Findlen Ursula M, Malhotra Prashant S, Adunka Oliver F
Nationwide Children's Hospital- Division of Clinical Therapies, 700 Children's Drive, Suite T3D, Columbus, OH, 43205, USA; The Ohio State Wexner Medical Center, College of Medicine, Department of Otolaryngology - Head & Neck Surgery, OSU Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH, 43212, USA.
The Ohio State Wexner Medical Center, College of Medicine, Department of Otolaryngology - Head & Neck Surgery, OSU Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH, 43212, USA; Nationwide Children's Hospital- Pediatric Otology & Hearing Program, 700 Children's Drive, Suite 2A, Columbus, OH, 43205, USA.
Int J Pediatr Otorhinolaryngol. 2019 Jan;116:141-146. doi: 10.1016/j.ijporl.2018.10.044. Epub 2018 Oct 31.
Family-centered healthcare demands that families provide input regarding the care of their children. Very little is known, however, about how families perceive their experience in different types of multidisciplinary team models, and specifically, in the multidisciplinary setting currently utilized in many pediatric hearing clinics.
Quantitative and qualitative parent survey responses were collected and analyzed in a tertiary care pediatric medical center after a one-day multidisciplinary assessment clinical appointment. Questions pertained to information across five domains, including overall experience, diagnosis, treatment plan formulation, additional testing, and resources. Quantitative responses were analyzed descriptively while qualitative responses were evaluated using content analysis to derive themes. Quantitative and qualitative data were evaluated separately and then compared to delineate themes for strengths and weaknesses.
Overall, high satisfaction was evident in both quantitative and qualitative responses. Results suggested that a one-day multidisciplinary assessment appointment may contribute to parents feeling overwhelmed by information shared and not fully understanding which disciplines are providing care. Analysis revealed a specific area of weakness in our particular setting was inadequate provision of information about functional hearing (e.g., listening socially and academically). Results contributed to a change from a multidisciplinary team model to an interdisciplinary care coordination approach to pediatric hearing healthcare.
Understanding parent perspectives and expectations is the corner stone of family-centered care and may ultimately influence a child's developmental outcome. A systematic way of evaluating parent perspectives on the clinical process can influence service delivery and help children with hearing loss meet their potential.
以家庭为中心的医疗保健要求家庭为其子女的护理提供意见。然而，对于家庭如何看待他们在不同类型的多学科团队模式中的经历，特别是在目前许多儿科听力诊所采用的多学科环境中的经历，我们知之甚少。
在一家三级医疗儿科中心，于一日多学科评估临床预约后收集并分析家长的定量和定性调查回复。问题涉及五个领域的信息，包括总体体验、诊断、治疗方案制定、额外检查和资源。对定量回复进行描述性分析，同时使用内容分析法对定性回复进行评估以得出主题。分别评估定量和定性数据，然后进行比较以勾勒出优势和劣势的主题。
总体而言，定量和定性回复中都明显表现出高度满意度。结果表明，一日多学科评估预约可能会让家长因所分享的信息而感到不知所措，且无法完全理解哪些学科在提供护理。分析显示，在我们特定的环境中，一个特定的薄弱环节是关于功能性听力（例如社交和学业聆听）的信息提供不足。这些结果促使从多学科团队模式转变为儿科听力保健的跨学科护理协调方法。
理解家长的观点和期望是以家庭为中心的护理的基石，最终可能会影响孩子的发育结果。一种系统评估家长对临床过程观点的方法可以影响服务提供，并帮助听力损失儿童发挥其潜力。
