Qualitative study of the clinician–parent interface in discussing prognosis following MRI and US imaging of preterm infants in the UK

Harvey, M.E. and Redshaw, M.E. (2016) Qualitative study of the clinician–parent interface in discussing prognosis following MRI and US imaging of preterm infants in the UK. BMJ Open, 6 (9). e011472. ISSN 2044-6055

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Abstract

Objective: To explore communication and interaction
between parents and clinicians following neonatal
ultrasound (US) and MRI of the brain of babies born
preterm.
Setting: This qualitative study was undertaken as part
of a larger UK study of neonatal brain imaging. 511
infants were cared for in 14 London neonatal units
with MR and cerebral US imaging in a specialist
centre.
Participants: Parents with infants born at <33 weeks
gestation were randomised to receive prognostic
information based on either MRI or US findings on
their infants at term-corrected age.
Methods: Discussions between parents and clinicians
about the MRI or US result were audio recorded.
Parents were told about the findings and their baby’s
predicted outcome. A topic guide ensured essential
aspects were covered. Recordings were fully
transcribed. Discussion of the scan results, the
content and style of the interaction and parental
response were analysed qualitatively in 36 recordings
using NVivo V.10.
Outcomes: Key themes and subthemes were
identified in the clinician–parent discussions.
Results: The overarching theme of ‘the communication
interface’ was identified with three key themes: ‘giving
information’, ‘managing the conversation’ and ‘getting it
right’ and further subthemes. A range of approaches
were used to facilitate parental understanding and
engagement. There were differences in the exchanges
when information about an abnormal scan was given.
The overall structure of the discussions was largely
similar, though the language used varied. In all of the
discussions, the clinicians talked more than the parents.
Conclusions: The discussions represent a difficult
situation in which the challenge is to give and receive
complex prognostic information in the context of
considerable uncertainty. The study highlights the
importance of being able to re-visit specific issues and
any potential areas of misunderstanding, of making time
to talk to parents appreciating their perspective and level
of knowledge.
Trial registration number: EudraCT 2009-013888-19;
Pre-results.

Item Type: Article
Subjects: A300 Clinical Medicine
B700 Nursing
Divisions: Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR) > Family Health
Faculty of Health, Education and Life Sciences > School of Nursing and Midwifery
Depositing User: Dr. Merryl Harvey
Date Deposited: 27 Mar 2017 05:14
Last Modified: 30 Mar 2017 14:32
URI: http://www.open-access.bcu.ac.uk/id/eprint/4132

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