Shaw Stokoe et al 2016 SHI IR version.pdf (653.96 kB)
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Parental involvement in neonatal critical care decision-making

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journal contribution
posted on 05.05.2016, 11:24 by Chloe Shaw, Elizabeth StokoeElizabeth Stokoe, Katie Gallagher, Narendra Aladangady, Neil Marlow
The paper analyses the decision-making process between doctors and parents of babies in neonatal intensive care. In particular, it focuses on cases in which the decision concerns the redirection of care from full intensive care to palliative care at the end of life. Thirty one families were recruited from a neonatal intensive care unit in England and their formal interactions with the doctor recorded. The conversations were transcribed and analysed using conversation analysis. Analysis focused on sequences in which decisions about the redirection of care were initiated and progressed. Two distinct communicative approaches to decision-making were used by doctors: ‘making recommendations’ and ‘providing options.’ Different trajectories for parental involvement in decision-making were afforded by each design, as well as differences in terms of the alignments, or conflicts, between doctors and parents. ‘Making recommendations’ led to misalignment and reduced opportunities for questions and collaboration; ‘providing options’ led to an aligned approach with opportunities for questions and fuller participation in the decision-making process. The findings are discussed in the context of clinical uncertainty, moral responsibility and the implications for medical communication training and guidance

Funding

Funding: National Institute of Health Research (NIHR) Programme Development Grant RG-DG-0611-10006

History

Published in

Sociology of Health and Illness

Volume

38

Issue

8

Citation

SHAW, C. ... et al, 2016. Parental involvement in neonatal critical care decision-making. Sociology of Health and Illness, 38 (8), pp. 1217-1242.

Publisher

© Wiley

Version

AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Acceptance date

07/04/2016

Publication date

2016-09-25

Notes

This is the peer reviewed version of the following article: SHAW, C. ... et al, 2016. Parental involvement in neonatal critical care decision-making. Sociology of Health and Illness, 38 (8), pp. 1217-1242, which has been published in final form at https://doi.org/10.1111/1467-9566.12455. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

ISSN

0141-9889

Language

en