Division of Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, Missouri, USA.
Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware, USA.
Pediatr Blood Cancer. 2022 Dec;69(12):e30016. doi: 10.1002/pbc.30016. Epub 2022 Sep 24.
Individuals with sickle cell disease (SCD) experience systemic barriers in accessing high-quality care. Research suggests that patient/family-provider relationships are an important indicator of healthcare quality and can influence disease self-management and outcomes. The Patient Centered Communication (PCC) framework holds that patient/family-centered communication (e.g., eliciting, understanding, and validating patients' perspectives within their unique psychosocial contexts) contributes to improved family-provider relationships, as well as self-efficacy for disease management, adherence, and health outcomes. While the PCC framework has been useful in guiding the evaluation of patient/family-provider communication in other pediatric populations, it has not yet been applied in the context of pediatric SCD. This study aimed to use this framework to examine patient and family perceptions of communication with pediatric SCD healthcare providers.
Total 17 caregivers (82% mothers, 94% Black/African American) and eight patients (62% female, aged 13-19 years, M = 16.50) completed semi-structured interviews. The PCC framework informed the development of a preliminary codebook. Thematic content analysis summarized family perspectives regarding communication with providers.
For youth with SCD and their caregivers, specific themes related to family-centered communication included: reducing patient/family distress, supporting disease self-management efforts, facilitating information exchange and decision-making, and fostering positive and trusting relationships with providers.
This study helps to address gaps in the literature related to patient/family-provider communication within pediatric SCD. Results underscore the importance of patient- and family-centered communication across pediatric SCD care. These findings can inform future research and clinical care initiatives to improve patient/family-provider interactions and health outcomes for this underserved population.
患有镰状细胞病(SCD)的个体在获得高质量医疗方面面临系统性障碍。研究表明,医患关系是医疗质量的一个重要指标,它可以影响疾病的自我管理和结果。以患者为中心的沟通(PCC)框架认为,以患者为中心的沟通(例如,在患者独特的心理社会背景下,引出、理解和验证患者的观点)有助于改善医患关系,以及疾病管理、依从性和健康结果的自我效能。虽然 PCC 框架在指导其他儿科人群中评估医患沟通方面很有用,但尚未在儿科 SCD 中应用。本研究旨在使用该框架来检查儿科 SCD 患者及其家属对与儿科 SCD 医疗服务提供者沟通的看法。
共有 17 名照顾者(82%为母亲,94%为黑/非裔美国人)和 8 名患者(62%为女性,年龄在 13-19 岁,M=16.50)完成了半结构化访谈。PCC 框架为初步编码本的制定提供了信息。主题内容分析总结了家庭对与提供者沟通的看法。
对于患有 SCD 的青少年及其照顾者,与以家庭为中心的沟通相关的具体主题包括:减轻患者/家庭的痛苦,支持疾病自我管理,促进信息交流和决策,并与提供者建立积极和信任的关系。
本研究有助于解决儿科 SCD 中与医患沟通相关的文献空白。结果强调了在儿科 SCD 护理中以患者和家庭为中心的沟通的重要性。这些发现可以为未来的研究和临床护理计划提供信息,以改善这一服务不足人群的医患互动和健康结果。