
Assessment of parent understanding in conferences for critically ill neonates.
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.
Duke Scholars
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Related Subject Headings
- Public Health
- Professional-Family Relations
- Parents
- Infant, Newborn
- Infant
- Humans
- Critical Illness
- Communication
- 4203 Health services and systems
- 17 Psychology and Cognitive Sciences
Citation

Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Public Health
- Professional-Family Relations
- Parents
- Infant, Newborn
- Infant
- Humans
- Critical Illness
- Communication
- 4203 Health services and systems
- 17 Psychology and Cognitive Sciences