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Parent and Clinician Perceptions of Suctioning in Hospitalized Children With Bronchiolitis
Robert J Willer1, Hadley M Brighton2, Polina Frolova Gregory3
1University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, Utah.
Insights
Parents viewed airway suctioning favorably for hospitalized infants with bronchiolitis, believing it aided recovery. Clinicians, however, expressed concerns about potential harm and overuse of this common intervention.
Area of Science:
- Pediatric Respiratory Medicine
- Qualitative Health Research
- Patient and Clinician Perceptions
Background:
- Bronchiolitis is a common respiratory infection in infants, often requiring hospitalization.
- Airway suctioning is a frequent intervention used in managing hospitalized children with bronchiolitis.
- Understanding perceptions of suctioning is crucial for optimizing care and communication.
Purpose of the Study:
- To characterize and compare parent and clinician perceptions of airway suctioning in hospitalized children with bronchiolitis.
- To identify areas of agreement and disagreement between parents and clinicians regarding suctioning practices.
- To inform future guidelines and patient-centered care strategies.
Main Methods:
- A multicenter qualitative study involving semistructured interviews.
- Inclusion of parents of children under 2 years with bronchiolitis and healthcare clinicians (physicians, advanced practice clinicians, nurses, respiratory therapists).
- Inductive thematic analysis of interview data to identify key themes.
Main Results:
- Parents generally perceived suctioning positively, associating it with improved feeding, sleep, and faster recovery.
- Clinicians expressed more guarded views, citing concerns about potential harm and overuse of suctioning.
- Conflicting views were identified, highlighting a divergence in perspectives on the benefits and risks of suctioning.
Conclusions:
- Significant differences exist between parent and clinician perceptions of airway suctioning in pediatric bronchiolitis.
- Families tend to have favorable views, while clinicians are more cautious, often viewing suctioning as overused.
- Addressing these differing perspectives is essential for improving the management of bronchiolitis.
Objective:
Our objective was to characterize parent and clinician perceptions of suctioning in hospitalized children with bronchiolitis in a multicenter study.
Patients And Methods:
We included parents of hospitalized children younger than 2 years with bronchiolitis and clinicians (physicians, advanced practice clinicians, respiratory therapists, and nurses) who care for hospitalized children with bronchiolitis at 4 children's hospitals. We excluded patients with a tracheostomy, ventilator dependence, hemodynamically significant cardiac disease, or neuromuscular disease. We used a general qualitative framework with an inductive thematic analysis approach and semistructured interviews. All interviews were conducted by a trained research coordinator with coding by 2 trained professionals for the first 25%, with the remainder of the interviews coded by a primary coder. Interviews continued until sufficient information power was obtained.
Results:
We conducted 14 parent and 25 clinician interviews from January 2024 through May 2024. Most parent interviews were completed by mothers of hospitalized children (71%). Clinician interviews were completed by 7 (28%) nurses, 10 (40%) physicians or advanced practice clinicians, and 8 (32%) respiratory therapists with a wide range of experience. We identified clear parent and clinician themes and themes in which parents and providers held conflicting views. Parents felt that suctioning helped feeding and sleeping and led to faster overall recovery from illness, whereas clinicians often cited the time-oriented nature of bronchiolitis. Clinicians felt that suctioning carried the potential for harm and generally felt that suctioning was overused.
Conclusions:
Families generally had favorable views of suctioning, whereas clinicians' views were much more guarded.
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