Attitudes of neonatal clinicians towards resuscitation of the extremely premature infant: An exploratory survey

Oei, Ju Lee; Askie, LM; Tobiansky, Rodney; Lui, Kei

doi:10.1046/j.1440-1754.2000.00517.x

Cited by 37 publications

(54 citation statements)

References 18 publications

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“…Although several hospital-based studies and surveys have detailed physicians' attitudes and practices on life support and end-of-life decisions for premature infants, 19,29,30,[33][34][35][36]45,46 only a few have addressed parents' perspectives of counseling and decision-making. 42,45,47 To our knowledge, this is the first cross-cultural study of counseling and resuscitation decision-making from the perspective of parents of VLBW premature infants.…”

Section: Discussionmentioning

confidence: 99%

International Comparison of Care for Very Low Birth Weight Infants: Parents' Perceptions of Counseling and Decision-Making

et al. 2005

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ABSTRACT. Objective. To characterize parent perceptions and satisfaction with physician counseling and delivery-room resuscitation of very low birth weight infants in countries with neonatal intensive care capacity.Study Design. Convenience sample of 327 parents of 379 inborn very low birth weight infants (<1501 g) who had received resuscitation and neonatal intensive care in 9 neonatal intensive care units (NICUs) in 6 Pacific Rim countries and in 2 California hospitals. The sample comprised mostly parents whose infants survived, because in some centers interviews of parents of nonsurviving infants were culturally inappropriate. Of 359 survivors for whom outcome data were asked of parents, 29% were reported to have long-term sequelae. Half-hour structured interviews were performed, using trained interpreters as necessary, at an interval of 13.7 months after the infant's birth. We compared responses to interview questions that detailed counseling patterns, factors taken into consideration in decisions, and acceptance of parental decision-making.Results. Parents' recall of perinatal counseling differed among centers. The majority of parents assessed physician counseling on morbidity and mortality as adequate in most, but not all, centers. They less commonly perceived discussions of other issues as adequate to their needs. The majority (>65%) of parents in all centers felt that they understood their infant's prognosis after physician counseling. The proportion of parents who expected long-term sequelae in their infant varied from 15% (in Kuala Lumpur, Malaysia) to 64% (in Singapore). The majority (>70%) of parents in all centers, however, perceived their infant's outcome to be better than they expected from physician counseling. A majority of parents across all centers feared that their infant would die in the NICU, and approximately one third continued to fear that their infant might die at home after nursery discharge. The parents' regard for physicians' and, to a lesser extent, partners' opinions was important in decision-making. Less than one quarter of parents perceived that physicians had made actual life-support decisions on their own except in Melbourne, Australia, and Tokyo, Japan (where 74% and 45% of parents, respectively, reported sole physician decision-making). Parents would have preferred to play a more active, but not autonomous, role in decisions made for their infants. Counseling may heighten parents' anxiety during and after their infant's hospitalization, but that does not diminish their recalled satisfaction with counseling and the decisionmaking process.Conclusions. Counseling differs by center among these centers in Australasia and California. Given that parents desire to play an active role in decision-making for their premature infant, physicians should strive to provide parents the medical information critical for informed decision-making. Given that parents do not seek sole decision-making capacity, physicians should foster parental involvement in life-support decisions to the extent app...

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Section: Discussionmentioning

confidence: 99%

International Comparison of Care for Very Low Birth Weight Infants: Parents' Perceptions of Counseling and Decision-Making

et al. 2005

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“…[35][36][37][38][39][40][41][42][43][44] In a 1992 US study, approximately 10% of respondents, were willing to withhold delivery room resuscitation at 24 weeks' gestation; whereas, 51% of neonatologists in our sample were willing to do so specifically at parental request. 37 In a recent California study, neonatologists were asked the gestational age limit below which the respondent would not routinely resuscitate; 42% of respondents chose 22 completed weeks' gestation and almost 40% chose 23 completed weeks.…”

Section: Discussionmentioning

confidence: 99%

Delivery room decision-making at the threshold of viability

Peerzada

Richardson²,

Burns

2004

The Journal of Pediatrics

102

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“…The medical model of disability has been a driving force on how the public has understood disability (Polsky, Willke, Scott, Schulman, & Glick, 2001; Sackett & Torrance, 1978; Ubel et al, 2001; Ubel, Loewenstein, & Jepson, 2003). Evidence is mounting that HCPs’ attitudes and beliefs affects their judgments and interactions related to persons with various IPHCs (Janvier, Leblanc, & Barrington, 2008a, 2008b; Kelly, Brillante, Kushner, Gehron Robey, & Collins, 2005; Oei, Askie, Tobiansky, Liu, 2000; ten Klooster, Dannenberg, Taal, Burger, & Rasker, 2009). What is revealed from this synthesis is a need to espouse cultural humility and cultural competence at all levels of learning and practice for all HCPs, in order to improve interactions.…”

Section: Discussionmentioning

confidence: 99%

Challenging Nurses’ Cultural Competence of Disability to Improve Interpersonal Interactions

Roscigno

2013

Journal of Neuroscience Nursing

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Worldwide, at least 6.9 billion people have an impairment producing health condition (IPHC). Insensitive encounters with health care providers (HCPs) can result in negative appraisals, fear, and avoidance, but little is known about what things are commonly perceived as insensitive. A review of published narratives describing negative encounters with HCPs was conducted. Narrative analysis was used to compare, contrast, and synthesize six themes describing the common negative encounters: (a) ignoring or minimizing their knowledge; (b) detached interpersonal interactions; (c) placing a negative skew on their life quality; (d) a lack of HCP knowledge related to their complete needs; (e) assuming they should be asexual and childless; and, (f) an inherent power differential. The medical model of disability is perceived by individuals with IPHCs to inform negative encounters perceived as insensitive. This preliminary knowledge is important so we can address education needs, plan future research questions, and establish clinical practice improvements.

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Attitudes of neonatal clinicians towards resuscitation of the extremely premature infant: An exploratory survey

Cited by 37 publications

References 18 publications

International Comparison of Care for Very Low Birth Weight Infants: Parents' Perceptions of Counseling and Decision-Making

International Comparison of Care for Very Low Birth Weight Infants: Parents' Perceptions of Counseling and Decision-Making

Delivery room decision-making at the threshold of viability

Challenging Nurses’ Cultural Competence of Disability to Improve Interpersonal Interactions

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