80 Family Caregiver Emotional and Communication Needs in Canadian Paediatric Emergency Departments

Abstract

Abstract Background Paediatric emergency departments (EDs) have been identified as inherently stressful for families, making it challenging to understand and meet families’ global needs, beyond urgent medical care. There is a paucity of research describing how effectively the emotional and communication needs of family caregivers are met during ED visits. Objectives To describe the extent to which family caregivers’ emotional and communication needs were met during paediatric ED visits and relate these findings to visit and demographic characteristics. Design/Methods Electronic surveys with medical record review were deployed at ten Canadian paediatric EDs from October 2018 – March 2020. A convenience sample of families with children <18 years presenting to a paediatric ED were enrolled, for one week every three months, for one year per site. Caregivers completed one survey in the ED and a follow-up survey, up to seven days post-visit. Results This study recruited 2005 caregivers who were mostly identified as mothers (74.3%, 1462/1969); mean age was 37.8 years (SD 7.7). 71.7% (1081/1507) of caregivers felt their emotional needs were met. Staff physicians (35.6% [535/1502]), bedside nurses (24.2% [364/1502]), residents/medical students (13.8% [207/1502]) and triage nurses (12.4% [186/1502]) were identified as providing the best emotional support to caregivers. 86.4% (1293/1496) identified communication with the doctor as good/very good and 83.4% (1249/1498) with their child’s nurse. Caregiver involvement in their child’s care was reported as good/very good 85.6% (1271/1485) of the time. 81.8% (1074/1313) of caregivers felt comfortable in caring for their child at home at the time of discharge. Greater triage acuity, being the father (vs. mother), lower caregiver anxiety, respect for the child’s privacy, caregiver involvement in their child’s care, satisfactory updates, and having questions adequately addressed positively impacted caregiver emotional needs. Caregivers feeling less scared during an ED visit, lower caregiver anxiety, caregiver involvement in their child’s care, satisfactory updates, and having questions adequately addressed increased caregiver comfort in caring for their child’s illness at home. Conclusion Approximately 30% of caregivers presenting to paediatric EDs have unmet emotional needs, over 15% have unmet communication needs, and 15% felt inadequately involved in their child’s care, challenging healthcare providers to do better. Family caregiver involvement in care and good communication from ED staff are key elements in improving overall patient experience and satisfaction.