Differences in the perceptions of parents and healthcare professionals on pediatric intensive care practices.
OBJECTIVE
To explore similarities and differences in perceptions on pediatric intensive care practices between parents and staff by using data from two studies.


METHODS
A two-round Delphi method among nurses and physicians followed by an empiric survey among parents.


METHODS
Pediatric intensive care units at eight university medical centers.


METHODS
Parents whose child has been admitted to a pediatric intensive care unit, nurses, and physicians.


METHODS
None.


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.
Department of Pediatrics, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. j.latour@erasmusmc.nl
Jos M
JM
Latour
Johannes B
JB
van Goudoever
Hugo J
HJ
Duivenvoorden
Marcel J I J
MJ
Albers
Nicolette A M
NA
van Dam
Eugenie
E
Dullaart
Marc
M
van Heerde
Marjorie
M
de Neef
Carin W M
CW
Verlaat
Elise M
EM
van Vught
Jan A
JA
Hazelzet
D001291:Attitude of Health Personnel; D003697:Delphi Technique; D022143:Family Nursing; D006301:Health Services Needs and Demand; D006801:Humans; D015278:Intensive Care Units, Pediatric; D009426:Netherlands; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires