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Screening for neonatal herpes: physicians' descriptions of discussions with parents
Sian Cotton1, Beverly L Connelly, Sheila S Cohen
1Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati, OH, USA. sxc130@po.cwru.edu
Insights
Physicians use direct communication and contextualize herpes simplex virus (HSV) diagnosis to manage parental anxiety during neonatal screening. Strategies focus on honesty and discussing disease severity to alleviate distress.
Area of Science:
- Neonatal Medicine
- Medical Communication
- Infectious Diseases
Background:
- Screening for neonatal herpes simplex virus (HSV) infection can cause significant anxiety for parents and healthcare providers.
- Effective communication strategies are crucial for managing parental distress during this sensitive process.
Purpose of the Study:
- To explore physicians' experiences communicating with families about neonatal herpes screening.
- To identify effective communication techniques and stigma management strategies used by physicians.
Main Methods:
- Conducted semi-structured interviews with 15 physicians at a pediatric institution.
- Coded audiotapes to identify common themes in physician communication regarding neonatal herpes screening.
Main Results:
- Physicians employ direct, honest communication and appropriate timing/setting for discussions.
- Strategies for managing stigma include providing epidemiological context and discussing disease severity.
- Physicians identified various parental emotional reactions and developed coping strategies.
Conclusions:
- Effective communication strategies are vital for supporting families undergoing neonatal herpes screening.
- Further research is needed to optimize training for physicians and evaluate the efficacy of communication techniques.
Abstract:
Screening for possible herpes simplex virus infection in neonates may raise feelings of anxiety and distress among parents and physicians. To elicit physicians' experiences of communicating with families when screening for neonatal herpes, we conducted a series of semi-structured interviews with 15 physicians from one paediatric institution, and coded the resulting audiotapes for common themes. These included how physicians prepared families for screening and treatment, how physicians managed stigma, and perceived parental reactions. Techniques for fostering good communication included being direct and honest and ensuring the time and place for discussion were appropriate; strategies for managing stigma included placing the diagnosis in epidemiological context, and discussing the potential severity of the disease. Physicians described many parental emotional reactions, some of which were herpes-specific, and suggested strategies to manage potential discomfort when discussing neonatal herpes with families. Future research can determine which strategies are most effective, which are associated with negative psychological outcomes, and how medical students and residents can be better trained to screen for this diagnosis.