A qualitative study of predelivery counselling for extreme prematurity

Young, Elizabeth; Tsai, Ellen; O’Riordan, Anne

doi:10.1093/pch/17.8.432

Cited by 28 publications

(27 citation statements)

References 13 publications

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“…Facilitating parents’ questions and listening to parents’ worries during the antenatal consultations were identified as strengths by parents in our study. Our results confirm that parents want to hear a message of hope [5,19] but still want to face the reality and be told the truth, even though devastating [13]. But more importantly, rather than receiving neutral information as described by Payot et al [6], our parents described that they appreciated “balanced” information that describes both risks and benefits of treatment options.…”

Section: Discussionsupporting

confidence: 73%

Shared Decision Making at the Limit of Viability: A Blueprint for Physician Action

2016

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ObjectiveTo document interactions during the antenatal consultation between parents and neonatologist that parents linked to their satisfaction with their participation in shared decision making for their infant at risk of being born at the limit of viability.MethodsThis multiple-case ethnomethodological qualitative research study, included mothers admitted for a threatened premature delivery between 200/7 and 266/7 weeks gestation, the father, and the staff neonatologist conducting the clinical antenatal consultation. Content analysis of an audiotaped post-antenatal consultation interview with parents obtained their satisfaction scores as well as their comments on physician actions that facilitated their desired participation.ResultsFive cases, each called a “system—infant at risk”, included 10 parents and 6 neonatologists. From the interviews emerged a blueprint for action by physicians, including communication strategies that parents say facilitated their participation in decision making; such as building trustworthy physician-parent relationships, providing "balanced" information, offering choices, and allowing time to think.ConclusionParent descriptions indicate that the opportunity to participate to their satisfaction in the clinical antenatal consultation depends on how the physician interacts with them.Practice implicationsThe parent-identified communication strategies facilitate shared decision making regarding treatment in the best interest of the infant at risk to be born at the limit of viability.

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Section: Discussionsupporting

confidence: 73%

Shared Decision Making at the Limit of Viability: A Blueprint for Physician Action

2016

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“…Hope may permit parents to feel they have provided their baby with the best possible care option. It is an important value for many parents when making decisions regarding care of their EPI (5,36,37). Some HCPs were concerned about creating false hope, which may lead to a sense of anger and distrust among parents (38).…”

Section: Discussionmentioning

confidence: 99%

Shared decision making during antenatal counselling for anticipated extremely preterm birth

Barker

Dunn

Moore

et al. 2018

Paediatrics &Amp; Child Health

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Objective(s): To explore health care providers' (HCPs) perceptions of using shared decision making (SDM) and to identify facilitators of and barriers to its use with families facing the anticipated birth of an extremely preterm infant at 22 +0 to 25 +6 weeks gestational age. Study Design: Qualitative descriptive study design: we conducted interviews with 25 HCPs involved in five cases at a tertiary care centre and completed qualitative content analysis of their responses. Results: Nine facilitators and 16 barriers were identified. Facilitators included: a correct understanding of this process and how to apply it, a belief that parents should be the decision makers in these situations, and a positive outlook toward using SDM during antenatal counselling. Barriers included: HCPs' misunderstandings of how and when to apply SDM during antenatal counselling, challenges using the process for cases at the lower end of the gestational age range, fear of the negative emotions and stress parents face when making decisions, and HCPs' uncertainty about their ability to properly apply SDM. Conclusion(s): This study identified facilitators and barriers to use of SDM during antenatal counselling for anticipated birth of extremely preterm infants that can be used to inform development of tailored strategies to facilitate future implementation of shared decision making in this area.

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“…Fathers who were absent during their spouse's antenatal consultation previously have criticized this practice. 27 Parents should be told when the neonatologist will meet them to ensure both can be present. Mothers also wanted to see the neonatologist again to ask questions important to them; these often arose after the consultation.…”

Section: Discussionmentioning

confidence: 99%

“…Mothers also wanted to see the neonatologist again to ask questions important to them; these often arose after the consultation. Parents in a study by Young et al 27 also stated they needed an opportunity to "digest" the information and formulate their own questions.…”

Section: Discussionmentioning

confidence: 99%

Personalized Antenatal Consultations for Preterm Labor: Responding to Mothers' Expectations

Gaucher

Nadeau

Barbier

et al. 2016

The Journal of Pediatrics

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A qualitative study of predelivery counselling for extreme prematurity

Cited by 28 publications

References 13 publications

Shared Decision Making at the Limit of Viability: A Blueprint for Physician Action

Shared Decision Making at the Limit of Viability: A Blueprint for Physician Action

Shared decision making during antenatal counselling for anticipated extremely preterm birth

Personalized Antenatal Consultations for Preterm Labor: Responding to Mothers' Expectations

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