Assessment of parent understanding in conferences for critically ill neonates.

Conference Paper

OBJECTIVES: This study aimed to characterize the use and impact of assessments of understanding in parent-clinician communication for critically ill infants. METHODS: We enrolled parents and clinicians participating in family conferences for infants with neurologic conditions. Family conferences were audio recorded as they occurred. We used a directed content analysis approach to identify clinician assessments of understanding and parent responses to those assessments. Assessments were classified based on an adapted framework; responses were characterized as "absent," "yes/no," or "elaborated." RESULTS: Fifty conferences involving the care of 25 infants were analyzed; these contained 374 distinct assessments of understanding. Most (n = 209/374, 56%) assessments were partial (i.e. okay?); a minority (n = 60/374, 16%) were open-ended. When clinicians asked open-ended questions, parents elaborated in their answers most of the time (n = 55/60, 92%). Approximately three-quarter of partial assessments yielded no verbal response from parents. No conferences included a teach-back. CONCLUSIONS: Although common, most clinician assessments of understanding were partial or close-ended and rarely resulted in elaborated responses from parents. Open-ended assessments are an effective, underutilized strategy to increase parent engagement and clinician awareness of information needs. PRACTICE IMPLICATIONS: Clinicians hoping to facilitate parent engagement and question-asking should rely on open-ended statements to assess understanding.

Full Text

Duke Authors

Cited Authors

  • Barks, MC; Schindler, EA; Ubel, PA; Jiao, MG; Pollak, KI; Huffstetler, HE; Lemmon, ME

Published Date

  • March 2022

Published In

Volume / Issue

  • 105 / 3

Start / End Page

  • 599 - 605

PubMed ID

  • 34130892

Pubmed Central ID

  • PMC8664893

Electronic International Standard Serial Number (EISSN)

  • 1873-5134

Digital Object Identifier (DOI)

  • 10.1016/j.pec.2021.06.013

Conference Location

  • Ireland