Trust of inpatient physicians among parents of children with medical complexity: a qualitative study.

Autor:	Dewan T; Department of Pediatrics, University of Calgary, Calgary, AB, Canada.; Section of Pediatric Hospital Medicine, Alberta Children's Hospital, Calgary, AB, Canada., Whiteley A; Department of Pediatrics, University of Calgary, Calgary, AB, Canada., MacKay LJ; School of Nursing, Trinity Western University, Langley, BC, Canada., Martens R; Canchild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.; Azrrieli Accelerator, University of Calgary, Calgary, AB, Canada., Noel M; Department of Psychology, University of Calgary, Calgary, AB, Canada., Barnard C; Department of Pediatrics, University of Calgary, Calgary, AB, Canada.; Section of Pediatric Hospital Medicine, Alberta Children's Hospital, Calgary, AB, Canada., Jordan I; Independent Researcher, Squamish, BC, Canada., Janvier A; Division of Neonatology, Research Center, Unité d'éthique Clinique, Bureau du Partenariat Patients-Familles-Soignants, CHU Sainte-Justine, Montréal, QC, Canada.; Department of Pediatrics, Bureau de l'éthique clinique (BEC), Université de Montréal, Montréal, QC, Canada., Thorne S; School of Nursing, University of British Columbia, Vancouver, BC, Canada.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2024 Sep 27; Vol. 12, pp. 1443869. Date of Electronic Publication: 2024 Sep 27 (Print Publication: 2024).
DOI:	10.3389/fped.2024.1443869
Abstrakt:	Background: Trust is a foundation of the therapeutic relationship and is associated with important patient outcomes. Building trust between parents of children with medical complexity (CMC) and physicians during inpatient care is complicated by lack of relational continuity, cumulative (sometimes negative) parent experiences and the need to adjust roles and expectations to accommodate parental expertise. This study's objective was to describe how parents of CMC conceptualize trust with physicians within the pediatric inpatient setting and to provide recommendations for building trust in these relationships. Methods: Interviews with 16 parents of CMC were completed and analyzed using interpretive description methodology. Results: The research team identified one overarching meta theme regarding factors that influence trust development: situational awareness is needed to inform personalized care of children and families. There were also six major themes: (1) ensuring that the focus is on the child and family, (2) respecting both parent and physician expertise, (3) collaborating effectively, (4) maintaining a flow of communication, (5) acknowledging the impact of personal attributes, and (6) recognizing issues related to the healthcare system. Discussion: Many elements that facilitated trust development were also components of patient- and family-centered care. Parents in this study approached trust with inpatient physicians as something that needs to be earned and reciprocated. To gain the trust of parents of CMC, inpatient physicians should personalize medical care to address the needs of each child and should explore the perceptions, expertise, and previous experiences of their parents. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Dewan, Whiteley, Mackay, Martens, Noel, Barnard, Jordan, Janvier and Thorne.)
Databáze:	MEDLINE
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