Parental involvement in neonatal critical care decision-making

Bibliographic Data

ID2249157
AuthorsChloë Shaw (0000-0002-4496-9011, Department of Neonatology University College London UK, corresponding author), E Stokoe (0000-0002-7353-4121, Loughborough University), Katie Gallagher (0000-0002-6847-9594, Department of Neonatology University College London UK), Narendra Aladangady (0000-0001-9140-4278, Department of Neonatology Homerton University Hospital London UK), Neil Marlow (0000-0001-5890-2953, Department of Neonatology University College London UK)
Year2016
Volume38
Issue8
Pages1217-1242
Publication date2016-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12455
PMID27666147
OpenAlexW2465119400
LanguageIT
Citations received14
References cited53

The article analyses the decision-making process between doctors and parents of babies in neonatal intensive care. In particular, it focuses on cases in which the decision concerns the redirection of care from full intensive care to palliative care at the end of life. Thirty one families were recruited from a neonatal intensive care unit in England and their formal interactions with the doctor recorded. The conversations were transcribed and analysed using conversation analysis. Analysis focused on sequences in which decisions about the redirection of care were initiated and progressed. Two distinct communicative approaches to decision-making were used by doctors: 'making recommendations' and 'providing options'. Different trajectories for parental involvement in decision-making were afforded by each design, as well as differences in terms of the alignments, or conflicts, between doctors and parents. 'Making recommendations' led to misalignment and reduced opportunities for questions and collaboration; 'providing options' led to an aligned approach with opportunities for questions and fuller participation in the decision-making process. The findings are discussed in the context of clinical uncertainty, moral responsibility and the implications for medical communication training and guidance.A Virtual Abstract of this paper can be accessed at:https://www.youtube.com/watch?v=MyuymxDNupk&feature=youtu.be

Business · Clinical decision making · Context (archaeology · Conversation · Conversation analysis · Decision-making · Family medicine · Intensive care · Making-of · Neonatal intensive care unit · Operations management · Palliative care · Process (computing · Communication · Computer Science · Engineering · Ethics and Legal Issues in Pediatric Healthcare · Family and Patient Care in Intensive Care Units · Medicine · Nursing · Patient-Provider Communication in Healthcare · Psychology