Neonatologists can impede or support parents’ participation in decision‐making during medical rounds in neonatal intensive care units

Abstract

The neonatologists played a central role in facilitating parental participation and their interaction during medical rounds were characterised by the level of parent participation in decision-making.

Parents' and nurses' experiences of partnership in neonatal intensive care units: A qualitative review and meta‐synthesis

“…This, in turn, facilitates parents' participation in caregiving at their own pace, and promotes their empowerment and autonomy, resulting in parents experiencing acknowledgement of their personal situation (Brødsgaard et al, ; Fegran et al, ). This is fundamental for realising shared decision‐making between parents and healthcare professionals (Axelin, Outinen, Lainema, Lehtonen, & Franck, ; Hoffmann, Montori, & Del Mar, ). It is important, however, that collaboration and care plans are documented to guide different nurses in their daily work with the family, creating consistency and supporting parent trust.…”

“…Communication that integrates parents' personal values and preferences is central to reach a shared understanding and decision‐making (Axelin et al, ; Weis, Zoffmann, & Egerod, ). Nurses may think they know what the parents want to say (Weis et al, ), but studies have shown discrepancies between the support provided by the nurses and the parents' actual perceptions and needs (Fegran et al, ; Franck & Axelin, ).…”

“…Conversely, through effective person‐centred communication, parents are listened to and their views are respected. This has been described as reciprocal communication, where the first word is given to the parents, asking for their experiences and observations (Axelin et al, ). The professionals listen actively and confirm their understanding of the parents' account (Axelin et al, ; Weis et al, ).…”

Conditions for communication between health care professionals and parents on a neonatal ward in the presence of language barriers

“…Physicians can support parental participation in decision making during medical rounds by asking the parents how they view their child's condition. The parents are able to express how their child is doing, and the neonatologist can express agreement and understanding both verbally and through non-verbal communication such as nodding and smiling (Axelin, Outinen, Lainema, Lehtonen, & Franck, 2018). One study showed that parents who were allowed to participate in the medical round, and were given the opportunity to take decisions concerning their child, felt that they were closer to their child (Treherne, Feeley, Charbonneau, & Axelin, 2017).…”

Highlights in this issue

“…Axelin et al. observed the parents of 11 singletons and four sets of twins and how they interacted with two neonatologists during 15 medical rounds in a neonatal intensive care unit in Turku, Finland. They found that neonatologists played a central role in facilitating the level of parental participation and that their interaction affected how the parents participated in decision‐making in both positive and negative ways.…”