Qualitative study of Black and Latino (a/e) caregiver participation on family-centered rounds

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-07-18 DOI:10.1016/j.pec.2025.109267

Katie Margolis , Kathryn I. Pollak , Laura Fish , Margaret Falkovic , Pedro Gomez Altamirano , Heather Parnell , Victoria Parente

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引用次数: 0

Abstract

Background

Family-centered rounds (FCR), multi-disciplinary rounds at bedside that involve the patient and family, has become the standard of care in pediatric hospitalizations. Caregiver participation on FCR improves shared-decision making and communication among providers, patients, and families. Evidence suggests Black and Latino (a/e) caregivers participate less during FCR than White caregivers, likely due to interpersonal and structural inequities, however contributing factors have not been adequately explored.

Objective

To better understand factors positively and negatively influencing Black and Latino (a/e) participation during FCR.

Design/Methods

We conducted a qualitative study of Black and Latino(a/e) caregivers and attending clinicians of hospitalized children admitted to a general pediatrics team at a tertiary care children’s hospital. We conducted virtual semi-structured interviews to assess factors that promoted and hindered caregiver participation on FCR. Clinician interviews addressed experiences encouraging caregiver participation on FCR with a focus on Black and Latino(a/e) caregivers. Investigators worked together to organize codes into common themes, select representative quotes, and create a conceptual framework.

Results

We conducted 21 interviews (14 caregivers, 7 clinicians) at an academic medical center. From our interviews, caregivers and their clinicians identified four major themes that influenced caregiver participation during rounds: 1) verbal and nonverbal interpersonal communication, 2) shared understanding and language, 3) structural factors (team size and time pressures), and 4) race, racism, and previous healthcare experiences.

Conclusions

Caregivers and their clinicians identified structural and modifiable clinician and health system factors that can promote Black and Latino (a/e) participation on FCR. Future research and interventions focused on these factors may improve not only racial inequities in clinician-caregiver communication, but also pediatric health outcomes.

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黑人和拉丁裔照护者参与以家庭为中心查房的定性研究

家庭中心查房（FCR），涉及患者和家庭的床边多学科查房，已成为儿科住院治疗的标准。护理人员参与FCR可改善提供者、患者和家属之间的共同决策和沟通。有证据表明，黑人和拉丁裔（a/e）看护者在FCR期间的参与度低于白人看护者，这可能是由于人际关系和结构上的不平等，但影响因素尚未得到充分探讨。目的更好地了解影响黑人和拉丁裔（a/e）参与FCR的积极和消极因素。设计/方法我们对一家三级儿童医院普通儿科小组收治的住院儿童的黑人和拉丁裔护理人员和主治临床医生进行了定性研究。我们进行了虚拟的半结构化访谈，以评估促进和阻碍护理人员参与FCR的因素。临床医生访谈讨论了鼓励护理人员参与FCR的经验，重点是黑人和拉丁裔（a/e）护理人员。调查人员一起工作，将代码组织成共同的主题，选择有代表性的引用，并创建一个概念框架。结果我们在某学术医疗中心进行了21次访谈（14名护理人员，7名临床医生）。从我们的访谈中，护理人员和他们的临床医生确定了影响护理人员参与查房的四个主要主题：1)口头和非口头人际沟通，2)共享理解和语言，3)结构因素（团队规模和时间压力），4)种族，种族主义和以前的医疗保健经验。结论护理提供者及其临床医生确定了结构性和可修改的临床医生和卫生系统因素，可以促进黑人和拉丁裔（a/e）参与FCR。未来针对这些因素的研究和干预可能不仅会改善临床医生与护理人员沟通中的种族不平等，还会改善儿科健康结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

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.