Strengths and weaknesses of parent–staff communication in the NICU: a survey assessment

Abstract

BackgroundParents of infants hospitalized in the neonatal intensive care unit (NICU) find themselves in a situation of emotional strain. Communication in the NICU presents special challenges due to parental stress and the complexity of the highly technologized environment. Parents’ need for communication may not always be met by the NICU staff. This study aimed to describe strengths and weaknesses of parent–nurse and parent–doctor communication in a large level III NICU in Sweden in order to improve our understanding of parents’ communication needs.MethodsParents were asked to complete a survey consisting of sixteen questions about their experiences of communication with nurses and doctors in the NICU. In each question the parents evaluated some aspect of communication on a five- or six-point Likert scale. They also had the opportunity on each question to comment on their experiences in their own words. Data were analyzed using IBM SPSS Statistics 20.0 and qualitative manifest content analysis.Results270 parents (71.4%) completed the survey. Parents generally rated communication with the staff in the NICU positively and appreciated having received emotional support and regular information about their child´s care. Although a large majority of the parents were satisfied with their communication with doctors and nurses, only about half of the parents felt the nurses and doctors understood their emotional situation very well. Some parents would have desired easier access to conversations with doctors and wanted medical information to be given directly by doctors rather than by nurses. Parents’ communication with the staff was hampered when many different nurses were involved in caring for the infant or when the transfer of information in connection with shift changes or between the maternity ward and NICU was poor. Parents also desired to be present during doctors’ rounds on their infant.ConclusionsTraining both doctors and nurses in communication skills, especially in how to meet parents’ emotional needs better, could make communication at the NICU more effective and improve parental well-being. Creating a framework for the parents of what to expect from NICU communication might also be helpful. In addition, our results support the use of primary nurse teams to improve continuity of care and thereby promote successful communication.

Vision-related quality of life in children with retinopathy of prematurity

“…Consequently, the bond between the physician and the family may be constructed and strengthened because of greater confidence. Previous studies have highlighted the problems of communication between patients' families and health professionals as a result of the use of technical language (19,(24)(25)(26)(27)(28) . According to Holditch-Davis et al (29) , the stress experienced by mothers when confronted by child prematurity can be aggravated by low education levels and socioeconomic status.…”

The Role of Multidisciplinary Teams: A Focus on Communicating Bad News

“…In addition, parents' rate information provided by medical and special education practitioners as the most important sources of information, which was confirmed by research conducted by Potměšil and Pospisil [4]. Wigert et al [5] and Orioles [6] research studies focus on the communications by staff of neonatology departments and parents, and define areas of communication skills such as empathic, informative and communicative behaviours that need to be improved. The studies yielded eleven parameters that parents considered critical for acceptable communication: Empathy, availability, individual access to the child, respect for parents' knowledge about the child, leaving room for hope, body language, diligence, care above and beyond professional duty, responsibility, willingness to listen to questions, and sensitivity to the child's suffering.…”

“…In this context, it is in our view necessary to increase the trans-disciplinary level of care and services. Orioles et al [6] as well as Wigert [5] illustrate the results of a sample of 270 parents with the same requirements.…”

Dimensões qualificadoras para a comunicação de notícias difíceis na unidade de terapia intensiva neonatal Dimensions qualifying for communication of difficult news in neonatal intensive care unit

“…9 In addition to the unfamiliar environment, mothers and other family members become dependent professionals to be able to handle the situation and to become familiar with the condition and the child's care. Therefore, the communication between mothers, families and professionals is an essential dimension of care in neonatal intensive care units.…”