Trust of inpatient physicians among parents of children with medical complexity: a qualitative study.

hospital medical complexity parents patient- and family-centered care pediatrics physician relationship trust

Journal

Frontiers in pediatrics
ISSN: 2296-2360
Titre abrégé: Front Pediatr
Pays: Switzerland
ID NLM: 101615492

Informations de publication

Date de publication:
2024
Historique:
received: 04 06 2024
accepted: 30 08 2024
medline: 14 10 2024
pubmed: 14 10 2024
entrez: 14 10 2024
Statut: epublish

Résumé

Trust is a foundation of the therapeutic relationship and is associated with important patient outcomes. Building trust between parents of children with medical complexity (CMC) and physicians during inpatient care is complicated by lack of relational continuity, cumulative (sometimes negative) parent experiences and the need to adjust roles and expectations to accommodate parental expertise. This study's objective was to describe how parents of CMC conceptualize trust with physicians within the pediatric inpatient setting and to provide recommendations for building trust in these relationships. Interviews with 16 parents of CMC were completed and analyzed using interpretive description methodology. The research team identified one overarching meta theme regarding factors that influence trust development: situational awareness is needed to inform personalized care of children and families. There were also six major themes: (1) ensuring that the focus is on the child and family, (2) respecting both parent and physician expertise, (3) collaborating effectively, (4) maintaining a flow of communication, (5) acknowledging the impact of personal attributes, and (6) recognizing issues related to the healthcare system. Many elements that facilitated trust development were also components of patient- and family-centered care. Parents in this study approached trust with inpatient physicians as something that needs to be earned and reciprocated. To gain the trust of parents of CMC, inpatient physicians should personalize medical care to address the needs of each child and should explore the perceptions, expertise, and previous experiences of their parents.

Sections du résumé

Background UNASSIGNED
Trust is a foundation of the therapeutic relationship and is associated with important patient outcomes. Building trust between parents of children with medical complexity (CMC) and physicians during inpatient care is complicated by lack of relational continuity, cumulative (sometimes negative) parent experiences and the need to adjust roles and expectations to accommodate parental expertise. This study's objective was to describe how parents of CMC conceptualize trust with physicians within the pediatric inpatient setting and to provide recommendations for building trust in these relationships.
Methods UNASSIGNED
Interviews with 16 parents of CMC were completed and analyzed using interpretive description methodology.
Results UNASSIGNED
The research team identified one overarching meta theme regarding factors that influence trust development: situational awareness is needed to inform personalized care of children and families. There were also six major themes: (1) ensuring that the focus is on the child and family, (2) respecting both parent and physician expertise, (3) collaborating effectively, (4) maintaining a flow of communication, (5) acknowledging the impact of personal attributes, and (6) recognizing issues related to the healthcare system.
Discussion UNASSIGNED
Many elements that facilitated trust development were also components of patient- and family-centered care. Parents in this study approached trust with inpatient physicians as something that needs to be earned and reciprocated. To gain the trust of parents of CMC, inpatient physicians should personalize medical care to address the needs of each child and should explore the perceptions, expertise, and previous experiences of their parents.

Identifiants

pubmed: 39398419
doi: 10.3389/fped.2024.1443869
pmc: PMC11466756
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1443869

Informations de copyright

© 2024 Dewan, Whiteley, Mackay, Martens, Noel, Barnard, Jordan, Janvier and Thorne.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Auteurs

Tammie Dewan (T)

Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
Section of Pediatric Hospital Medicine, Alberta Children's Hospital, Calgary, AB, Canada.

Andrea Whiteley (A)

Department of Pediatrics, University of Calgary, Calgary, AB, Canada.

Lyndsay Jerusha MacKay (LJ)

School of Nursing, Trinity Western University, Langley, BC, Canada.

Rachel Martens (R)

Canchild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.
Azrrieli Accelerator, University of Calgary, Calgary, AB, Canada.

Melanie Noel (M)

Department of Psychology, University of Calgary, Calgary, AB, Canada.

Chantelle Barnard (C)

Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
Section of Pediatric Hospital Medicine, Alberta Children's Hospital, Calgary, AB, Canada.

Isabel Jordan (I)

Independent Researcher, Squamish, BC, Canada.

Anne Janvier (A)

Division of Neonatology, Research Center, Unité d'éthique Clinique, Bureau du Partenariat Patients-Familles-Soignants, CHU Sainte-Justine, Montréal, QC, Canada.
Department of Pediatrics, Bureau de l'éthique clinique (BEC), Université de Montréal, Montréal, QC, Canada.

Sally Thorne (S)

School of Nursing, University of British Columbia, Vancouver, BC, Canada.

Classifications MeSH