Aboriginal perspectives on recognising clinical deterioration in their child and communicating concerns to clinicians

• Published in: Journal of pediatric nursing 2022-03, Vol.63, p.e10-e17
• Main Authors: Gill, Fenella J., Cooper, Alannah L., Laird, Pamela, Leslie, Gavin D.
• Format: Article
• Language: English
• Subjects: Aboriginal; Australia; Child; Clinical Deterioration; Communication Barriers; Escalation of care; Family; Family involvement; Humans; Paediatric; Parent concern; Qualitative Research
• ISSN: 0882-5963; 1532-8449; 1532-8449
• DOI: 10.1016/j.pedn.2021.11.010

To explore the perspectives of family members of Aboriginal children about a) their involvement in recognising clinical deterioration in a hospital setting and b) the effectiveness of a poster designed to promote family involvement. To assist in the early recognition and response to clinical deterioration for hospitalised children, many escalation of care processes now include family involvement. Little is currently known about the perspectives of Australian Aboriginal families in recognising deterioration in their child and raising the alarm, or if current escalation of care systems meet the needs of Aboriginal families. Qualitative pragmatist approach using semi-structured interviews. Seven interviews were conducted with five mothers and two grandmothers of Aboriginal children who were inpatients at a children's hospital. Thematic analysis was undertaken. Two themes were identified: Theme one was: Family role in recognising and responding to clinical deterioration, with two subthemes of knowing when to worry and communicating concerns. Participants reported that some families needed more knowledge to recognise clinical deterioration. Communication barriers between families and clinicians were identified. Theme two was: Effective visual communication with three subthemes of linguistic clarity, visual appeal and content. Additional strategies are needed to promote effective communication between clinicians and families of Aboriginal children in hospital. Posters were considered effective, particularly if including a cultural connection, images and simplified language. These insights provide important information for health professionals and health service managers to be aware that additional communication strategies are required to support Aboriginal family involvement in recognising clinical deterioration and escalation of care. •Aboriginal families reported that knowledge of signs of clinical deterioration is necessary to be able to raise the alarm•A poster promoting Aboriginal family involvement can be an effective tool if adapted to ensure cultural relevance.•Additional work is required to develop a culturally secure environment, improve health literacy and facilitate carer and clinician communication.