Department of Pediatrics, New York University School of Medicine and New York University Langone Health, New York, New York
Department of Pediatrics, New York University School of Medicine and New York University Langone Health, New York, New York.
Hosp Pediatr. 2021 Jan;11(1):61-70. doi: 10.1542/hpeds.2020-000596. Epub 2020 Dec 10.
Although families positively perceive family-centered rounds (FCR), factors associated with engagement have been examined in few studies. Our objective for this study was to test the hypothesis that inviting the parent to speak and nurse presence are associated with parent engagement during FCR.
We conducted a cross-sectional study with English-speaking parents ( = 199) of inpatients on the pediatric hospital medicine service at an academic medical center. We used a standardized checklist to record outcomes of engagement (number of questions asked and participation occurrences), predictor variables (team invited parent to speak, nurse presence), and other encounter-related variables. Parents were surveyed to assess parent and child characteristics and experiences during FCR. We examined parent, child, and encounter characteristic associations with the above outcomes using bivariate analyses and (for those associated in bivariate analyses) Poisson regressions.
Inviting the parent to speak was independently associated with the number of questions asked (incident rate ratio [IRR] 1.4; 95% confidence interval [CI] 1.1-1.7). Trusting the medical team was inversely associated with questions asked (IRR 0.8; 95% CI 0.6-0.97). Factors associated with total participation included invitation for the parent to speak (IRR 1.5; 95% CI 1.3-1.6), nurse presence (IRR 1.3; 95% CI 1.1-1.5), white race (IRR 1.2; 95% CI 1.1-1.4), clerkship student presentation (IRR 1.2; 95% CI 1.03-1.3), and parent inclusion in rounding arrangement (IRR 1.5; 95% CI 1.05-2).
Parents present during FCR are more engaged when invited to speak. Nurse presence was associated with total parent participation. Future studies to inform interventions to optimize engagement are warranted.
尽管家庭对以家庭为中心的查房(FCR)持积极态度,但很少有研究探讨与参与相关的因素。本研究旨在检验以下假设,即邀请家长发言和护士在场与 FCR 期间家长的参与度相关。
我们在一家学术医疗中心的儿科住院医师服务中进行了一项横断面研究,纳入了 199 名英语为母语的住院患儿的家长。我们使用标准化清单记录参与度的结果(提出的问题数量和参与次数)、预测变量(团队邀请家长发言、护士在场)以及其他与就诊相关的变量。家长接受调查以评估 FCR 期间的家长和孩子特征及体验。我们使用双变量分析和(在双变量分析中相关的情况下)泊松回归,检查家长、孩子和就诊特征与上述结果的关联。
邀请家长发言与提出的问题数量独立相关(发生率比 [IRR] 1.4;95%置信区间 [CI] 1.1-1.7)。信任医疗团队与提出的问题呈负相关(IRR 0.8;95% CI 0.6-0.97)。与总参与度相关的因素包括邀请家长发言(IRR 1.5;95% CI 1.3-1.6)、护士在场(IRR 1.3;95% CI 1.1-1.5)、白种人(IRR 1.2;95% CI 1.1-1.4)、实习医学生陈述(IRR 1.2;95% CI 1.03-1.3)和家长纳入查房安排(IRR 1.5;95% CI 1.05-2)。
在 FCR 期间被邀请发言的家长更积极参与。护士在场与家长的总参与度相关。有必要开展进一步研究,以确定优化参与度的干预措施。