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Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit
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When shared decision-making and evidence based practice clash: Infant sleep practices.

Ben Gray1, Tumaini R Coker2,3

  • 1Department of Primary Health Care and General Practice, University of Otago Wellington, Wellington, New Zealand.

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|July 30, 2019
PubMed
Summary
This summary is machine-generated.

Navigating clinical practice guidelines versus patient preferences in complex decisions, like infant sleep, requires balancing evidence-based recommendations with family-centred, culturally sensitive care. Trust and cultural humility are key to effective clinician-parent discussions.

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Area of Science:

  • Pediatrics
  • Medical Ethics
  • Health Communication

Background:

  • Clinical practice guidelines offer evidence-based recommendations but can conflict with patient-specific circumstances and preferences.
  • Shared decision-making (SDM) aims to integrate patient values into clinical choices, yet adherence to guidelines remains a concern for clinicians.

Observation:

  • Infant sleep practices frequently present a conflict between national recommendations and family-centered preferences during well-baby visits.
  • Three case studies illustrate the tension between adhering to safe sleep guidelines and respecting diverse family values.

Findings:

  • Cultural humility, understanding complexity, and building trust are crucial for reconciling evidence-based guidance with family-centered infant sleep discussions.
  • Effective communication strategies can integrate safe sleep guidelines into culturally relevant, family-specific advice.

Implications:

  • Clinicians need frameworks to navigate guideline-patient preference conflicts, particularly in areas like infant sleep.
  • Promoting cultural humility in SDM can improve adherence to safe sleep practices while respecting family autonomy.
  • Future research should explore best practices for culturally sensitive SDM in pediatrics.