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    Communication strategies and persuasion as core components of shared decision-making for children with life-limiting conditions: A multiple case study

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    Author
    Popejoy, Emma
    Manning, Joseph C
    Keyword
    Child
    Communication
    Parents
    Family
    Date
    2022
    
    Metadata
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    Publisher's URL
    https://doi.org/10.1177/02692163211068997
    Abstract
    Background: Families and professionals caring for children with life-limiting conditions face difficult healthcare decisions. Shared decision-making is promoted in many countries, however little is known about factors influencing these processes. Aim(s): To explore the communication strategies used in shared decision-making for children with life-limiting conditions. Design(s): A longitudinal, qualitative, multiple-case study. Cases were centred around the child and parent/carer(s). Most cases also included professionals or extended family members. Data from interviews, observations and medical notes were re-storied for each case into a narrative case summary. These were subject to comparative thematic analysis using NVivo11. Setting/participants: Eleven cases recruited from three tertiary hospitals in England. 23 participants were interviewed (46 interviews). Cases were followed for up to 12 months between December 2015 and January 2017. 72 observations were conducted and the medical notes of nine children reviewed. Finding(s): Strategies present during shared decision-making were underpinned by moral work. Professionals presented options they believed were in the child's best interests, emphasising their preference. Options were often presented in advance of being necessary to prevent harm, therefore professionals permitted delay to treatment. Persuasion was utilised over time when professionals felt the treatment was becoming more urgent and when families felt it would not promote the child's psychosocial wellbeing. Conclusion(s): Communication strategies in shared decision-making are underpinned by moral work. Professionals should be aware of the models of shared decision-making which include such communication strategies. Open discussions regarding individuals' moral reasoning may assist the process of shared decision-making. Copyright © The Author(s) 2021.
    Citation
    Popejoy E., Almack K., Manning J.C., Johnston B. and Pollock K. (2022) 'Communication strategies and persuasion as core components of shared decision-making for children with life-limiting conditions: A multiple case study', Palliative Medicine, 36(3), pp. 519–528. doi: 10.1177/02692163211068997 https://doi.org/10.1177/02692163211068997.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/19162
    Collections
    Nottingham Children's Hospital
    Nursing and Midwifery Registered

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