Influence of caregiver-nurse communication on quality of life and clinical outcomes of children with long-term ventilator dependence.
Barbara K Giambra, Kathleen Knafl, Nanhua Zhang and 4 others
PMID 39396891WHAT IT FOUND
In children on long-term ventilators, nurse-caregiver communication behaviors were linked with both better and worse post-discharge quality of life and infections.
Nurse asking questions was linked with better quality of life; caregiver listening and some role negotiation were linked with poorer outcomes.
Key findings
01More nurse asking of caregivers was associated with better child quality of life, while more nurse negotiating care roles was associated with poorer child quality of life and poorer mobility or peer relationships.
02More family caregiver listening was associated with poorer child quality of life at one week and one month, and with more unplanned visits at one week.
03Family caregiver advocating was associated with more child fatigue and respiratory illness, whereas nurse advocating was associated with less child fatigue and more mobility.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational and nonrandom, so it cannot show that a communication behavior caused an outcome. Only 91 of the 100 enrolled families had usable recordings. It was done on one unit in one hospital, with English-speaking caregivers who were mostly well-educated and white. Only some conversations with nurses were recorded, and conversations with physicians or respiratory therapists were not included. The study did not determine what happened after a specific communication behavior, such as whether advocating led to a role change. Child quality of life was measured with different tools for different age groups, which makes comparison across ages harder. Video recording may have changed how people behaved, although participants could turn off recorders and none did.
The easy way to misread this
Do not conclude that changing one communication behavior will improve outcomes. This was an observational study of recorded conversations and post-discharge reports, so associations do not show cause, and many behaviors were counted together without knowing which specific exchange produced each outcome.