Schweiberger Kelsey, Harris Kelly W, Kavanaugh-McHugh Ann, Soudi Abdesalam, Arnold Robert M, Merlin Jessica S, Kasparian Nadine A, Chang Judy C
Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
J Cardiovasc Dev Dis. 2023 Sep 13;10(9):394. doi: 10.3390/jcdd10090394.
The way clinicians communicate with parents during pregnancy about congenital heart disease (CHD) can significantly influence parental understanding of and psychological response to the diagnosis. A necessary first step to improving communication used in fetal cardiology consultations is to understand and describe the language currently used, which this paper aims to do. Nineteen initial fetal cardiology consultations with parents were audio-recorded, transcribed verbatim, and coded by two independent coders. A codebook was inductively developed and applied to all transcripts. The finalized coding was used to characterize fetal cardiologists' language. We identified four discourse styles employed in fetal cardiology consultations: small talk, medical, plain, and person-centered. Plain language was used to define and emphasize the meaning of medical language. Person-centered language was used to emphasize the baby as a whole person. Each consultation included all four discourse styles, with plain and medical used most frequently. Person-centered was used less frequently and mostly occurred near the end of the encounters; whether this is the ideal balance of discourse styles is unknown. Clinicians also used person-centered language (as opposed to disease-centered language), which is recommended by medical societies. Future studies should investigate the ideal balance of discourse styles and the effects of clinician discourse styles on family outcomes, including parents' decision-making, psychological adjustment, and quality of life.
临床医生在孕期与父母就先天性心脏病(CHD)进行沟通的方式,会显著影响父母对该诊断的理解以及心理反应。改善胎儿心脏病学咨询中沟通方式的必要第一步,是理解并描述当前所使用的语言,本文旨在做到这一点。对19次与父母进行的初始胎儿心脏病学咨询进行了录音、逐字转录,并由两名独立编码员进行编码。通过归纳法制定了一个编码手册,并应用于所有转录文本。最终确定的编码用于描述胎儿心脏病专家的语言。我们识别出胎儿心脏病学咨询中使用的四种话语风格:闲聊、医学、平实和以患者为中心。平实语言用于定义和强调医学语言的含义。以患者为中心的语言用于强调婴儿是一个完整的个体。每次咨询都包含所有四种话语风格,其中平实和医学风格使用最为频繁。以患者为中心的风格使用较少,且大多出现在会诊接近尾声时;这种话语风格的平衡是否理想尚不清楚。临床医生还使用了医学学会推荐的以患者为中心的语言(而非以疾病为中心的语言)。未来的研究应调查话语风格的理想平衡以及临床医生话语风格对家庭结果的影响,包括父母的决策、心理调适和生活质量。