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

Publication ,  Journal Article
Boss, RD; Lemmon, ME; Arnold, RM; Donohue, PK
Published in: J Perinatol
November 2017

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.

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Published In

J Perinatol

DOI

EISSN

1476-5543

Publication Date

November 2017

Volume

37

Issue

11

Start / End Page

1224 / 1229

Location

United States

Related Subject Headings

  • Video Recording
  • Truth Disclosure
  • Quality of Life
  • Qualitative Research
  • Prognosis
  • Professional-Family Relations
  • Perception
  • Pediatrics
  • Parents
  • Male
 

Citation

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Boss, R. D., Lemmon, M. E., Arnold, R. M., & Donohue, P. K. (2017). Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors. J Perinatol, 37(11), 1224–1229. https://doi.org/10.1038/jp.2017.118
Boss, R. D., M. E. Lemmon, R. M. Arnold, and P. K. Donohue. “Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors.J Perinatol 37, no. 11 (November 2017): 1224–29. https://doi.org/10.1038/jp.2017.118.
Boss RD, Lemmon ME, Arnold RM, Donohue PK. Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors. J Perinatol. 2017 Nov;37(11):1224–9.
Boss, R. D., et al. “Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors.J Perinatol, vol. 37, no. 11, Nov. 2017, pp. 1224–29. Pubmed, doi:10.1038/jp.2017.118.
Boss RD, Lemmon ME, Arnold RM, Donohue PK. Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors. J Perinatol. 2017 Nov;37(11):1224–1229.

Published In

J Perinatol

DOI

EISSN

1476-5543

Publication Date

November 2017

Volume

37

Issue

11

Start / End Page

1224 / 1229

Location

United States

Related Subject Headings

  • Video Recording
  • Truth Disclosure
  • Quality of Life
  • Qualitative Research
  • Prognosis
  • Professional-Family Relations
  • Perception
  • Pediatrics
  • Parents
  • Male