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Communication between neonatologists and parents when prognosis is uncertain.

Laura L Drach1, Debra A Hansen2, Tracy M King3

  • 1Division of Pediatric Palliative Care, Johns Hopkins All Children's Hospital, St. Petersburg FL, 501 6th Ave So, St. Petersburg, FL, 33701, USA. Ldrach1@jhmi.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|May 9, 2020
PubMed
Summary

Effective communication between neonatologists and parents is crucial when an infant's prognosis is uncertain. Challenges exist, but a multidisciplinary approach can improve patient-centered communication and collaboration in the Neonatal Intensive Care Unit (NICU).

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Area of Science:

  • Neonatal medicine
  • Medical communication
  • Qualitative research

Background:

  • Communication between neonatologists and parents is challenging when infant prognoses are uncertain.
  • Establishing a strong parent-clinician partnership is vital for shared decision-making and care goals.

Purpose of the Study:

  • To explore communication dynamics between neonatologists and parents of infants with uncertain prognoses.
  • To identify factors that enhance or hinder effective parent-clinician communication and partnership.

Main Methods:

  • Qualitative study employing semi-structured individual interviews.
  • Utilized the National Cancer Institute (NCI) Patient Centered Communication framework.
  • Included nine dyads of neonatologists and English-speaking parents.

Main Results:

  • Parents reported general satisfaction with communication regarding their infant's uncertain trajectory.
  • Both parents and neonatologists experienced communication challenges and distress.
  • These difficulties impeded collaboration and engagement.

Conclusions:

  • Families and neonatologists recognize the value of patient-centered communication principles.
  • Implementing these principles presents practical challenges in neonatal care settings.
  • A multidisciplinary approach may enhance patient-centered communication in cases of prognostic uncertainty within the NICU.