Communication in pediatric critical care: A proposal for an evidence-informed framework

Area of Science:

• Pediatric Intensive Care Unit (PICU) Communication
• Healthcare Professional-Parent Interactions
• Qualitative Health Research

Background:

• Communication between parents and healthcare professionals (HCPs) in the PICU is complex and impacts patient outcomes.
• Previous research has explored aspects of this communication, but a comprehensive analysis integrating diverse perspectives and outcomes is needed.

Purpose of the Study:

• To comprehensively examine communication dynamics between parents and HCPs in the PICU.
• To identify key themes and develop a conceptual framework for PICU communication.
• To inform practice, education, and research priorities.

Main Methods:

• Secondary analysis of data from three previous qualitative studies.
• Inclusion of 30 physicians, 37 nurses, and 38 parents from France and Quebec (Canada).
• Examination of communication in cases involving survival, death, and withdrawal/withholding of life-sustaining treatments.

Main Results:

• Three interrelated dimensions of communication were identified: informational, relational, and communication and parental coping.
• Specific themes related to parental and HCP concerns were identified within each dimension.
• A comprehensive analysis was achieved by including diverse case types, participant groups, and study sites.

Conclusions:

• An evidence-informed conceptual framework for PICU communication between parents and HCPs is proposed.
• Identified communication themes and dimensions offer insights into improving parent-provider interactions.
• Priorities for practice, education, and research in PICU communication are outlined.