Background. Single session email consultations in web-based parenting support may be used for a variety of reasons. Parents may be looking for information on developmental needs of children, for suggestions to improve their parenting skills, or for referrals to helpful resources. The way the practitioner meets the needs of parents, choosing a short-term and text-based approach, has not been analyzed up till now. Objective. To determine if and how practitioner response in single session email consultation matches the need of parents. Method. A content analysis of single session email consultations (129 questions; 5,997 response sentences) was conducted. Three perspectives on the parent-practitioner communication were distinguished to assess the match between parenting questions and consultations, i.e., the expert oriented, parent oriented and context oriented perspective. Results. The parent oriented type is the dominant paradigm in requesting and providing email consultations, with which the other types may be combined. Most consultations showed a mixed perspective with the use of a limited amount of techniques within each perspective. Correlations between the practitioner’s approach and parental expectancies were weak. Conclusions. Professionals have a broad approach to email consultation, offering advice of different perspectives, rather than restricting the advice in order to match a prevalent parental need. All proposed textual techniques were observed in email consultations, providing evidence of their feasibility. Since practice of email consultations is relatively new, practitioners may benefit from the proposed systematic approach to writing email consultations, identifying parental need and permitting the use of professional techniques.
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Background: Shared decision-making is one key element of interprofessional collaboration. Communication is often considered to be the main reason for inefficient or ineffective collaboration. Little is known about group dynamics in the process of shared decision-making in a team with professionals, including the patient or their parent. This study aimed to evaluate just that. Methods: Simulation-based training was provided for groups of medical and allied health profession students from universities across the globe. In an overt ethnographic research design, passive observations were made to ensure careful observations and accurate reporting. The training offered the context to directly experience the behaviors and interactions of a group of people. Results: Overall, 39 different goals were defined in different orders of prioritizing and with different time frames or intervention ideas. Shared decision-making was lacking, and groups chose to convince the parents when a conflict arose. Group dynamics made parents verbally agree with professionals, although their non-verbal communication was not in congruence with that. Conclusions: The outcome and goalsetting of an interprofessional meeting are highly influenced by group dynamics. The vision, structure, process, and results of the meeting are affected by multiple inter- or intrapersonal factors.
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Background: Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for “good practice”. Methods: We used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units. Findings: We conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: “talk work” – small talk and humour – and “work beyond words” – familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves “paradoxical care”, e.g., concurrent acts of “regulated spontaneity” and “informal formalities”. Discussion: Acknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents. Conclusion: Good communication and collaboration in maternity care involves “paradoxical care” requiring social sensitivity and self-reflection, skills that should be included as part of professional training.
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