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Conflict escalation in paediatric services: findings from a qualitative study

OBJECTIVE: To explore clinician and family experiences of conflict in paediatric services, in order to map the trajectory of conflict escalation. DESIGN: Qualitative interview study, employing extreme-case sampling. Interviews were analysed using an iterative thematic approach to identify common the...

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Autores principales: Forbat, Liz, Teuten, Bea, Barclay, Sarah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518764/
https://www.ncbi.nlm.nih.gov/pubmed/25940425
http://dx.doi.org/10.1136/archdischild-2014-307780
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author Forbat, Liz
Teuten, Bea
Barclay, Sarah
author_facet Forbat, Liz
Teuten, Bea
Barclay, Sarah
author_sort Forbat, Liz
collection PubMed
description OBJECTIVE: To explore clinician and family experiences of conflict in paediatric services, in order to map the trajectory of conflict escalation. DESIGN: Qualitative interview study, employing extreme-case sampling. Interviews were analysed using an iterative thematic approach to identify common themes regarding the experience and escalation of conflict. PARTICIPANTS: Thirty-eight health professionals and eight parents. All participants had direct experience of conflict, including physical assault and court proceedings, at the interface of acute and palliative care. SETTING: Two teaching hospitals, one district general hospital and two paediatric hospices in England, in 2011. RESULTS: Conflicts escalate in a predictable manner. Clearly identifiable behaviours by both clinicians and parents are defined as mild, moderate and severe. Mild describes features like the insensitive use of language and a history of unresolved conflict. Moderate involves a deterioration of trust, and a breakdown of communication and relationships. Severe marks disintegration of working relationships, characterised by behavioural changes including aggression, and a shift in focus from the child's best interests to the conflict itself. Though conflicts may remain at one level, those which escalated tended to move sequentially from one level to the next. CONCLUSIONS: Understanding how conflicts escalate provides clinicians with a practical, evidence-based framework to identify the warning signs of conflict in paediatrics.
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spelling pubmed-45187642015-08-03 Conflict escalation in paediatric services: findings from a qualitative study Forbat, Liz Teuten, Bea Barclay, Sarah Arch Dis Child Original Article OBJECTIVE: To explore clinician and family experiences of conflict in paediatric services, in order to map the trajectory of conflict escalation. DESIGN: Qualitative interview study, employing extreme-case sampling. Interviews were analysed using an iterative thematic approach to identify common themes regarding the experience and escalation of conflict. PARTICIPANTS: Thirty-eight health professionals and eight parents. All participants had direct experience of conflict, including physical assault and court proceedings, at the interface of acute and palliative care. SETTING: Two teaching hospitals, one district general hospital and two paediatric hospices in England, in 2011. RESULTS: Conflicts escalate in a predictable manner. Clearly identifiable behaviours by both clinicians and parents are defined as mild, moderate and severe. Mild describes features like the insensitive use of language and a history of unresolved conflict. Moderate involves a deterioration of trust, and a breakdown of communication and relationships. Severe marks disintegration of working relationships, characterised by behavioural changes including aggression, and a shift in focus from the child's best interests to the conflict itself. Though conflicts may remain at one level, those which escalated tended to move sequentially from one level to the next. CONCLUSIONS: Understanding how conflicts escalate provides clinicians with a practical, evidence-based framework to identify the warning signs of conflict in paediatrics. BMJ Publishing Group 2015-08 2015-05-04 /pmc/articles/PMC4518764/ /pubmed/25940425 http://dx.doi.org/10.1136/archdischild-2014-307780 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Original Article
Forbat, Liz
Teuten, Bea
Barclay, Sarah
Conflict escalation in paediatric services: findings from a qualitative study
title Conflict escalation in paediatric services: findings from a qualitative study
title_full Conflict escalation in paediatric services: findings from a qualitative study
title_fullStr Conflict escalation in paediatric services: findings from a qualitative study
title_full_unstemmed Conflict escalation in paediatric services: findings from a qualitative study
title_short Conflict escalation in paediatric services: findings from a qualitative study
title_sort conflict escalation in paediatric services: findings from a qualitative study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518764/
https://www.ncbi.nlm.nih.gov/pubmed/25940425
http://dx.doi.org/10.1136/archdischild-2014-307780
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