• Jos M Latour, Johannes B van Goudoever, Hugo J Duivenvoorden, Marcel J I J Albers, Nicolette A M van Dam, Eugenie Dullaart, Marc van Heerde, Marjorie de Neef, Carin W M Verlaat, Elise M van Vught, and Jan A Hazelzet.
• Department of Pediatrics, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. j.latour@erasmusmc.nl
• Pediatr Crit Care Me. 2011 Sep 1; 12 (5): e211-5.

ObjectiveTo explore similarities and differences in perceptions on pediatric intensive care practices between parents and staff by using data from two studies.DesignA two-round Delphi method among nurses and physicians followed by an empiric survey among parents.SettingsPediatric intensive care units at eight university medical centers.SubjectsParents whose child has been admitted to a pediatric intensive care unit, nurses, and physicians.InterventionsNone.Measurements And Main ResultsOutcome measures were 74 satisfaction-with-care items divided into five domains: 1) information; 2) care and cure; 3) organization; 4) parental participation; and 5) professional attitude. The Delphi study was completed by 218 nurses and 46 physicians and the survey by 559 of 1042 (54%) parents. Parents rated 31 items more important than the professionals based on the standardized mean difference (Cohen's d, 0.21-1.18, p < .003). Ten of these were related to information provision. Information on the effects of medication had the largest effect size (Cohen's d 1.18, p = .001). Correct medication administration by professionals was also rated significantly more important by parents (Cohen's d 0.64, p = .001). The professionals rated 12 items more important than the parents (Cohen's d -0.23 to -0.73, p < .005), including three about multicultural care. Significant differences remained on two of the three multicultural care items when the Dutch (n = 483) and non-Dutch parents (n = 76) were separately compared with professionals. On the domain level, parents rated the domains information and parental participation more important than the professionals (Cohen's d 0.36 and 0.26, p = .001).ConclusionsCompared with the parents' perceptions, nurses and physicians undervalued a substantial number of pediatric intensive care unit care items. This finding may reflect a gap in the understanding of parental experiences as well as incongruity in recognizing the needs of parents.

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