Abstract：
OBJECTIVE:Goals of care discussions are crucial in helping parents navigate complex medical decisions and shown to improve quality of care. Little is known about whether physicians elicit or address parents' goals during a child's hospitalization. The purpose of this study was to understand the current practice of goal setting at the beginning of hospitalization by exploring the perspectives of parents of hospitalized children and their hospital physicians. METHODS:A qualitative study with semi-structured interviews was conducted from 2018 to 2019 at a 361-bed quaternary suburban freestanding children's hospital. Twenty-seven parents of hospitalized children and 16 pediatric hospital medicine faculty were matched to participate. Data were analyzed using modified grounded theory, with themes identified through constant comparative approach. RESULTS:Five themes were identified: 1) Majority of hospitalized children's parents want to share their goals with physicians. 2) Parents and physicians share the same underlying goal of getting the child better to go home. 3) Parents of children with chronic diseases identified nonhospital goals that were not addressed. 4) Physicians do not explicitly elicit but rather assume what parents' goals of care are. 5) Factors related to patient, parent, and physician were identified as barriers to goal setting. CONCLUSIONS:Physicians may not consistently elicit parents' goals of care for their hospitalized children at the start of hospitalization. Parents desire their physicians to explicitly ask about their goals and involve them in goal setting during hospitalization. Strategies were identified by parents and physicians to improve goal setting with parents of hospitalized children.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Hoang K,Halpern-Felsher B,Brooks M,Blankenburg Rdoi
10.1016/j.acap.2020.05.016subject
Has Abstractpub_date
2020-05-31 00:00:00eissn
1876-2859issn
1876-2867pii
S1876-2859(20)30202-3pub_type
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journal_title：Academic pediatrics
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更新日期：2020-10-15 00:00:00
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pub_type： 杂志文章,多中心研究
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更新日期：2012-09-01 00:00:00
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更新日期：2019-01-01 00:00:00
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更新日期：2020-09-30 00:00:00
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更新日期：2019-01-01 00:00:00
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更新日期：2019-03-01 00:00:00
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更新日期：2016-09-01 00:00:00
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更新日期：2014-09-01 00:00:00
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pub_type： 杂志文章
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更新日期：2016-05-01 00:00:00
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pub_type： 杂志文章
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更新日期：2016-04-01 00:00:00
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pub_type： 杂志文章,随机对照试验
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