Culturally Informed Communication of Neonatal Death in Chinese Neonatal Intensive Care Units

Area of Science:

• Medical Communication
• Cultural Competence in Healthcare
• Neonatal Care

Background:

• Neonatal death communication in China presents unique cultural sensitivities for neonatal intensive care unit (NICU) clinicians.
• Clinicians face pressure to convey profound loss appropriately within traditional Chinese cultural expectations.

Purpose of the Study:

• To explore how NICU physicians and nurses communicate neonatal death to parents.
• To examine the navigation of cultural expectations during these sensitive conversations.
• To understand communication decision-making across diverse clinical scenarios.

Main Methods:

• Qualitative study utilizing semistructured interviews with NICU clinicians in China.
• Descriptive phenomenological approach, specifically the Colaizzi 7-step method, for data analysis.
• Data collected from 24 physicians and nurses across two tertiary care hospitals.

Main Results:

• Fathers were prioritized for death disclosures, with mothers sometimes shielded from direct communication.
• The term "death" was often avoided, with news disclosed incrementally and metaphors used for medical terms.
• Post-disclosure procedures strictly adhered to cultural norms, including grief suppression and managing the infant's remains.

Conclusions:

• NICU staff in China communicate neonatal death with sensitivity to traditional cultural norms.
• Key areas for improvement include reducing stigma, developing culturally attuned bereavement services, and understanding parental experiences.
• Further research should explore parental preferences and enhance culturally sensitive communication strategies.