Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors.
J Perinatol
; 37(11): 1224-1229, 2017 11.
Article
in En
| MEDLINE
| ID: mdl-28749479
ABSTRACT
OBJECTIVE:
Delivering prognostic information to families requires clinicians to forecast an infant's illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician-family concordance regarding infant outcomes. STUDYDESIGN:
Prospective audiorecording of neonatal intensive care unit family conferences, immediately followed by parent/clinician surveys. Existing qualitative analysis frameworks were applied.RESULTS:
We analyzed 19 conferences. Most prognostic discussion targeted predicted infant functional needs, for example, medications or feeding. There was little discussion of how infant prognosis would affect infant/family quality of life. Prognostic framing was typically optimistic. Most parents left the conference believing their infant's prognosis to be more optimistic than did clinicians.CONCLUSIONS:
Clinician approach to prognostic disclosure in these audiotaped family conferences tended to be broad and optimistic, without detail regarding implications of infant health for infant/family quality of life. Families and clinicians left these conversations with little consensus about infant prognosis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parents
/
Professional-Family Relations
/
Prognosis
/
Truth Disclosure
Type of study:
Prognostic_studies
/
Qualitative_research
Aspects:
Patient_preference
Limits:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
J Perinatol
Journal subject:
PERINATOLOGIA
Year:
2017
Document type:
Article
Affiliation country:
Estados Unidos