Accounting for medical communication: Parents’ perceptions of communicative roles and responsibilities in the pediatric intensive care unit

Authors

  • Cynthia Gordon Syracuse University, Syracuse, NY, USA
  • Ellen Barton Wayne State University
  • Kathleen L. Meert Children's Hospital of Michigan
  • Susan Eggly Karmans Cancer Institute, Detroit
  • Murray Pollack Phoenix Children's Hospital, Phoenix
  • Jerry Zimmerman Children’s Hospital & Regional Medical Center, Seattle
  • K. J.S. Anand Arkansas Children’s Hospital, Little Rock
  • Joseph Carcillo Children’s Hospital of Pittsburgh, Pittsburgh
  • Christopher J.L. Newth Children’s Hospital Los Angeles, Los Angeles
  • J. Michael Dean University of Utah
  • Douglas F. Willson University of Virginia Children’s Hospital, Charlottesville
  • Carol Nicholson National Institute of Child Health and Human Development, Bethesda

DOI:

https://doi.org/10.1558/cam.v6i2.177

Keywords:

doctor-patient interaction, team communication, roles and responsibilities, parents’ perceptions, end-of-life, bereavement, discourse analysis

Abstract

Through discourse analysis of transcribed interviews conducted over the phone with parents whose child died in the Pediatric Intensive Care Unit (PICU) (n = 51), this study uncovers parents’ perceptions of clinicians’ and their own communicative roles and responsibilities in the context of team-based care. We examine parents’ descriptions and narratives of communicative experiences they had with PICU clinicians, focusing on how parents use accounts to evaluate the communicative behaviors they report (n = 47). Findings indicate that parental perceptions of communicative responsibilities are more nuanced than assumed in previous research: Parents identified their own responsibilities as participating as part of the team of care, gathering information, interacting with appropriate affect, and working to understand complex and uncertain medical information. Complementarily, parents identified clinician responsibilities as communicating professionally, providing medical information clearly, managing parents’ hope responsibly, and communicating with appropriate affect. Through the accounts they provide, parents evaluate both parental and clinician role-responsibilities as fulfilled and unfulfilled. Clinicians’ management of prognostic uncertainty and parents’ struggles to understand that uncertainty emerged as key, complementary themes with practical implications for incorporating parents into the PICU care team. The study also highlights insights retrospective interview data bring to the examination of medical communication.

Author Biographies

  • Cynthia Gordon, Syracuse University, Syracuse, NY, USA
    Syracuse University, Syracuse, NY, USA
  • Ellen Barton, Wayne State University
    Ellen Barton, PhD is a Professor in the Linguistics Program at Wayne State University. Her research interests in medical communication include end-of-life discussions, recruitment to clinical research, and the investigation of ethics-in-interaction.
  • Kathleen L. Meert, Children's Hospital of Michigan
    Kathleen Meert, MD is a Professor of Pediatrics at Wayne State University and a practising pediatric intensive care physician at Children’s Hospital of Michigan. Her research interests include end-of life care for children and bereavement care for families.
  • Susan Eggly, Karmans Cancer Institute, Detroit
    Susan Eggly, PhD is an Assistant Professor in the Communication and Behavioral Oncology Program at Karmanos Cancer Institute, Wayne State University. Her research interests include physician-patient communication and end-of-life care in pediatric and adult settings.
  • Murray Pollack, Phoenix Children's Hospital, Phoenix
    Murray Pollack has an interest in medical communication and is a member of the NICHD CPCCRN.
  • Jerry Zimmerman, Children’s Hospital & Regional Medical Center, Seattle
    Jerry Zimmerman has an interest in medical communication and is a member of the NICHD CPCCRN.
  • K. J.S. Anand, Arkansas Children’s Hospital, Little Rock
    K.J.S. Anand has an interest in medical communication and is a member of the NICHD CPCCRN
  • Joseph Carcillo, Children’s Hospital of Pittsburgh, Pittsburgh
    Joseph Carcillo has an interest in medical communication and is a member of the NICHD CPCCRN
  • Christopher J.L. Newth, Children’s Hospital Los Angeles, Los Angeles
    Christopher J.L. Newth has an interest in medical communication and is a member of the NICHD CPCCRN
  • J. Michael Dean, University of Utah
    J. Michael Dean has an interest in medical communication and is a member of the NICHD CPCCRN
  • Douglas F. Willson, University of Virginia Children’s Hospital, Charlottesville
    Douglas F. Willson has an interest in medical communication and is a member of the NICHD CPCCRN
  • Carol Nicholson, National Institute of Child Health and Human Development, Bethesda
    Carol Nicholson has an interest in medical communication and is a member of the NICHD CPCCRN

Published

2010-01-20

Issue

Section

Articles

How to Cite

Gordon, C., Barton, E., Meert, K. L., Eggly, S., Pollack, M., Zimmerman, J., Anand, K. J., Carcillo, J., Newth, C. J., Dean, J. M., Willson, D. F., & Nicholson, C. (2010). Accounting for medical communication: Parents’ perceptions of communicative roles and responsibilities in the pediatric intensive care unit. Communication and Medicine, 6(2), 177-188. https://doi.org/10.1558/cam.v6i2.177