Communicating prognosis with parents of critically ill infants: Direct observation of clinician behaviors

R. D. Boss, M. E. Lemmon, R. M. Arnold, P. K. Donohue

Research output: Contribution to journalArticle

Abstract

Objective:Delivering prognostic information to families requires clinicians to forecast an infant's illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician-family concordance regarding infant outcomes.Study Design:Prospective audiorecording of neonatal intensive care unit family conferences, immediately followed by parent/clinician surveys. Existing qualitative analysis frameworks were applied.Results:We analyzed 19 conferences. Most prognostic discussion targeted predicted infant functional needs, for example, medications or feeding. There was little discussion of how infant prognosis would affect infant/family quality of life. Prognostic framing was typically optimistic. Most parents left the conference believing their infant's prognosis to be more optimistic than did clinicians.Conclusions:Clinician approach to prognostic disclosure in these audiotaped family conferences tended to be broad and optimistic, without detail regarding implications of infant health for infant/family quality of life. Families and clinicians left these conversations with little consensus about infant prognosis.

Original languageEnglish (US)
Pages (from-to)1224-1229
Number of pages6
JournalJournal of Perinatology
Volume37
Issue number11
DOIs
StatePublished - Nov 1 2017

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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