A Seat at the Table: Family Conferences for Infants with Neurological Conditions.

IF 2.2 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of palliative medicine Pub Date : 2024-10-23 DOI:10.1089/jpm.2024.0272
Kathleen A Young, Natalie K Field, Nikhita Nanduri, Hannah C Glass, Kathryn I Pollak, Simran Bansal, Blyth Lord, Monica E Lemmon
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Abstract

Objective: We aimed to characterize parents' perspectives on the value of and opportunities to improve conferences between parents of critically ill infants and the health care team. Background: The parent perspective on the value of family conferences in the intensive care unit is not well characterized. Methods: In this descriptive qualitative study, parents of infants with neurological conditions in the intensive care unit at a U.S. academic medical center completed longitudinal semi-structured interviews about their experiences making decisions and communicating with clinicians. Parents were included if they had an upcoming family conference to discuss goals of care or neurological prognosis. This secondary data analysis targets interview content about family conferences. Parent responses were characterized using a conventional content analysis approach. Results: Fifty-two parents of 37 infants completed 123 interviews. Parents described valuing when clinicians (1) provided space to process emotions, (2) prioritized "big picture" discussions about serious decisions, (3) dedicated time to parent questions, and (4) responded to parent concerns and made an effort to foster consensus. Parent-identified opportunities for improvement included: (1) having the team assume responsibility for calling regular meetings, (2) prioritizing attendance of consistent and supportive team members, and (3) summarizing meeting content for parents and documenting discussions for clinicians. Conclusions: These findings demonstrate that parents of infants with neurological conditions value family conferences as an important venue for communicating with the health care team. Future studies should explore the feasibility and impact of regularly scheduled family conferences, attendees dedicated to parent support, and accessible meeting summaries on therapeutic alliance, parent well-being, and communication quality.

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餐桌旁的座位:神经系统疾病婴儿家庭会议。
目的:我们旨在了解家长对重症婴儿家长与医疗团队之间会议的价值和改进机会的看法。背景:重症监护室中家长对家庭会议价值的看法尚不明确。研究方法:在这项描述性定性研究中,美国一家学术医疗中心重症监护室中患有神经系统疾病婴儿的家长完成了纵向半结构式访谈,了解了他们做出决定以及与临床医生沟通的经历。如果家长即将召开家庭会议讨论护理目标或神经系统预后,他们也会被纳入其中。本二次数据分析针对的是有关家庭会议的访谈内容。采用传统的内容分析方法对家长的回答进行分析。结果:37 名婴儿的 52 位家长完成了 123 次访谈。家长们认为临床医生(1)提供了处理情绪的空间,(2)优先考虑了有关重大决定的 "全局性 "讨论,(3)专门花时间回答家长的问题,以及(4)回应了家长的关切并努力促成共识。家长认为需要改进的地方包括(1) 让团队承担召集定期会议的责任,(2) 优先安排一贯支持团队的成员出席会议,(3) 为家长总结会议内容并为临床医生记录讨论情况。结论:这些研究结果表明,患有神经系统疾病的婴儿家长重视家庭会议,将其视为与医疗团队沟通的重要渠道。未来的研究应探讨定期召开家庭会议、专门为家长提供支持的与会者以及可获取的会议摘要对治疗联盟、家长福祉和沟通质量的可行性和影响。
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来源期刊
Journal of palliative medicine
Journal of palliative medicine 医学-卫生保健
CiteScore
3.90
自引率
10.70%
发文量
345
审稿时长
2 months
期刊介绍: Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments. The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.
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