Teaching antenatal counseling skills to neonatal providers

Stokes, Theophil A.; Watson, Kathleen B.; Boss, Renee D.

doi:10.1053/j.semperi.2013.07.008

Cited by 60 publications

(38 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The American Association of Pediatrics (AAP) also states that decision making is the primary focus of prenatal counseling at the limits of viability—to which we agree [7]. Thereby, this decision making involves more than medical factors, it is of utmost importance to be empathic, provide support, and give parents hope during the counseling [3, 30, 40, 49]. …”

Section: Discussionmentioning

confidence: 99%

Professionals’ preferences in prenatal counseling at the limits of viability: a nationwide qualitative Dutch study

Geurtzen¹,

Heijst²,

Draaisma³

et al. 2017

Eur J Pediatr

View full text Add to dashboard Cite

Prenatal counseling practices at the limits of viability do vary, and constructing a counseling framework based on guidelines, professional and parental preferences, might achieve more homogeneity. We aimed to gain insight into professionals’ preferences on three domains of counseling, particularly content, organization, and decision making and their influencing factors. A qualitative, nationwide in-depth exploration among Dutch perinatal professionals by semi-structured interviews in focus groups was performed. Regarding content of prenatal counseling, preparing parents on the short-term situation (delivery room care) and revealing their perspectives on “quality of life” were considered important. Parents should be informed on the kind of decision, on the difficulty of individual outcome predictions, on survival and mortality figures, short- and long-term morbidity, and the burden of hospitalization. For organization, the making of and compliance with agreements between professionals may promote joint counseling by neonatologists and obstetricians. Supportive materials were considered useful but only when up-to-date, in addition to the discussion and with opportunity for personalization. Regarding decision making, it is not always clear to parents that a prenatal decision needs to be made and they can participate, influencing factors could be, e.g., unclear language, directive counseling, overload of information, and an immediate delivery. There is limited familiarity with shared decision making although it is the preferred model. Conclusion: This study gained insight into preferred content, organization, and decision making of prenatal counseling at the limits of viability and their influencing factors from a professionals’ perspective. What is Known: • Heterogeneity in prenatal counseling at the limits of viability exists • Differences between preferred counseling and actual practice also exists What is New: • Insight into preferred content, organization, and decision making of prenatal periviability counseling and its influencing factors from a professionals’ perspective. Results should be taken into account when performing counseling. • Particularly the understanding of true shared decision making needs to be improved. Furthermore, implementation of shared decision making in daily practice needs more attention.

show abstract

Section: Discussionmentioning

confidence: 99%

Professionals’ preferences in prenatal counseling at the limits of viability: a nationwide qualitative Dutch study

Geurtzen¹,

Heijst²,

Draaisma³

et al. 2017

Eur J Pediatr

View full text Add to dashboard Cite

show abstract

“…In addition to direct observation, simulated counseling sessions can mirror the real-life clinical situation and may assist individuals in developing and improving their communication skills. 68,69 Communication Among Providers Good communication among health care providers promotes optimal decision-making. Whenever possible, obstetricians and neonatologists should discuss each case together before, during, and after discussions with the prospective parents.…”

Section: Developing and Improving Communication Skillsmentioning

confidence: 99%

Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation

Cummings¹,

Watterberg²,

Eichenwald³

et al. 2015

Pediatrics

228

133

View full text Add to dashboard Cite

The anticipated birth of an extremely low gestational age (<25 weeks) infant presents many difficult questions, and variations in practice continue to exist. Decisions regarding care of periviable infants should ideally be well informed, ethically sound, consistent within medical teams, and consonant with the parents’ wishes. Each health care institution should consider having policies and procedures for antenatal counseling in these situations. Family counseling may be aided by the use of visual materials, which should take into consideration the intellectual, cultural, and other characteristics of the family members. Although general recommendations can guide practice, each situation is unique; thus, decision-making should be individualized. In most cases, the approach should be shared decision-making with the family, guided by considering both the likelihood of death or morbidity and the parents’ desires for their unborn child. If a decision is made not to resuscitate, providing comfort care, encouraging family bonding, and palliative care support are appropriate.

show abstract

“…Physicians must strive to develop a reassuring and trusting relationship with patients by listening to their questions, addressing their concerns and providing information that is important to them and relevant to their perspective 4 18. Stokes et al suggest that antenatal consultations be an exercise in ‘relational competence’ for neonatologists, that is, ‘physicians must accept and cultivate their role as counselors’ 19. Antenatal consultations are complex and emotionally charged for both parents and physicians.…”

Section: Discussionmentioning

confidence: 99%