Penn State Hershey Children's Hospital, Hershey, PA, USA.
Children's National Health System, Washington, DC, USA; The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
J Natl Med Assoc. 2020 Feb;112(1):74-81. doi: 10.1016/j.jnma.2019.09.005. Epub 2019 Oct 22.
To compare the communication experiences and preferences of racial/ethnic minority and non-Hispanic white (NHW) families in the pediatric intensive care unit (PICU), including their interactions with bedside nurses.
Retrospective cohort study performed at a quaternary university-affiliated children's hospital with 70 pediatric intensive care beds. From October 2013 to December 2014, English-speaking family members of children admitted to the PICU were asked about their experiences communicating with PICU caregivers using a survey tool.
107 participants were included for analysis, of which 60 self-identified as a racial minority and 47 as NHW. Overall, 11% of families chose family meetings as their preferred setting for receiving information, as compared to family-centered rounds or unplanned bedside meetings. Only 50% of those with a family meeting felt they learned new information during the meeting. Chi-square statistics or Fisher's exact tests showed that minority families were less likely to report their bedside nurses spent enough time speaking with them (minority 67%, NHW 85%; p = 0.03) and less likely to receive communication from the medical team in their preferred setting (minority 63%, NHW 85%; p = 0.01). Logistic regression, controlling for covariates including education, insurance, and risk of mortality, showed that the relationship between minority status and concordance of preferred setting persisted (OR = 0.32, 95% C·I.: 0.11, 0.91).
In general, families of PICU patients prefer meeting with the medical team during rounds or unplanned bedside meetings as opposed to formal family meetings. Despite this preference, minority families are less likely to receive communication from the medical team in their preferred settings. Meeting all families' communication setting needs may improve their communication experiences in the PICU.
比较儿科重症监护病房（PICU）中少数民族和非西班牙裔白人（NHW）家庭的沟通体验和偏好，包括他们与床边护士的互动。
这是一项在拥有 70 张儿科重症监护病床的四级大学附属儿童医院进行的回顾性队列研究。2013 年 10 月至 2014 年 12 月，向 PICU 收治的儿童的英语家庭，使用调查工具询问他们与 PICU 护理人员沟通的经历。
纳入分析的 107 名参与者中，60 名自我认定为少数民族，47 名自我认定为 NHW。总体而言，11%的家庭选择家庭会议作为他们接受信息的首选场所，而不是以家庭为中心的查房或计划外的床边会议。只有 50%参加家庭会议的人表示他们在会议期间了解了新信息。卡方检验或 Fisher 确切检验显示，少数民族家庭认为他们的床边护士与他们交谈的时间不够（少数民族 67%，NHW 85%；p=0.03），也不太可能在他们首选的场所收到医疗团队的沟通（少数民族 63%，NHW 85%；p=0.01）。控制教育、保险和死亡率风险等协变量的逻辑回归显示，少数民族身份与首选场所一致的关系仍然存在（OR=0.32，95%置信区间：0.11，0.91）。
一般来说，PICU 患者的家属更希望在查房或计划外的床边会议期间与医疗团队会面，而不是正式的家庭会议。尽管有这种偏好，少数民族家庭仍不太可能在他们首选的场所收到医疗团队的沟通。满足所有家庭的沟通场所需求，可能会改善他们在 PICU 的沟通体验。
