Differences in the perceptions of parents and healthcare professionals on pediatric intensive care practices

作者：Latour Jos M^*; van Goudoever Johannes B; Duivenvoorden Hugo J; Albers Marcel J I J; van Dam Nicolette A M; Dullaart Eugenie; van Heerde Marc; de Neef Marjorie; Verlaat Carin W M; van Vught Elise M; Hazelzet Jan A

来源：Pediatric Critical Care Medicine, 2011, 12(5): E211-E215.

DOI：10.1097/PCC.0b013e3181fe3193

• experiences
• family-centered care
• needs
• nurses
• physicians
• professional-family relations
• satisfaction

Objective: To explore similarities and differences in perceptions on pediatric intensive care practices between parents and staff by using data from two studies.
Design: A two-round Delphi method among nurses and physicians followed by an empiric survey among parents.
Settings: Pediatric intensive care units at eight university medical centers.
Subjects: Parents whose child has been admitted to a pediatric intensive care unit, nurses, and physicians.
Interventions: None.
Measurements and Main Results: Outcome measures were 74 satisfaction-with-care items divided into five domains: 1) information; 2) care and cure; 3) organization; 4) parental participation; and 5) professional attitude. The Delphi study was completed by 218 nurses and 46 physicians and the survey by 559 of 1042 (54%) parents. Parents rated 31 items more important than the professionals based on the standardized mean difference (Cohen's d, 0.21-1.18, p < .003). Ten of these were related to information provision. Information on the effects of medication had the largest effect size (Cohen's d 1.18, p = .001). Correct medication administration by professionals was also rated significantly more important by parents (Cohen's d 0.64, p = .001). The professionals rated 12 items more important than the parents (Cohen's d -0.23 to -0.73, p < .005), including three about multicultural care. Significant differences remained on two of the three multicultural care items when the Dutch (n = 483) and non-Dutch parents (n = 76) were separately compared with professionals. On the domain level, parents rated the domains information and parental participation more important than the professionals (Cohen's d 0.36 and 0.26, p = .001).
Conclusions: Compared with the parents' perceptions, nurses and physicians undervalued a substantial number of pediatric intensive care unit care items. This finding may reflect a gap in the understanding of parental experiences as well as incongruity in recognizing the needs of parents. (Pediatr Crit Care Med 2011; 12:e211-e215)

• 出版日期2011-9