Dialectical Tensions Associated with Health Advocacy

Area of Science:

• Healthcare advocacy
• Patient and family-centered care
• Qualitative research

Background:

• Family members often serve as crucial health advocates for patients in pediatric intensive care units (PICUs).
• These advocates navigate complex emotional and logistical challenges during a child's critical illness.
• Understanding the advocate's lived experience is vital for improving support systems.

Purpose of the Study:

• To explore the dialectical tensions experienced by a health advocate for a child in the PICU.
• To identify strategies for managing these inherent tensions.
• To propose metacommunication as a tool for reframing advocate experiences.

Main Methods:

• A narrative inquiry approach was used to recount the lived experiences of a health advocate.
• The study focuses on the dialectical tensions of emotionality-rationality and presence-absence.
• Analysis draws on communication theory, specifically metacommunication.

Main Results:

• The advocate experienced significant dialectical tensions between emotional responses and rational decision-making.
• The advocate also grappled with the tension between physical presence and the need for personal absence.
• Metacommunication emerged as a key strategy for navigating these dualities.

Conclusions:

• The dialectical tensions of emotionality-rationality and presence-absence are inherent in pediatric intensive care unit advocacy.
• "Metacommunication" offers a framework for health advocates to reframe these tensions as complementary.
• Empowering advocates through reframed perspectives can lead to more productive experiences and improved well-being.