Division of Pediatric Palliative Care, Johns Hopkins All Children's Hospital, St. Petersburg FL, 501 6th Ave So, St. Petersburg, FL, 33701, USA.
Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 100 Hitchcock Way, Manchester, NH, 03104, USA.
J Perinatol. 2020 Sep;40(9):1412-1422. doi: 10.1038/s41372-020-0673-6. Epub 2020 May 7.
When an infant's prognosis is uncertain, communication between neonatologists and parents surrounding goals of care and decision-making can be challenging. This qualitative study explored communication between neonatologists and parents to discover qualities which may enhance or impede parent-clinician partnership under such difficult circumstances.
Guided by the National Cancer Institute (NCI) Patient Centered Communication framework, semi-structured individual interviews were conducted and analyzed regarding neonatologist and parent perceptions of their communication. Subjects consisted of nine dyads of neonatologists and English-speaking parents whose infant had an uncertain prognosis.
Parents were overall satisfied with neonatologists' communications concerning their infant's uncertain trajectory. Nonetheless, both experienced challenges and distress during communication, impeding collaboration and engagement.
Families and neonatologists value principles of patient centered communication but report challenges implementing this practice. Incorporating a multidisciplinary approach in settings of prognostic uncertainty to foster patient centered communication, may enhance communication surrounding NICU care.
当婴儿的预后不确定时，新生儿科医生与家长围绕治疗目标和决策进行沟通可能具有挑战性。本定性研究探讨了新生儿科医生与家长之间的沟通，以发现在这种困难情况下可能增强或阻碍医患合作关系的素质。
本研究以美国国立癌症研究所（NCI）以患者为中心的沟通框架为指导，对新生儿科医生和英语家长对其沟通的看法进行了半结构化的个体访谈和分析。研究对象由 9 对新生儿科医生和英语家长组成，他们的婴儿预后不确定。
家长总体上对新生儿科医生就其婴儿不确定的病情传达的信息感到满意。尽管如此，双方在沟通时都经历了挑战和困扰，阻碍了协作和参与。
家庭和新生儿科医生重视以患者为中心的沟通原则，但报告在实施这一实践时存在挑战。在预后不确定的情况下，采用多学科方法来促进以患者为中心的沟通，可能会增强围绕新生儿重症监护病房护理的沟通。
