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Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e3181fe3193
Online Brief Reports

Differences in the perceptions of parents and healthcare professionals on pediatric intensive care practices

Latour, Jos M. RN, MSN, FEfCCNa; van Goudoever, Johannes B. MD, PhD; Duivenvoorden, Hugo J. PhD; Albers, Marcel J. I. J. MD, PhD; van Dam, Nicolette A. M. MD; Dullaart, Eugenie RN; van Heerde, Marc MD; de Neef, Marjorie RN, MSc; Verlaat, Carin W. M. MD; van Vught, Elise M. RN, BSN; Hazelzet, Jan A. MD, PhD, FCCM

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Abstract

Objective: To explore similarities and differences in perceptions on pediatric intensive care practices between parents and staff by using data from two studies.

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

Settings: Pediatric intensive care units at eight university medical centers.

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

Interventions: None.

Measurements and Main 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.

©2011The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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