Communication between neonatologists and parents when prognosis is uncertain

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.