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An Observational Study of Dialogue about Uncertainty in Clinician-Family Counseling Conversations Following Prenatal Diagnosis of Complex Congenital Heart Disease.
Harris, Kelly W; Schweiberger, Kelsey; Kavanaugh-McHugh, Ann; Arnold, Robert M; Merlin, Jessica; Chang, Judy C; Kasparian, Nadine A.
Afiliación
  • Harris KW; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Schweiberger K; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Kavanaugh-McHugh A; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Arnold RM; Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Merlin J; Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Chang JC; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Kasparian NA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
PEC Innov ; 4: 100265, 2024 Dec.
Article en En | MEDLINE | ID: mdl-38404930
ABSTRACT

Objective:

Families who receive a prenatal diagnosis of complex congenital heart disease (cCHD) often experience severe psychological distress and identify uncertainty as a key source of that distress. This study examined clinician-family conversations during initial fetal cardiology consultations to identify the topics of uncertainty discussed.

Methods:

In this observational, qualitative study, initial fetal cardiology consultations were audio-recorded, transcribed verbatim, and coded by two independent coders. A codebook was inductively and deductively developed and applied. This content analysis focused on uncertainty-related codes and associated themes.

Results:

During 19 consultations including five clinicians, 13 different cardiac diagnoses were discussed (seven with high mortality risk). Median consultation length was 37 min (IQR 26-51), with only 11% of words spoken by families. On average, 51% of total words spoken focused on uncertainty in relation to cardiac diagnosis, etiology, comorbidities, prognosis, childbirth, therapeutics, and logistics. Family-initiated discussion on uncertainty largely focused on childbirth and pregnancy and postpartum logistics.

Conclusions:

Half of dialogue within initial fetal cardiology encounters discussed uncertainty surrounding prenatally diagnosed cCHD. Parent and clinician perspectives should be gathered on the essential content and optimal delivery of uncertainty-related topics. Innovation This study is conceptually and methodologically innovative as one of the first to examine audio-recorded dialogue between fetal cardiology clinicians and families.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: PEC Innov Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: PEC Innov Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos