School of Nursing, University of Wisconsin-Madison, Madison, USA.
School of Nursing, University of Wisconsin-Madison, Madison, USA.
Patient Educ Couns. 2024 Aug;125:108317. doi: 10.1016/j.pec.2024.108317. Epub 2024 May 7.
The purpose of this study was to explore how moral accountability is navigated when clinicians talk about parental behaviors to support the health of the hospitalized child.
We conducted a secondary data analysis of 74 conversations during daily rounds video recorded as part of a randomized controlled trial of an intervention to advance family-centered rounds in one children's hospital. Conversations involving children under the age 18 who were cared for by a pediatric hospitalist service, pulmonary service, or hematology/oncology service were recorded. We used conversation analysis to analyze sequences in which physicians engaged in talk that had implications for parent behavior.
Two phenomena were apparent in how physicians and parents navigated moral accountability. First, physicians avoided or delayed parental agency in their references to parent behaviors. Second, parents demonstrated and clinicians reassured parental competence of parents caring for their children.
Physicians appeared to be oriented toward the potential moral implications of asking about parental behavior.
Avoiding attributions of agency and moral accountability as well as providing reassurance for the parents' competence may be useful for clinicians to maintain a good relationship with the parents of children in their care in the hospital setting.
本研究旨在探讨临床医生在谈论支持住院儿童健康的父母行为时，如何应对道德责任问题。
我们对在一家儿童医院进行的一项旨在推进以家庭为中心的查房干预措施的随机对照试验中记录的 74 次日常查房视频进行了二次数据分析。记录了由儿科住院医师服务、肺病科服务或血液科/肿瘤科服务照顾的 18 岁以下儿童的谈话。我们使用会话分析来分析医生在谈论可能影响父母行为的内容时的序列。
在医生和父母如何应对道德责任方面，有两个现象很明显。首先，医生在提及父母行为时避免或延迟了父母的代理权。其次，父母表现出并让医生放心，父母有能力照顾他们的孩子。
医生似乎对询问父母行为的潜在道德影响有倾向。
避免将代理权和道德责任归因于父母，并为父母照顾孩子的能力提供保证，这可能对临床医生在医院环境中与他们所照顾的孩子的父母保持良好关系很有用。
