When Differing Perspectives Between Health Care Providers and Parents Lead to “Communication Crises”: A Conceptual Framework to Support Prevention and Navigation in the Pediatric Hospital Setting
Bibliographic record
Abstract
OBJECTIVES: The communication experience and therapeutic relationships between parents and health care providers (HCPs) impacts the quality of patient care. A guiding "communication crisis" description was created to encourage study participants to describe difficult communication encounters between parents and HCPs where their perspectives regarding the recommended patient care conflicted (ie, parent refusal of a lumbar puncture), which created barriers to the provision of optimal care and the development of therapeutic relationships in the pediatric hospital setting. The purpose of this research was to highlight factors that may contribute to communication crises through the characterization of these circumstances. METHODS: = 37) with firsthand experience regarding communication crises. Data were collected through focus groups (7), semistructured interviews (2), and a verification focus group where open-ended questions regarding participants' experiences were used. Data were analyzed by using a constructivist grounded theory approach. RESULTS: Three themes and 11 subthemes (communication crisis risk factors) were identified: (1) health care team factors (communication skills, care processes, and interprofessional communication), (2) family and/or parent factors (language or cultural barriers, mental health conditions, socioeconomic factors, and beliefs), (3) patient factors (acute condition, unclear diagnosis, unstable condition, and medical complexity). A core theory emerged: parent trust in their HCP significantly impacts the therapeutic relationship and can mitigate communication crises despite the presence of risk factors. CONCLUSIONS: We highlight factors that may be predisposing to communication crises in pediatric hospital settings. Awareness of these factors can support timely identification and implementation of relationship care and foster the establishment of trusting relationships.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".