A protocol for seriously ill children with severe psychosocial symptoms: Avoiding potential disasters.

Simms, Steven

doi:10.1037/h0089080

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…(12,15) The results of this study suggest an association between difficult patients and/or families and distancing behaviors in nurses and physicians. Further exploration of these interactions is needed to also understand how team conflict and communication among health care team members affect physician and nurse engagement with patients/families.…”

Section: Discussionmentioning

confidence: 65%

“…(1,3,12) In an academic hospital, like the one in this study, there are two potential explanations for the breakdown in communication. First, as is common in most academic hospitals, attending physicians and fellows frequently rotate on and off service, while nurses continue to provide ongoing care to patients.…”

Section: Discussionmentioning

confidence: 97%

“…One potential intervention, a “difficult family protocol,” has been proposed for those working with pediatric complex care patients. (12) This protocol focuses on the need to recognize three players in a pediatric patient’s care: the child, the family, and the health care team. Another potential solution may be the use of physician hospitalists who would devote more time to the inpatient unit and provide greater continuity of care for patients.…”

Section: Discussionmentioning

confidence: 99%

“…(12) However, when the child is a complex care patient the medical and psychosocial variables involved with the child’s care can contribute to tensions and conflicts in both the relationship between the family and staff, as well as the relationship among health care team members. When such conflicts intensify staff responses vary.…”

Section: Introductionmentioning

confidence: 99%

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Staff engagement during complex pediatric medical care: The role of patient, family, and treatment variables

Meltzer

Steinmiller

Simms

et al. 2009

Patient Education and Counseling

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Objective-To examine the role of patient, family, and treatment variables on self-reported engagement for physicians and nurses working with pediatric complex care patients.Methods-Sixty-eight physicians and 85 registered nurses at a children's hospital reviewed eight case scenarios that varied by the patient and patient's family (each cooperative vs. difficult) and the length of hospitalization (<30 vs. >30 days). Participants rated their engagement from highly engaged/responsive to distancing/disconnected behaviors.Results-Nurses were more likely than physicians to engage in situations with a difficult patient/ cooperative family but less likely to engage in situations with a cooperative patient/difficult family. Nurses were more likely to consult a colleague regarding the care of a difficult patient/difficult family, while physicians were more likely to refer a difficult patient/difficult family to a psychosocial professional.Conclusions-Differences were found for engagement with "difficult" patients/families, with physicians more likely to distance themselves or refer to a psychosocial professional, while nurses were more likely to consult with a colleague.Practice Implications-Communication between health care team members is essential for optimal family centered health care. Thus, interventions are needed that focus on communication and support for health care teams working with pediatric complex care patients and their families.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Staff engagement during complex pediatric medical care: The role of patient, family, and treatment variables

Meltzer

Steinmiller

Simms

et al. 2009

Patient Education and Counseling

View full text Add to dashboard Cite

show abstract

“…A developmental framework guides the CCCT and involves some basic tenets: (a) the patient/family is often isolated and alone and it is the job of caregivers to find a way to reach out to them and reconnect; (b) the patient/family are more competent than they appear, and caregivers need to find an avenue to help patients/families become more competent both medically and psychosocially; and (c) caregivers must find a way to manage their frustrations with the patient/family and each other to be effective (Simms, 1995). The purpose of the CCCT is to coordinate the efforts of all members of a patient's healthcare team and to identify the major problems in working with a patient with a complex medical and psychosocial history.…”

Section: Consultation With the Complex Care Consultation Teammentioning

confidence: 99%