A Descriptive Study of Decision-Making Conversations during Pediatric Intensive Care Unit Family Conferences

Area of Science:

• Pediatric Critical Care Medicine
• Health Communication
• Shared Decision Making

Background:

• Decision-making conversations during pediatric intensive care unit (PICU) family conferences (FCs) are not well understood.
• Effective communication is crucial for family-centered care in high-stakes environments.

Purpose of the Study:

• To describe the decision-making process during PICU family conferences.
• To evaluate the implementation of shared decision making (SDM) within these conferences.

Main Methods:

• An observational study analyzed 14 recorded and transcribed PICU family conferences.
• A modified grounded theory and content analysis approach examined decision-making stages and SDM elements.

Main Results:

• Decision-making (DM) progressed through nonlinear stages: information exchange, deliberation, and planning.
• While clinical issues and alternatives were presented, key SDM elements like assessing family understanding (21%) and eliciting opinions (42%) were infrequent.

Conclusions:

• PICU family conferences involve a nonlinear decision-making process.
• Gaps in SDM elements suggest areas for improving parent involvement and communication in PICU care.