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Measuring communication quality in the Neonatal Intensive Care Unit



High quality communication between providers and parents of seriously ill neonatal patients is vital and yet poorly understood. Feudtner summarized five challenges and seven priorities to the study and advancement of pediatric palliative care. Improvement of communication is a priority, while lack of specification and measurement of outcomes relevant to the pediatric population remains a challenge. Specifically, measurement of communication quality in pediatrics, and especially neonatology, is problematic.


We conducted a focused review of this topic which we hope will serve to support further research. We reviewed the current literature in Pubmed and searched the Palliative Care Research Cooperative (PCRC) instrument library.


We found five validated instruments which met our criteria, relied on patient or surrogate report, and were developed to measure quality of communication and/or satisfaction with communication with adult patients or their surrogates. Our Pubmed search yielded 249 unique results, only two of which met our inclusion criteria.


We conclude that development and exhaustive testing of a validated, comprehensive measure of communication quality for the neonatal population is needed. Without such a measure, it will be difficult to advance the field and achieve high quality prognostic communication for the parents of seriously ill babies.


  • Measurement of communication quality in pediatrics, and especially neonatology, is problematic, understudied, and yet critical to the advancement of the field.

  • There has not been an overview of existing measures of communication quality in the NICU published, nor has there been a comprehensive discussion of this important topic. Our paper provides such an overview and initiates such a discussion.

  • We present a narrative review of existing measures of communication quality in the NICU in order to highlight the need for further study.

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Fig. 1: Study flow diagram.


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A.S.K.’s work is funded by NIA K24AG062785.

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Each author has met the Pediatric Research authorship requirements as delineated below: substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published: all authors.

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Correspondence to Katherine F. Guttmann.

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The authors declare no competing interests.

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Patient consent was not required for this study.

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Guttmann, K.F., Orfali, K. & Kelley, A.S. Measuring communication quality in the Neonatal Intensive Care Unit. Pediatr Res 91, 816–819 (2022).

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