Neonatologists’ perspectives of palliative and end-of-life care in neonatal intensive care units

Cortezzo, DonnaMaria E.; Sanders, Marilyn R.; Brownell, Elizabeth; Moss, Kerry

doi:10.1038/jp.2013.38

Cited by 53 publications

(71 citation statements)

References 28 publications

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“…Existen algunos estudios que describen el actitudes hacia la atención del paciente con cáncer al final de la vida, como el realizado por Cherny y Catane (17) que analizaron las actitudes de los oncólogos al paciente oncológico terminal, encontrando que más del 75% de los oncólogos acordaron que todos los pacientes con cáncer avanzado deben recibir cuidados paliativos y que todos los centros de atención a pacientes con cáncer deben tener un servicio de cuidados paliativos (89,1%); que los oncólogos médicos deben coordinar el cuidado de los pacientes con cáncer en todas las etapas de la enfermedad, incluida la atención al final de su vida (88,4%); y que debe ser experto en la gestión de la síntomas físicos y psicológicos de avanzada cáncer (88,1%); con-cluyendo que las actitudes son dignas de atención especial en la formación de los médicos oncólogos, ya que no están incluidos los cuidados paliativos durante su entrenamiento profesional, y que la mayoría de los oncólogos tienen una baja preparación para controlar los síntomas físicos y psicológicos del cáncer avanzado. Por otro lado, Cortezzo, Sanders, Brownell y Moss (18) analizaron la perspectiva y actitudes que tienen los neonatolgos con respecto a los cuidados paliativos y los cuidados intensivos neonatales, reportando que las barreras para poder implementar los servicios de cuidados paliativos eran las dificultades emocionales, los desacuerdos y dificultades en la formación de equipos de cuidados paliativos.…”

Section: Introductionunclassified

Adaptación en español de la escala de actitudes ante cuidados paliativos: confiabilidad y análisis factorial

Huertas

2016

Psicooncología

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This instrumental study presents the reliability and factor analysis as part of the Spanish adaptation of the Scale of Attitudes Palliative Care (PSST). I was done with the aim of knowing if the scale has psychometric properties, to be used to assess attitudes with health staff towards palliative care. The sample was of 132 health professionals (80.3% women), aged between 20 and 40 years (M = 30, SD = 9.11). Exploratory and confirmatory analysis showed a satisfactory rate of reliability (Cronbach's alpha: 0.807) to explain the 65,063% of the variance and factorial solution containing the correlations between the original variables and each of the factors. Among the most important factors we consider: Factor 1 refers to the process and guidelines for care units Palliative Care Factor 2 that relate personal experiences with death; and Factor 5 which relate to social support have Palliative Care. Concluding that the scale fulfills the psychometric properties for use in both clinical and research field.

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Section: Introductionunclassified

Adaptación en español de la escala de actitudes ante cuidados paliativos: confiabilidad y análisis factorial

Huertas

2016

Psicooncología

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“…Despite a recently increased focus on palliative care of neonates in the setting of a neonatal intensive care unit (NICU), [1][2][3][4][5][6][7] little is actually known about how neonates die under primary palliative care (PPC) in the delivery room (DR). There is some evidence to show that pharmacological analgesia or sedation in neonates undergoing palliative care differs grossly between DR and NICUs.…”

Section: Introductionmentioning

confidence: 99%

Primary palliative care in the delivery room: patients’ and medical personnel’s perspectives

et al. 2015

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“…Recognition of the importance of supporting staff through potentially traumatic bereavement following perinatal loss has been noted (Cortezzo et al, ; Ewing & Carter, ). However, there also has been acknowledgment in the literature that staff support and education in palliative and end‐of‐life‐care are lacking.…”

Section: Discussionmentioning

confidence: 99%

Supporting Preterm Infant Attachment and Socioemotional Development in the Neonatal Intensive Care Unit: Staff Perceptions

Twohig

Reulbach

Figuerdo

et al. 2016

Infant Ment. Health J.

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The infant-parent relationship has been shown to be of particular significance to preterm infant socioemotional development. Supporting parents and infants in this process of developing their relationships is an integral part of neonatal intensive care; however, there is limited knowledge of NICU staff perceptions about this aspect of care. To explore NICU staff perceptions about attachment and socioemotional development of preterm infants, experience of training in this area and the emotional impact of their work. A cross-sectional questionnaire survey of staff perceptions of the emotional experiences of parents and the developing parent-infant relationship in an NICU was conducted in a Level III NICU, after pilot testing, revision, and ethical approval. Fifty-seven (68%) of NICU staff responded to the survey. Respondents identified parents' emotional experiences such as "anxiety," "shock," "loss of control," and "lack of feelings of competence as parents" as highly prevalent. Infant cues of "responding to parent's voice" and "quieting-alerting" were ranked most highly; "crying" and "physiological changes" were ranked lowest. Preterm infant medical risk, maternal emotional state, and mental health are perceived to impact most highly on the developing relationship, as compared with infant state or behavior and socioeconomic factors. Fifty-three (93%) respondents felt confident, and 50 (87.8%) felt competent discussing their emotional experiences with parents. Fifty-four (95%) responded that attending to these areas was an integral part of their role; however, staff had seldom received education in this area. Respondents also perceived that specific psychological support for parents was lacking both during and after the infant's discharge. While all staff surveyed perceived the nature of their work to be emotionally stressful, there were differences among NICU staff disciplines and with years of experience in the NICU in terms of their perceptions about education in this area, the place of supervision for staff, and in relation to opportunities to discuss the emotional impact of the work on staff. NICU staff perceive their role as integral to supporting the developing parent-infant relationship and preterm infant socioemotional development; however, education in this area and provision of specific psychological support are lacking. Opportunities for staff to discuss and reflect on this aspect of their work should be developed and evaluated given the essential, but emotionally challenging, nature of their work with preterm babies and their parents.

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Neonatologists’ perspectives of palliative and end-of-life care in neonatal intensive care units

Abstract: Neonatologists believe that palliative care is important. Education and palliative care teams help provide quality care. Exploration of differing views of palliative care among team members is needed.

Cited by 53 publications

References 28 publications

Adaptación en español de la escala de actitudes ante cuidados paliativos: confiabilidad y análisis factorial

Adaptación en español de la escala de actitudes ante cuidados paliativos: confiabilidad y análisis factorial

Primary palliative care in the delivery room: patients’ and medical personnel’s perspectives

Supporting Preterm Infant Attachment and Socioemotional Development in the Neonatal Intensive Care Unit: Staff Perceptions

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