Attitudes of Parents and Health Care Professionals Toward Active Treatment of Extremely Premature Infants

Streiner, David L.; Saigal, Saroj; Burrows, Elizabeth; Stoskopf, Barbara; Rosenbaum, Peter

doi:10.1542/peds.108.1.152

Cited by 140 publications

(106 citation statements)

References 39 publications

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“…[18][19][20] The American Academy of Pediatrics statement on The Care of Adolescent Parents and Their Children suggests that physicians adapt their counseling to the developmental level of the teen parent. 7 Our clinical experience has been that providers worry that adolescent parents are too inexperienced to understand what is happening with their infant, and seek to communicate with an adult in the family. We did not find that teen understanding was associated with whether physicians had spoken with the teen's parents.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] Data regarding parent perceptions of communication with providers in the NICU have generally not focused specifically on the experiences of adolescent parents. 5,[7][8][9][10] Adolescent parents may be particularly vulnerable to adverse outcomes related to poor parent-provider communication, as many have appreciable socioeconomic burdens. We were interested in knowing how much adolescent mothers in the NICU knew about key components of their newborn's illness and their report of the interactions with health-care providers.…”

Section: Introductionmentioning

confidence: 99%

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Adolescent mothers in the NICU: how much do they understand?

2009

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Objective: We aimed to characterize adolescent parents' understanding of their infant's diagnosis, treatment and illness severity in the intensive care unit.Study Design: Adolescent mothers were interviewed and neonatal medical records were reviewed.Result: Forty-two teens were interviewed. All had spoken with providers: 86% with nurses, 60% with physicians and 45% with both. Most teens could name their infant's diagnosis and treatment but often underestimated the illness severity. Teens reported reluctance to ask providers to clarify technical language. Those who said they spoke with a physician were less likely to understand their infant's illness severity than those who said they had not spoken with a physician (48 vs 82%). Parents' knowledge was better if physicians had documented explicit efforts to communicate with parents. Conclusion:Teens often underestimated the critical nature of their infant's illness. Future work should target adolescent willingness to ask questions and provider ability to accurately gauge parent knowledge.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adolescent mothers in the NICU: how much do they understand?

2009

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“…3,4 Two surveys of parents have indicated that the vast majority of parents prefer resuscitation to be initiated even when there is great uncertainty about the outcome. 47,48 Parents should also be told that if the decision is not to initiate resuscitation or if resuscitation is unsuccessful, their infant will be provided comfort care and they will have the opportunity to hold their infant after delivery.…”

Section: Communications With the Parentsmentioning

confidence: 99%

Antenatal Counseling Regarding Resuscitation at an Extremely Low Gestational Age

Batton¹,

Newborn²

2009

Pediatrics

182

120

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The anticipated delivery of an extremely low gestational age infant raises difficult questions for all involved, including whether to initiate resuscitation after delivery. Each institution caring for women at risk of delivering extremely preterm infants should provide comprehensive and consistent guidelines for antenatal counseling. Parents should be provided the most accurate prognosis possible on the basis of all the factors known to affect outcome for a particular case. Although it is not feasible to have specific criteria for when the initiation of resuscitation should or should not be offered, the following general guidelines are suggested. If the physicians involved believe there is no chance for survival, resuscitation is not indicated and should not be initiated. When a good outcome is considered very unlikely, the parents should be given the choice of whether resuscitation should be initiated, and clinicians should respect their preference. Finally, if a good outcome is considered reasonably likely, clinicians should initiate resuscitation and, together with the parents, continually reevaluate whether intensive care should be continued. Whenever resuscitation is considered an option, a qualified individual, preferably a neonatologist, should be involved and should be present in the delivery room to manage this complex situation. Comfort care should be provided for all infants for whom resuscitation is not initiated or is not successful.

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“…Streiner et al 22 Tabela 1 -Trabalhos que utilizam metodologia quantitativa nascidos de peso normal, em relação a investir no tratamento de recém-nascidos no limite da viabilidade e quem deveria estar envolvido nesta decisão. Os pais são mais favoráveis à intervenção para salvar os recém-nascidos, independente do peso de nascimento ou da condição clínica, do que os profissionais.…”

Section: Os Estudosunclassified

A metodologia utilizada em estudos que envolvem ecos da prematuridade na história da família

Pereira

Cardoso

2005

J. Hum. Growth Dev.

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Resumo: O objetivo deste artigo foi revisar a literatura para identificar a natureza da metodologia utilizada e qual a área de atuação dos autores na abordagem do impacto da prematuridade na família e, a longo prazo, na criança. Baseou-se em: bases de dados do Medline e Lilacs utilizandose como palavras-chaves: "premature, family"; "intensive care unit, neonatal"; "quality of life"; "qualitative research". Foram selecionados artigos médicos nas áreas de Pediatria, Psiquiatria, Medicina Psicossocial e nas áreas de Enfermagem e Ciências Humanas, publicados nos idiomas inglês, espanhol e português, nos últimos dez anos e artigos identificados a partir das referências bibliográficas citadas nos primeiros artigos. Utilizadas teses de pós-graduação com informações relevantes. foram revistos onze artigos que utilizaram a metodologia quantitativa com questionários estruturados e semi-estruturados, analisados por testes estatísticos de distribuição de freqüência, qui-quadrado, regressão logística e covariância e seis estudos, sendo duas teses de mestrado e quatro artigos que utilizaram a metodologia qualitativa, com entrevista não estruturada, entrevista com grupos focais, história de vida e observação participante, analisados por fenomenologia, fenomenologia-hermenêutica e análise temática. Concluiu-se que os estudos que abordam o impacto da prematuridade na família, em sua maioria, utilizam metodologia quantitativa e são produzidos na área da Medicina, principalmente Neonatologia e Psiquiatria. A metodologia qualitativa está começando a ser aplicada a esses estudos, em áreas não médicas. São necessárias novas pesquisas para que os médicos, especialmente Neonatologistas, conheçam a especificidade da metodologia qualitativa em gerar evidências, podendo ser fonte de observação tão significativa quanto aquela proveniente da pesquisa quantitativa, para estudos que abordam prematuridade e família. Palavras

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Attitudes of Parents and Health Care Professionals Toward Active Treatment of Extremely Premature Infants

Cited by 140 publications

References 39 publications

Adolescent mothers in the NICU: how much do they understand?

Adolescent mothers in the NICU: how much do they understand?

Antenatal Counseling Regarding Resuscitation at an Extremely Low Gestational Age

A metodologia utilizada em estudos que envolvem ecos da prematuridade na história da família

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