Center for Comprehensive Care, Rainbow Babies and Children's Hospital, Cleveland, Ohio;
Nursing Research and Quality Outcomes and.
Hosp Pediatr. 2021 May;11(5):485-491. doi: 10.1542/hpeds.2020-003319.
Parents' ideas about what it means to be a "good parent" to their seriously ill child influence parental decision-making. Little is known about when, why, and how clinicians offer good-parent praise or how parents react. Our objective was to describe clinicians' spontaneous use of good-parent praise statements to parents during PICU care conferences and how parents respond.
Single-center, cross-sectional review of 72 transcripts of audio-recorded PICU care conferences in a quaternary medical center. Qualitative analysis was conducted to code triggers for clinician good-parent statements and parent responses.
Clinicians made at least one statement of good-parent praise in 32% of family conferences. Triggers for clinician statements of good-parent praise were categorized into 6 themes: decision making, gratitude to the clinical team, defense of parenting, parental body language, parental guilt, and intention to close the meeting. Parental responses to clinician statements of good-parent praise fell into 6 themes: acknowledgment, medical talk, deepening of feelings expressed in conversation, focusing on a decision, redirecting on the patient, and gratitude.
Clinicians spontaneously praised parents for their role in being a good parent in less than one-third of family conferences. Clinician statements were triggered by verbal and nonverbal parental behaviors, a critical decision-making point in the conversation, and an intention to close the meeting. In response, parents frequently responded positively to the praise and often returned the gratitude or reflected on their feelings about caregiving for their child.
父母对自己作为重病患儿“好家长”的看法影响着他们的决策。目前，人们对临床医生何时、为何以及如何表扬好家长，以及家长对此的反应知之甚少。我们的目的是描述临床医生在 PICU 护理会议期间自发使用表扬好家长的语句的情况，以及家长的反应。
在一家四级医疗中心对 72 份音频记录的 PICU 护理会议记录进行单中心、横断面回顾。采用定性分析对临床医生表扬好家长语句的触发因素和家长的反应进行编码。
临床医生在 32%的家庭会议中至少发表了一次表扬好家长的语句。触发临床医生表扬好家长的语句可以分为 6 个主题：决策、感谢临床团队、为育儿辩护、父母的肢体语言、父母的内疚感和结束会议的意图。家长对临床医生表扬好家长语句的反应分为 6 个主题：认可、谈论医学问题、深化对话中表达的感受、关注决策、转移到患者身上、表示感谢。
在不到三分之一的家庭会议中，临床医生会自发地表扬家长作为好家长的角色。临床医生的语句是由父母的言语和非言语行为、对话中的关键决策点以及结束会议的意图触发的。作为回应，家长经常对表扬做出积极的反应，通常会回报感谢或反思他们对照顾孩子的感受。
