"You Have to Find a Way for This Child to Be at the Center": Pediatric Cardiologists' Views on Triadic Communication...

Area of Science:

• Pediatric cardiology
• Medical communication
• Patient-centered care

Background:

• Congenital heart defects (CHDs) necessitate comprehensive management involving patients, families, and healthcare providers.
• Effective communication is crucial for patient-centered care, particularly in pediatric settings where children's developmental stages impact communication.
• The triadic dynamic of pediatric consultations (child, parent, physician) presents unique communication challenges.

Purpose of the Study:

• To explore pediatric cardiologists' perspectives on the roles of children, parents, and physicians in triadic encounters.
• To understand physicians' experiences communicating pediatric CHD information within these encounters.
• To identify challenges and strategies in integrating children into information exchange during consultations.

Main Methods:

• Qualitative study employing semi-structured interviews with 17 experienced pediatric cardiologists and cardiac surgeons.
• Grounded theory approach used for data analysis.
• Interviews conducted across three medical centers in Israel.

Main Results:

• Physicians advocate for child involvement in consultations but struggle with effective integration into information exchange.
• Key themes identified: child's positioning in encounters, addressing parental emotional needs, and the physician's role as mediator.
• Physicians rely on personal experience and beliefs to navigate communication due to a lack of clear guidelines.

Conclusions:

• Pediatric cardiologists face significant challenges in balancing patient- and family-centered care principles when communicating about CHDs.
• Strategies for effective communication in triadic pediatric cardiology encounters are often personalized and experience-based.
• Further research is needed to develop evidence-based guidelines for optimizing communication in pediatric CHD care.