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Parental communication satisfaction with the clinical team in the paediatric cardiac ICU
Jennifer K Walter1,2, Chris Feudtner1,2, Arzu Cetin2
1Pediatric Advanced Care Team, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Insights
Parental satisfaction with communication in the pediatric cardiac ICU is linked to child
Area of Science:
- Pediatric Critical Care Medicine
- Healthcare Communication
- Patient and Family Experience
Background:
- Effective communication between healthcare providers and parents is crucial in the pediatric cardiac intensive care unit (ICU).
- Understanding factors influencing parental satisfaction with communication can help address challenges in this high-stress environment.
Purpose of the Study:
- To investigate the relationship between parental and child characteristics and parental satisfaction with medical team communication in a pediatric cardiac ICU.
- To identify factors associated with higher communication satisfaction scores among parents of critically ill children.
Main Methods:
- A cross-sectional survey was administered to parents of pediatric patients admitted for at least two weeks in a cardiac ICU.
- Communication satisfaction was assessed using the Communication Assessment Tool for Team settings.
- Data on parental mood, stress, perceptions of care, demographics, and patient clinical characteristics were collected and analyzed using multivariable ordinal models.
Main Results:
- Parents of children with higher pre-surgical risk of mortality scores reported significantly higher communication satisfaction.
- The presence of surgical complications and greater overall satisfaction with ICU care were also associated with higher communication scores.
- 93 parents of 84 patients completed the survey, with 70% of patients being under 6 months old at admission.
Conclusions:
- Findings highlight specific patient and clinical factors associated with communication challenges, enabling providers to anticipate and prepare for difficult communication scenarios.
- Interventions aimed at reducing parental anxiety and improving communication, especially for patients with complex clinical trajectories, are warranted.
Introduction:
Understanding parents' communication preferences and how parental and child characteristics impact satisfaction with communication is vital to mitigate communication challenges in the cardiac ICU.
Methods:
This cross-sectional survey was conducted from January 2019 to March 2020 in a paediatric cardiac ICU with parents of patients admitted for at least two weeks. Family satisfaction with communication with the medical team was measured using the Communication Assessment Tool for Team settings. Clinical characteristics were collected via Epic, Pediatric Cardiac Critical Care Consortium local entry and Society for Thoracic Surgeons Congenital Heart Surgery Databases. Associations between communication score and parental mood, stress, perceptions of clinical care, and demographic characteristics along with patient demographic and clinical characteristics were examined. Multivariable ordinal models were conducted with characteristics significant in bivariate analysis.
Results:
In total, 93 parents of 84 patients (86% of approached) completed surveys. Parents were 63% female and 70% White. Seventy per cent of patients were <6 months old at admission, 25% had an extracardiac abnormality, and 80% had a cardiac surgery this admission. Parents of children with higher pre-surgical risk of mortality scores (OR 2.875; 95%CI 1.076-7.678), presence of surgical complications (72 [63.0, 75.0] vs. 64 [95%CI 54.6, 73] (p = 0.0247)), and greater satisfaction with care in the ICU (r = 0.93922; p < 0.0001) had significantly higher communication scores.
Conclusion:
These findings can prepare providers for scenarios with higher risk for communication challenges and demonstrate the need for further investigation into interventions that reduce parental anxiety and improve communication for patients with unexpected clinical trajectories.
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