"You Have to Find a Way for This Child to Be at the Center": Pediatric Cardiologists' Views on Triadic Communication in Consultations on Congenital Heart Defects.

Publisher: Routledge, Taylor & Francis Group Country of Publication: England NLM ID: 8908762 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-7027 (Electronic) Linking ISSN: 10410236 NLM ISO Abbreviation: Health Commun Subsets: MEDLINE

Publication: [London] : Routledge, Taylor & Francis Group
Original Publication: Hillsdale, N.J. : Lawrence Erlbaum Associates, c1989-

Heart Defects, Congenital*/psychology ; Heart Defects, Congenital*/therapy ; Communication* ; Cardiologists*/psychology ; Physician-Patient Relations* ; Attitude of Health Personnel*; Humans ; Female ; Male ; Parents/psychology ; Israel ; Interviews as Topic ; Child ; Adult ; Referral and Consultation ; Qualitative Research ; Patient-Centered Care ; Middle Aged

Congenital heart defects (CHDs) are present at birth and require ongoing management of personal, family, and medical aspects of care, including communication between family and medical staff. Effective communication is considered one of the main objectives of patient-centered care. Communication in pediatric medicine is especially challenging because it includes children and their parent(s), and children's cognitive and communication skills are still developing. Based on the model of behavior in pediatric communication , this study focused on pediatric cardiologists' views of the roles of children, parents, and physicians in the triadic encounter and their experiences in communicating information on pediatric CHDs in medical encounters. Semi-structured interviews were conducted with 17 experienced pediatric cardiologists and cardiac surgeons (five women and 12 men) at three medical centers in Israel. The grounded theory approach was used to identify three main categories: (1) the positioning (centrality) of the child in the setting (ideal vs. actual situation), (2) addressing parents' emotional needs, and (3) the physician's role as mediator between parent(s) and child. In each category, three elements are discussed: The physician's agenda, obstacles and challenges, and the physician's practical methods. Physicians strongly support children's involvement in triadic encounters yet face challenges in effectively integrating them into the information exchange process during cardiology consultations. Struggling to balance the principles of patient- and family-centered care, and without clear guidelines, they rely on their personal beliefs and experiences to formulate communication strategies that address parents' and children's needs.

Date Created: 20240401 Date Completed: 20250422 Latest Revision: 20250422

20250423

10.1080/10410236.2024.2329422

38557305