The CONNECT Instrument and Perception of Illness in Inpatient Pediatrics

Abstract

Emerging Knowledge for Clinical Practice Podium Presentations focusing on the Research Agenda Priority of Role and Practice Issues, Presented at NAPNAP’s 37th National Conference on Pediatric Healthcare, March 17, 2016, Atlanta, GA The purpose of this study is to assess for differences in perception of illness among attending physicians, advance practice providers (APP), and mothers of pediatric patients. The CONNECT Instrument was originally validated for use in an outpatient, adult, primary care setting to characterize patient and physician illness perspectives (Haidet et al. 2008). A study was performed in this population using the CONNECT Instrument which showed that physicians’ perception of their patients’ health beliefs differed significantly (p<0.001) from patients’ actual beliefs (Street and Haidet, 2011). The CONNECT Instrument was modified and shown to be reliable for use in an inpatient pediatric population (Magner et al, 2016). This allowed for data to be collected in a quantitative manner to assess attending physician and advanced practice provider understanding of parents' perception of illness. It is hypothesized that the CONNECT Instrument will show differences between health care providers' perception of mother's health beliefs and mother's actual beliefs regarding her child’s illness. The sample was recruited from the 8-bed Epilepsy Monitoring Unit (EMU) at Children’s Hospital of Wisconsin during scheduled admission for electroencephalography (EEG). The patient was screened for inclusion and exclusion criteria. If appropriate for the study, the mother of the patient was approached regarding enrollment in the study and if approved, consent was obtained. The CONNECT Instrument was distributed to the mother and collected after she completed the tool. Then, the health care provider (advance practice provider, epileptologist, or ideally both) were also asked to complete the CONNECT Instrument from the viewpoint of how they believed the mother perceived her child’s illness. Consent was implied with completion of the instrument. We enrolled a total of 30 mothers, 28 attending epileptologists and 27 advance practice providers. This study was analyzed using paired t-test analysis. Fifty five paired responses were analyzed and scores were standardized to a 100-point scale. Findings are as follows: Attending physician perceptions of MEANING are statistically different from mothers' perceptions (p<0.05). Attending physician perceptions of PREFERENCE FOR PARTNERSHIP are statistically different from mothers' perceptions (p<0.001). Advanced practice provider perceptions of FAULT are statistically different from mothers' perceptions (p<0.05). Attending physician perceptions of PREFERENCE FOR PARTNERSHIP are statistically different from advanced practice providers' perceptions (p<0.001). Perception of illness is important in healthcare and the CONNECT Instrument can be useful to obtain perceptions of parents regarding their child's illness and of health care providers regarding their understanding of parents' perception of illness. This study supports that there are statistically significant differences in perception of illness between advanced practice providers, attending physicians, and mothers. The many similarities in our study may be enhanced by the enrollment of experienced primary attending physicians and consistent advanced practice providers. No residents or fellows were enrolled. Most of the providers had children of their own and the primary problem of the patient was identified. The similarities between health care providers and mothers may show that pediatric providers have a different relationship with their patients and families that foster understanding regarding perception of illness.