Parent Experience of Communication about Children’s Surgery: A Qualitative Analysis

Abstract

Introduction: Parent experience is a core component of the quality of pediatric care and an increasingly common focus of quality improvement initiatives. However, the parent experience of communication in the pediatric surgical setting remains unexplored. Methods: We conducted semi-structured interviews with 20 parents of children undergoing surgery. Interviews were analyzed using directed qualitative content analysis. Results: Content analysis revealed 3 overarching themes. The theme of "provider-parent communication" included interpersonal behaviors and communication-originating skills of the surgeon. Parents valued surgeons incorporating multimodal information-sharing techniques, recognizing children's psychological needs, providing reassurance, engaging in teamwork, and including parents. The theme of "parental emotional experiences" included domains of parent worry, intimidation, offense, self-doubt, mistrust, and strength surrounding their child's surgery. Parents felt simultaneously responsible for their child's welfare and for understanding medical information. The theme of "process improvement" included preparation for surgery, efficiency, managing delays, anesthesia induction, emergence from anesthesia, privacy, and preparation for recovery. Conclusions: Themes identified through these parental narratives and proposed solutions inform quality improvement efforts related to surgeon communication strategies and facilitate family-centered surgical care for children. Parents often provided solutions after they described concerns, which attests to the utility of parent perspectives.

Parental Expression of Emotions and Surgeon Responses During Consultations for Obstructive Sleep-Disordered Breathing in Children

“…Moreover, this study was among the few that evaluated emotional communication between surgeons and parents. 44,45 Previous studies that used the VR-CoDES in pediatric populations have examined the language of pediatric patients themselves. 27,31 Because parents often serve as proxy decision-makers for pediatric patients, parent dialogue is important to analyze in the study of physician-patient communication.…”

“…To our knowledge, this is the first study to use the VR-CoDES to characterize emotional expressions and clinician responses in the surgical context. Moreover, this study was among the few that evaluated emotional communication between surgeons and parents . Previous studies that used the VR-CoDES in pediatric populations have examined the language of pediatric patients themselves .…”

The role of parental health and distress in assessing children’s health status

“…If, as recommended by some, differences between parent and child are not as biased or inaccurate in reporting by one or the other, but rather as a "quantifier of the gap" [12], including both could provide a more developed or comprehensive picture of the child's health. Exploring the nature of that gap during office visits, including parallel assessments of parental distress over the child's health, could have important implications for both effective clinical care for the child [2][3][4]16], for family-physician communication, for family-centered pediatric care [41,42], and for parents' health and well-being. Integration of measures of children's health-related quality of life, such as the CHRIS 2.0, and parent's health as additional "vital signs" in routine pediatric practice [43] could provide valuable and unique information for clinicians and researchers evaluating and tailoring treatment regimens and improving pediatric practice.…”