Related Experiment Video
Updated: Jul 21, 2026
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Differences in preferences for neonatal outcomes among health care professionals, parents, and adolescents
S Saigal1, B L Stoskopf, D Feeny
1Department of Pediatrics, McMaster University and Children's Hospital at Hamilton Health Sciences Corporation, Ontario, Canada. saigal@fhs.mcmaster.ca
Insights
Health care professionals rate child health states more negatively than parents and adolescents, impacting neonatal intensive care unit (NICU) decisions. Understanding these differing preferences is crucial for shared decision-making in NICU settings.
Area of Science:
- Neonatal intensive care
- Pediatric health outcomes
- Decision-making in healthcare
Background:
- Parents actively participate in clinical decisions for neonates in intensive care.
- Limited data exists on differing preferences between healthcare professionals and parents regarding health outcomes.
Purpose of the Study:
- To compare health state preferences among healthcare professionals, parents, and adolescents.
- To assess perspectives of neonatologists, neonatal nurses, parents, and adolescents (extremely low-birth-weight and normal birth-weight).
Main Methods:
- Cross-sectional cohort study involving 742 participants.
- Utilized standard gamble method via direct interviews to obtain utility scores for hypothetical child health states.
- Participants included neonatologists, neonatal nurses, adolescents (12-16 years), and parents.
Main Results:
- Healthcare professionals (neonatologists, nurses) reported similar preferences.
- Professionals rated health states significantly lower (more negatively) than parents and adolescents (P<.001).
- A higher percentage of healthcare professionals (64%) compared to parents (45%) deemed some health states worse than death.
Conclusions:
- Healthcare professionals tend to assign lower utility scores to child health states than parents and adolescents.
- These divergent preferences have significant implications for clinical management and shared decision-making in neonatal intensive care units.
- Findings highlight the need to consider varied perspectives when evaluating health-related quality of life for critically ill children.
Context:
In neonatal intensive care, parents make important clinical management decisions in conjunction with health care professionals. Yet little information is available on whether preferences of health care professionals and parents for the resulting health outcomes differ.
Objective:
To measure and compare preferences for selected health states from the perspectives of health care professionals (ie, neonatologists and neonatal nurses), parents of extremely low-birth-weight (ELBW) or normal birth-weight infants, and adolescents who were either ELBW or normal birth-weight infants.
Design:
Cross-sectional cohort study.
Setting And Participants:
A total of 742 participants were recruited and interviewed between 1993 and 1995, including 100 neonatologists from hospitals throughout Canada; 103 neonatal nurses from 3 regional neonatal intensive care units; 264 adolescents (aged 12-16 years), including 140 who were ELBW infants and 124 sociodemographically matched term controls; and 275 parents of the recruited adolescents.
Main Outcome Measure:
Preferences (utilities) for 4 to 5 hypothetical health states of children were obtained by direct interviews using the standard gamble method.
Results:
Overall, neonatologists and nurses had similar preferences for the 5 health states, and a similar proportion rated some health states as worse than death (59% of neonatologists and 68% of nurses; P=.20). Health care professionals rated the health states lower than did parents of ELBW and term infants (P<.001). Overall, 64% of health care professionals and 45% of parents rated 1 or more health states to be worse than death (P<.001). Differences in mean utility scores between health care professionals and parents and adolescent respondents were most pronounced for the 2 most severely disabled health states (P<.001).
Conclusions:
When asked to rate the health-related quality of life for the hypothetical conditions of children, health care professionals tend to provide lower utility scores than do adolescents and their parents. These findings have implications for decision making in the neonatal intensive care unit.
More Related Videos
11:50Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit
Published on: January 7, 2020
05:04A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect
Published on: September 22, 2023
Related Concept Videos
01:08Obedience
01:18Interdisciplinary Care: The Health Care Team-II
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
01:15Techniques of therapeutic communication I: Active Listening, Sharing Observations, Validation, and Using Touch
Therapeutic communication is not the same as social interaction. Social interaction has no goal or purpose and consists of casual information sharing, whereas therapeutic communication has a plan or purpose for the conversation. Therapeutic...
01:22Nursing Ethical Principles I
Autonomy
Autonomy underscores the significance of a patient's self-determination and freedom from external control. In healthcare, respecting the...
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:17Ethical Dilemmas I
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...