Pediatric Early Warning Systems (PEWS) improve provider-family communication from the provider perspective in pediatric cancer patients experiencing clinical deterioration.

Autor: Gillipelli SR; Baylor College of Medicine, Houston, Texas, USA.; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Kaye EC; Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Garza M; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Ferrara G; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Rodriguez M; Department of Oncology, Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala., Soberanis Vasquez DJ; Department of Nursing, Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala., Mendez Aceituno A; Department of Critical Care, Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala., Antillón-Klussmann F; Department of Oncology, Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala.; School of Medicine, Francisco Marroquin University, Guatemala City, Guatemala., Gattuso JS; Department of Nursing Research, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Mandrell BN; Department of Nursing Research, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Baker JN; Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Rodriguez-Galindo C; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Agulnik A; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Graetz DE; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Feb; Vol. 12 (3), pp. 3634-3643. Date of Electronic Publication: 2022 Sep 21.
DOI: 10.1002/cam4.5210
Abstrakt: Background: Communication between providers and patients' families is an integral part of clinical care. Family concern is a validated component of Pediatric Early Warning Systems (PEWS); however, little is known about the impact of PEWS on provider-family communication.
Methods: Semi-structured interviews were conducted with 83 ward and Pediatric Intensive Care Unit (PICU) providers involved in the care of patients with deterioration at two pediatric oncology hospitals of different resource levels: St. Jude Children's Research Hospital (n = 42) in the United States and Unidad Nacional de Oncología Pediátrica (UNOP, n = 41) in Guatemala. Interviews were conducted in the participants' native language (English or Spanish), transcribed, and translated into English. Transcripts were coded by two researchers and analyzed for thematic content surrounding family communication and concern.
Results: All participants recognized patients' families as a valuable part of the care team, particularly during events requiring escalation of care. Perceived barriers to communication included limited time spent at the bedside, and, at UNOP, language and literacy challenges which occasionally limited providers' ability to assess family concern and involve families in patient care. Despite these barriers, providers perceived PEWS improved communication by facilitating more interaction with families, allowing for relationship-building, anticipatory guidance, and destigmatization of the PICU. PEWS assessments also allowed families to contribute to identification of deterioration.
Conclusions: PEWS improve the quality of communication between providers and families by providing more opportunities for interaction, building relationships, and trust. These findings further support the use of PEWS in the care of children with cancer in hospitals of all resource-levels.
(© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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