information in an understandable manner. More work is needed to improve communication when decision making is not the main focus of the FC.
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U2 - 10.1080/10410236.2016.1217450
DO - 10.1080/10410236.2016.1217450
M3 - Article
C2 - 27612506
AN - SCOPUS:84986200937
VL - 32
SP - 1225
EP - 1232
JO - Health Communication
JF - Health Communication
SN - 1041-0236
IS - 10
ER -