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Drach LL, Hansen DA, King TM, Sibinga EMS. Communication between neonatologists and parents when prognosis is uncertain. J Perinatol. 2020;40(9):1412-1422. doi:10.1038/s41372-020-0673-6

Objective: When an infant’s prognosis is uncertain, communication between neonatologists and parents surrounding goals of care and decision-making can be challenging. This qualitative study explored communication between neonatologists and parents to discover qualities which may enhance or impede parent-clinician partnership under such difficult circumstances.

Study design: Guided by the National Cancer Institute (NCI) Patient Centered Communication framework, semi-structured individual interviews were conducted and analyzed regarding neonatologist and parent perceptions of their communication. Subjects consisted of nine dyads of neonatologists and English-speaking parents whose infant had an uncertain prognosis.

Results: Parents were overall satisfied with neonatologists’ communications concerning their infant’s uncertain trajectory. Nonetheless, both experienced challenges and distress during communication, impeding collaboration and engagement.

Conclusions: Families and neonatologists value principles of patient centered communication but report challenges implementing this practice. Incorporating a multidisciplinary approach in settings of prognostic uncertainty to foster patient centered communication, may enhance communication surrounding NICU care.

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