TY - JOUR
T1 - Parent Satisfaction with Communication Is Associated with Physician's Patient-Centered Communication Patterns during Family Conferences
AU - October, Tessie W.
AU - Hinds, Pamela S.
AU - Wang, Jichuan
AU - Dizon, Zoelle B.
AU - Cheng, Yao I.
AU - Roter, Debra L.
N1 - Publisher Copyright:
Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Objectives: To evaluate the association between physician's patient-centered communication patterns and parental satisfaction during decision-making family conferences in the PICU. Design: Single-site, cross-sectional study. Setting: Forty-four-bed PICUs in a free-standing children's hospital. Participants: Sixty-seven English-speaking parents of 39 children who participated in an audiorecorded family conference with 11 critical care attending physicians. Measurements and Main Results: Thirty-nine family conferences were audiorecorded. Sixty-seven of 77 (92%) eligible parents were enrolled. The conference recordings were coded using the Roter Interaction Analysis System and a Roter Interaction Analysis System-based patient-centeredness score, which quantitatively evaluates the conversations for physician verbal dominance and discussion of psychosocial elements, such as a family's goals and preferences. Higher patient-centeredness scores reflect higher proportionate dialogue focused on psychosocial, lifestyle, and socioemotional topics relative to medically focused talk. Parents completed satisfaction surveys within 24 hours of the conference. Conferences averaged 45 minutes in length (sd, 19 min), during which the medical team contributed 73% of the dialogue compared with parental contribution of 27%. Physicians dominated the medical team, contributing 89% of the team contribution to the dialogue. The majority of physician speech was medically focused (79%). A patient-centeredness score more than 0.75 predicted parental satisfaction (β = 12.05; p < 0.0001), controlling for the length of conference, child severity of illness, parent race, and socioeconomic status. Parent satisfaction was negatively influenced by severity of illness of the patient (β = -4.34; p = 0.0003), controlling for previously mentioned factors in the model. Conclusions: Parent-physician interactions with more patient-centered elements, such as increased proportions of empathetic statements, question asking, and emotional talk, positively influence parent satisfaction despite the child's severity of illness.
AB - Objectives: To evaluate the association between physician's patient-centered communication patterns and parental satisfaction during decision-making family conferences in the PICU. Design: Single-site, cross-sectional study. Setting: Forty-four-bed PICUs in a free-standing children's hospital. Participants: Sixty-seven English-speaking parents of 39 children who participated in an audiorecorded family conference with 11 critical care attending physicians. Measurements and Main Results: Thirty-nine family conferences were audiorecorded. Sixty-seven of 77 (92%) eligible parents were enrolled. The conference recordings were coded using the Roter Interaction Analysis System and a Roter Interaction Analysis System-based patient-centeredness score, which quantitatively evaluates the conversations for physician verbal dominance and discussion of psychosocial elements, such as a family's goals and preferences. Higher patient-centeredness scores reflect higher proportionate dialogue focused on psychosocial, lifestyle, and socioemotional topics relative to medically focused talk. Parents completed satisfaction surveys within 24 hours of the conference. Conferences averaged 45 minutes in length (sd, 19 min), during which the medical team contributed 73% of the dialogue compared with parental contribution of 27%. Physicians dominated the medical team, contributing 89% of the team contribution to the dialogue. The majority of physician speech was medically focused (79%). A patient-centeredness score more than 0.75 predicted parental satisfaction (β = 12.05; p < 0.0001), controlling for the length of conference, child severity of illness, parent race, and socioeconomic status. Parent satisfaction was negatively influenced by severity of illness of the patient (β = -4.34; p = 0.0003), controlling for previously mentioned factors in the model. Conclusions: Parent-physician interactions with more patient-centered elements, such as increased proportions of empathetic statements, question asking, and emotional talk, positively influence parent satisfaction despite the child's severity of illness.
KW - clinical conference
KW - communication barriers
KW - critical care
KW - decision making
KW - patient-centered care
KW - pediatric
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U2 - 10.1097/PCC.0000000000000719
DO - 10.1097/PCC.0000000000000719
M3 - Article
C2 - 27058750
AN - SCOPUS:84964037881
SN - 1529-7535
VL - 17
SP - 490
EP - 497
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 6
ER -