title: Communication intervention in the neonatal intensive care unit: can it backfire?
abstract: BACKGROUND
  For parents of a critically ill infant, good communication may help alleviate stress and anxiety. To improve communication, physicians must be responsive to families' needs and values surrounding the care of their hospitalized infant.
  
  
  OBJECTIVE
  We adapted a Decision-Making Tool for the Neonatal Intensive Care Unit (N-DMT) to encourage consideration of family concerns and preferences in daily care planning.
  
  
  METHODS
  This was a randomized controlled design.
  
  
  METHODS
  Parents and providers of critically ill neonates were eligible. Parents were randomized to an intervention group (using the N-DMT) or standard of care. N-DMT information was shared through the electronic medical record and communicated directly to the primary provider.
  
  
  METHODS
  Daily rounds on all infants were audio recorded. Parents completed the State-Trait Anxiety Inventory at the first interview and 2 weeks later. Parents completed the Family Inventory of Needs-Pediatrics (FIN-PED) survey and an N-DMT-specific survey 2 weeks postenrollment.
  
  
  RESULTS
  Complete data were obtained on 10 control and 9 intervention families. Groups did not differ on demographics or mean infant Score of Neonatal Acute Physiology (SNAP) scores (36 versus 37). FIN-PED scores were similar for both groups. The control group showed decreased anxiety over time. The content of rounds did not differ between groups. The intervention group reported lower satisfaction with care, specifically in questions regarding communication.
  
  
  CONCLUSIONS
  In this pilot study, we found that families in the intervention group were less satisfied with communication. Families who are primed to expect better communication, such as those participating in a communication intervention, may be less satisfied with standard care.
authors.affiliation: 1 Department of Pediatrics, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Clarke-Pounder
authors.forename: Renee D
authors.initials: RD
authors.lastname: Boss
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.forename: Nancy
authors.initials: N
authors.lastname: Hutton
authors.forename: Susan
authors.initials: S
authors.lastname: Larson
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Donohue
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D010347:Patient Care Planning; D010865:Pilot Projects; D011368:Professional-Family Relations; D055815:Young Adult