Nanon H M Labrie, Anne A M W van Kempen, Marleen Kunneman, Sylvia A Obermann-Borst, Liesbeth M van Vliet, Nicole R van Veenendaal
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引用次数: 0
Abstract
Objective: To examine the effects of clinicians' provision of (un)reasonable arguments on parent-related outcomes in neonatal (intensive) care (NICU), starting from the NICU Communication Framework.
Methods: A video-vignette experiment, in which we systematically varied clinicians' use of (reasonable, unreasonable, no) argumentation across two non-acute and two acute decision-making scenarios (3×4 design). Reasonable arguments were medically appropriate and constructive reasons to support the treatment plan, as defined by an expert panel. Based on argumentation theory, unreasonable arguments included hindering appeals to authority or the self-evident nature of the treatment plan. Parents of preterm infants completed an online survey, viewing 1 of 12 video-vignettes and answering questions pertaining to their communication stress, understanding, agreement, participation in communication, empowerment, trust and satisfaction with communication.
Results: N = 163 parents completed the full survey. We found statistically significant (p < 0.001) and large (η2: 0.13-0.38) effects of clinicians' use of argumentation across all parent-related outcomes. Reasonable argumentation led to lower communication stress and higher understanding, agreement, participation in communication, empowerment, trust, and satisfaction with communication than no argumentation. In turn, no argumentation led to improved outcomes compared to unreasonable argumentation. This pattern was similar across non-acute and acute scenarios.
Conclusion: Clinicians' use of reasonable argumentation has a consistently strong and positive impact on parent-related outcomes in neonatal care.
Practice implications: We argue that reasoned decision-making should be considered a good clinical practice, core to patient-centered communication. Our findings provide a starting point for (1) determining good argumentative practices and (2) designing evidence-based clinical argumentation trainings.
期刊介绍：
Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.
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