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Supporting parents' decision making surrounding the anticipated birth of an extremely premature infant
Karen Kavanaugh1, Teresa T Moro, Teresa A Savage
1Department of Women, Children, and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois 60612, USA. karenk@uic.edu
Insights
Supporting parents making critical decisions for extremely premature infants is vital. Compassionate communication and clear explanations from healthcare professionals, especially nurses, improve care during high-stakes situations.
Area of Science:
- Perinatal Medicine
- Neonatology
- Medical Ethics
Background:
- Parents face difficult decisions for extremely premature infants (22-25 weeks' gestation).
- Limited evidence exists on guidelines for involving parents in these life-altering decisions.
- Understanding parental decision support needs is crucial.
Purpose of the Study:
- Examine decision-making processes and support needs of parents of extremely premature infants.
- Analyze experiences from a collective case study, focusing on one case of antenatal hospitalization.
- Provide advice for healthcare professionals to improve care for families.
Main Methods:
- Qualitative case study approach.
- Interviews conducted with parents, physicians, and nurses.
- Focus on decisions made during antenatal hospitalization for an infant who was stillborn.
Main Results:
- The nurse's presence during information delivery is important.
- Compassionate communication enhances parental understanding of treatment options.
- Effective support is crucial for parents navigating complex decisions.
Conclusions:
- Nurses play a key role in supporting parents during critical perinatal decisions.
- Emphasize compassionate communication and clear explanation of treatment options.
- Improve healthcare professional practices for better family-centered care.
Abstract:
Parents who are at risk for giving birth to an extremely premature infant, defined as 22 to 25 weeks' gestation, can find themselves faced with urgent treatment decisions for their unborn infant that have life-altering consequences. Despite the recommendation for involving parents in decision making for these infants, there is limited evidence regarding guidelines for involving parents. In this article, we describe a case from a larger collective case study that examines the decision making and the decision support needs of parents regarding life support decisions made over time (prenatally and postnatally) for extremely premature infants from the perceptions of parents, physicians, and nurses. For this case study, we describe decisions that were made during the antenatal hospitalization of the mother whose infant was stillborn, the support the parents received, and advice for healthcare professionals for improving care to families. For this case, the mother and father, a physician, and 2 nurses were interviewed before the birth of the infant. The findings in this case study demonstrate the importance of the nurse being present when information is given to parents, of informing with compassion, and helping parents to understand treatment options and decisions.
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