Improving Care through Better Communication: Continuing the Debate

Damm, Lilly; Leiss, Ulrike; Habeler, Ulrike; Ehrich, J. H. H.

doi:10.1016/j.jpeds.2015.05.040

Cited by 15 publications

(12 citation statements)

References 13 publications

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“…Shared decision-making is a cornerstone of patient-centered care and improves patient knowledge, satisfaction, adherence, and outcomes (1)(2)(3)(4)(5). However, this process is particularly challenging in pediatrics because of the dynamic and complex relationship triad that encompasses the autonomy of the patient, legal authority of the parent, and the beneficence and clinical acumen of the physician (1,2,(6)(7)(8)(9). This complexity is compounded by the constantly changing nature of these relationships as the child matures.…”

Section: Introductionmentioning

confidence: 99%

Child and Parental Perspectives on Communication and Decision Making in Pediatric CKD: A Focus Group Study

Gutman

Hanson

Bernays

et al. 2018

American Journal of Kidney Diseases

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Parents value partnership with clinicians and consider long-term and quality-of-life implications of their child's illness. Children with CKD want more involvement in treatment decision making but are limited by vulnerability, fear, and uncertainty. There is a need to support the child to better enable him or her to become a partner in decision making and prepare him or her for adulthood. Collaborative and informed decision making that addresses the priorities and concerns of both children and parents is needed.

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Section: Introductionmentioning

confidence: 99%

Child and Parental Perspectives on Communication and Decision Making in Pediatric CKD: A Focus Group Study

Gutman

Hanson

Bernays

et al. 2018

American Journal of Kidney Diseases

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“…To potentially modify parental attitudes when there is initial resistance or reluctance from parents to participate in Asthma Link™, we can incorporate established evidence‐based strategies of speaking to parents in the refined program protocol. These include using simple, nonmedical jargon, eliminating technology to allow for face to face conversation, building trust and rapport by giving the parent space to voice their concerns and perspectives, being sensitive to emotional needs often through nonverbal cues, and stressing the quality of life for both the parent and the child …”

Section: Discussionmentioning

confidence: 99%

“…These include using simple, nonmedical jargon, eliminating technology to allow for face to face conversation, building trust and rapport by giving the parent space to voice their concerns and perspectives, being sensitive to emotional needs often through nonverbal cues, and stressing the quality of life for both the parent and the child. [23][24][25][26] All participants were motivated by the positive impacts seen on the childʼs health. The majority of patients, parents, nurses, and pediatric providers perceived that Asthma Link™ decreased rescue medication use, emergency room visits, and hospital admissions, consistent with the results from our pilot study, and also reported improved attendance, physical activity, and academic performance.…”

Section: Ssmentioning

confidence: 99%

Alignment of stakeholder agendas to facilitate the adoption of school‐supervised asthma therapy

Trivedi

Patel

Hoque

et al. 2019

Pediatric Pulmonology

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Background School‐supervised inhaled corticosteroid (ICS) therapy improves pediatric asthma medication adherence, outcomes, and morbidity. However, school‐supervised ICS therapy has not been widely adopted into practice. We developed Asthma Link™ as a sustainable, low‐cost model of school‐supervised asthma therapy, designed for real‐world adoption. Initial outcomes of Asthma Link™ demonstrated a significant improvement in health outcomes. Objective In this study, we examined the perspectives of Asthma Link™ participants to identify systems‐level barriers and facilitators to refine the Asthma Link™ protocol and facilitate real‐world uptake of school‐supervised asthma therapy. Methods Using qualitative research methods, we interviewed 29 participants in Asthma Link™ from 2016 to 2018. Semi‐structured interviews were conducted over the phone. Interviews were transcribed and the transcripts were coded to identify major themes within and across stakeholder groups. Results Stakeholders agreed on many facilitators for successful Asthma Link™ execution including the brief and easy to follow procedures and the perceived beneficial health impacts for children involved. Some of the barriers identified were deviations from the protocol and insurance companies denying coverage for two inhalers. However, the participants did propose solutions to address these barriers. Conclusion Asthma Link™ is a low‐cost, sustainable model of school‐supervised asthma therapy that leverages the established infrastructure and collaboration of medical providers, school staff, and families. In this study, we elicited the perspectives from these stakeholder groups and identified an agreement in several facilitators, barriers, and proposed solutions that will ultimately inform refinement of the program protocol and support real‐world adoption of Asthma Link™ and other similar models.

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“… 3 4 In paediatrics, communication can be especially challenging because of the patient–parent–physician triad that is present at almost every consultation. 5 6 Moreover, the way bad news is delivered can influence subsequent patient–parent–physician interactions and the parents’ perception, coping capability and acceptance of the disease as well as affect patient outcomes. 3 5 7 8 Not a lot of literature exists regarding communication between physician and paediatric patients as the child’s opinion regarding his doctor’s communication skills is less reliable and harder to evaluate with a validated tool.…”

Section: Introductionmentioning

confidence: 99%

Evaluating communication with parents in paediatric patient encounters: a systematic review protocol

et al. 2021

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IntroductionBreaking bad news and dealing with difficult patient encounters is a skill that medical residents must learn during their curriculum. Many different tools are available to measure communication quality, but their development and validation processes are often missing. In this paper, we present the protocol of a systematic review aiming to identify the validated tools for measuring communication skills or communication effectiveness with parents in a paediatrics setting in general, including for difficult patient encounters.Methods and analysisWe will conduct our systematic review in accordance with the methodology suggested by COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and will report this paper following the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses. We will include the studies in which authors developed and/or validated tools for assessing the quality of communication with families by residents and/or physicians during patient encounters in paediatric settings. Studies assessing communication in telemedicine and studies that use the tool to measure a different outcome than its validation will be excluded. Our search strategy will be developed by a scientific librarian and validated using the Peer Review of Electronic Search Strategy (PRESS) tool. Two reviewers will independently screen the studies for selection, extract data of the ones included and assess their level of risk of bias using the COSMIN Risk of Bias checklist. We will perform a narrative synthesis on the study selection process, the characteristics of studies and study population, the characteristics of tools identified, their process of development and/or validation and their psychometric properties. If sufficient data are available, we will do quantitative analyses for each psychometric property.Ethics and disseminationApproval from an ethics committee is not required, as there is no primary data collection. Our findings will be disseminated through a peer-reviewed publication and at local, national and international conferences.PROSPERO registration numberCRD42020151642.

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Improving Care through Better Communication: Continuing the Debate

Cited by 15 publications

References 13 publications

Child and Parental Perspectives on Communication and Decision Making in Pediatric CKD: A Focus Group Study

Child and Parental Perspectives on Communication and Decision Making in Pediatric CKD: A Focus Group Study

Alignment of stakeholder agendas to facilitate the adoption of school‐supervised asthma therapy

Evaluating communication with parents in paediatric patient encounters: a systematic review protocol

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