Parents' Descriptions of Neonatal Palliation as a Treatment Option Prior to Periviable Delivery
palliative care; neonatal intensive care; perinatal care; NICU; decision making; premature birth
During periviable deliveries, parents are confronted with overwhelming and challenging decisions. This study aimed to qualitatively explore the language that pregnant women and important others utilize when discussing palliation, or "comfort care," as a treatment option in the context of periviability. We prospectively recruited women admitted for a threatened periviable delivery (22-25 weeks) at 2 hospitals between September 2016 and January 2018. Using a semistructured interview guide, we investigated participants' perceptions of neonatal treatment options, asking items such as "How was the choice of resuscitation presented to you?" and "What were the options presented?" Conventional content analysis was used and matrices were created to facilitate using a within- and across-case approach to identify and describe patterns. Thirty women and 16 important others were recruited in total. Participants' descriptions of treatment options included resuscitating at birth or not resuscitating. Participants further described the option to not resuscitate as "comfort care," "implicit" comfort care, "doing nothing," and "withdrawal of care." This study revealed that many parents facing periviable delivery may lack an understanding of comfort care as a neonatal treatment option, highlighting the need to improve counseling efforts in order to maximize parents' informed decision-making.
Jager S; Kavanaugh K; Hoffman S; Laitano T; Jeffries E; Tucker Edmonds B
The Journal of perinatal & neonatal nursing
2020
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/JPN.0000000000000483" target="_blank" rel="noreferrer noopener">10.1097/JPN.0000000000000483</a>
Parents' Descriptions of Neonatal Palliation as a Treatment Option Prior to Periviable Delivery
decision making; neonatal intensive care; NICU; palliative care; perinatal care; premature birth
During periviable deliveries, parents are confronted with overwhelming and challenging decisions. This study aimed to qualitatively explore the language that pregnant women and important others utilize when discussing palliation, or "comfort care," as a treatment option in the context of periviability. We prospectively recruited women admitted for a threatened periviable delivery (22-25 weeks) at 2 hospitals between September 2016 and January 2018. Using a semistructured interview guide, we investigated participants' perceptions of neonatal treatment options, asking items such as "How was the choice of resuscitation presented to you?" and "What were the options presented?" Conventional content analysis was used and matrices were created to facilitate using a within- and across-case approach to identify and describe patterns. Thirty women and 16 important others were recruited in total. Participants' descriptions of treatment options included resuscitating at birth or not resuscitating. Participants further described the option to not resuscitate as "comfort care," "implicit" comfort care, "doing nothing," and "withdrawal of care." This study revealed that many parents facing periviable delivery may lack an understanding of comfort care as a neonatal treatment option, highlighting the need to improve counseling efforts in order to maximize parents' informed decision-making.
Jager S; Kavanaugh K; Hoffman S; Laitano T; Jeffries E; Tucker Edmonds B
The Journal of perinatal & neonatal nursing
2020
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/JPN.0000000000000483" target="_blank" rel="noreferrer noopener">10.1097/JPN.0000000000000483</a>
Brazilian Neonatal Nurses' Palliative Care Experiences
quality of life; infant; grief; newborn; Brazil; vulnerable population; education; palliative therapy; thematic analysis; human experiment; genetic transcription; neonatal intensive care unit; human; article; female; male; controlled study; interview; clinical article; neonatal nurse; convenience sample; exploratory research; quality of nursing care; registered nurse; teaching hospital
de Castro de Oliveira F; Cleveland LM; Darilek U; Borges Silva AR; Carmona EV
The Journal of perinatal & neonatal nursing
2018
<a href="http://doi.org/10.1097/JPN.0000000000000361" target="_blank" rel="noreferrer noopener">10.1097/JPN.0000000000000361</a>
Neonatal end-of-life spiritual support care
Female; Humans; infant; Pregnancy; Parent-Child Relations; Attitude to Death; Nurse's Role; Spirituality; bereavement; Newborn; Parents/psychology; Nursing Assessment/methods; Palliative Care/methods/psychology; Neonatal Nursing/methods; Pregnancy Outcome/psychology
The death of an infant is a profound loss that may complicate, disrupt, or end relationships between parents; and lead to maladaptive grieving, long-term decreased quality of life, and symptoms related to psychological morbidity. Facing neonatal loss is frequently experienced as traumatic assault on parents' spiritual and existential world of meaning. This article highlights the importance of supporting parents through loss by providing comprehensive care that focuses not only on the neonate's physical needs, but also addresses parents' and families' spiritual, religious, and existential needs. Our objective is to increase practitioners' awareness of spiritual and existential distress and to provide strategies to address such needs, particularly at the end of life.
Rosenbaum JL; Smith JR; Zollfrank R
The Journal Of Perinatal & Neonatal Nursing
2011
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/JPN.0b013e318209e1d2" target="_blank" rel="noreferrer">10.1097/JPN.0b013e318209e1d2</a>