Solan Lauren G, Beck Andrew F, Shardo Stephanie A, Sauers-Ford Hadley S, Simmons Jeffrey M, Shah Samir S, Sherman Susan N
Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, Ohio.
University of Rochester Medical Center, Division of Pediatric Hospital Medicine, Rochester, New York.
J Hosp Med. 2018 May;13(5):304-310. doi: 10.12788/jhm.2919.
Communication among those involved in a child's care during hospitalization can mitigate or exacerbate family stress and confusion. As part of a broader qualitative study, we present an in-depth understanding of communication issues experienced by families during their child's hospitalization and during the transition to home.
Focus groups and individual interviews stratified by socioeconomic status included caregivers of children recently discharged from a children's hospital after acute illnesses. An open-ended, semistructured question guide designed by investigators included communication-related questions addressing information shared with families from the medical team about discharge, diagnoses, instructions, and care plans. By using an inductive thematic analysis, 4 investigators coded transcripts and resolved differences through consensus.
A total of 61 caregivers across 11 focus groups and 4 individual interviews participated. Participants were 87% female and 46% non-white. Analyses resulted in 3 communication-related themes. The first theme detailed experiences affecting caregiver perceptions of communication between the inpatient medical team and families. The second revealed communication challenges related to the teaching hospital environment, including confusing messages associated with large multidisciplinary teams, aspects of family-centered rounds, and confusion about medical team member roles. The third reflected caregivers' perceptions of communication between providers in and out of the hospital, including types of communication caregivers observed or believed occurred between medical providers.
Participating caregivers identified various communication concerns and challenges during their child's hospitalization and transition home. Caregiver perspectives can inform strategies to improve experiences, ease challenges inherent to a teaching hospital, and determine which types of communication are most effective.
在儿童住院期间，参与其护理的各方之间的沟通可能会减轻或加剧家庭压力与困惑。作为一项更广泛的定性研究的一部分，我们深入了解了家庭在孩子住院期间以及过渡到家庭阶段所经历的沟通问题。
按社会经济地位分层的焦点小组和个人访谈，参与者包括近期因急性疾病从儿童医院出院的儿童的照料者。由研究人员设计的开放式、半结构化问题指南包括与沟通相关的问题，涉及医疗团队与家庭分享的有关出院、诊断、医嘱和护理计划的信息。通过归纳主题分析，4名研究人员对转录本进行编码，并通过协商一致解决分歧。
共有61名照料者参与了11个焦点小组和4次个人访谈。参与者中87%为女性，46%为非白人。分析得出3个与沟通相关的主题。第一个主题详细阐述了影响照料者对住院医疗团队与家庭之间沟通认知的经历。第二个主题揭示了与教学医院环境相关的沟通挑战，包括与大型多学科团队相关的信息混乱、以家庭为中心的查房的各个方面以及对医疗团队成员角色的困惑。第三个主题反映了照料者对医院内外医护人员之间沟通的认知，包括照料者观察到或认为发生在医疗服务提供者之间的沟通类型。
参与研究的照料者指出了孩子住院期间及过渡回家过程中的各种沟通问题和挑战。照料者的观点可为改善就医体验、缓解教学医院固有挑战以及确定哪种沟通方式最有效的策略提供参考。
