With good reason: Increasing parental involvement using argumentation in communication about treatment at the neonatal care unit (IMPACT)

BACKGROUND: Each year, approximately 12.000 (6.9%) Dutch children are born prematurely (gestation ≤37 weeks). These children are admitted to the neonatal care unit (NCU). Hospitalization can last between days to months and is often distressful. Parental involvement has been demonstrated to have positive effects on parent and infant wellbeing. Yet, research predominantly focuses on participation in practical care activities. To increase parental involvement in communication about treatment, neonatologists should use evidence-based strategies. Medical argumentation research offers insights to define effective/teachable communication skills. Yet, to date, experimental studies investigating the effects of argumentation at the NCU are lacking.
AIMS: This project aims to test the effects of neonatologists’ use of sound argumentation to support effective treatment decisions. Moreover (in the second phase of the project, registered separately), it explores whether argumentation theory can be taught to neonatologists to improve communication outcomes.
METHODS: This study entails a video-vignette experiment to assess the effects of sound and salient argumentation (vs. unsound or zero argumentation) on parent/infant-related outcomes, including parental involvement, recall of and agreement/adherence to treatment, and perceptions of the healthcare professional. Video-vignettes of role-played doctor-parent interactions will be rated by former NICU parents in an online survey environment. In a separate arm of the trial, parents will view videos wearing VR-glasses.This study is the first of two trials.

Sound/salient support of treatment recommendations with argumentations will enhance parental recall/agreement/acceptance of these recommendations and enhance their perceptions of the pediatrician/neonatologist as a credible and patient centered healthcare professional, as compared to unsound/no support of treatment recommendations.

Participants will be asked to complete a short series of questions before the intervention (Q0) as well as after having viewed the video (Q1). Q0, video viewing, and Q1 have to be completed in one sitting.

The use of 1. sound/salient argumentation vs. 2. unsound/not salient argumentation vs. 3. no argumentation across 3 clinical scenarios in a NICU setting. This leads to a multiple message 3x3 factorial design. In addition, 1 clinical scenario will be compared in terms of the study methods used for data collection (online survey vs. VR-glasses) in a single message 2x2 factorial design (sound vs. unsound x survey vs. VR).