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Consents or waivers of responsibility? Parents' information in NICU
Carlo V Bellieni1, Caterina Coradeschi2, Maria R Curcio2
1Department of Neonatal Intensive Care Unit, Siena University Hospital, Siena, Italy - cvbellieni@gmail.com.
Insights
Informing parents about Neonatal Intensive Care Unit (NICU) treatments is crucial, but many consent forms are inadequate. Most forms were either too long or too brief, hindering parental understanding and decision-making.
Area of Science:
- Neonatal Medicine
- Medical Ethics
- Patient Communication
Background:
- Informed consent is fundamental in modern medicine, yet its administration varies significantly across hospitals.
- Effective patient information is critical, especially for infants, requiring clear communication with parents for treatment approval.
Purpose of the Study:
- To evaluate the adequacy of information provided to parents of infants admitted to Neonatal Intensive Care Units (NICUs).
Main Methods:
- Analysis of consent forms from 21 Neonatal Intensive Care Units in center-north Italy.
- Assessment of form length, features, and simulated information process scoring for ease, comprehensibility, and explicability.
Main Results:
- Only 7 out of 21 NICUs had adequate information forms; 14 used lengthy "waiver of responsibility" (WOR) forms with excessive procedural details.
- Overall ease, comprehensibility, and explicability scores were suboptimal, particularly for WOR forms.
Conclusions:
- Information provided to parents in NICUs requires improvement, avoiding information overload and tailoring content to the infant's condition.
- Further research is needed to determine if the use of waiver of responsibility forms is common internationally.
Background:
Informing the patient is a base of modern medicine; nonetheless, a great discrepancy exists between hospitals on the way this information should be administered. This is particularly important when the patient are babies: the information should be given to their parents who should approve or disapprove the treatment. Aim of this study is to assess the adequacy of the information administered to the parents of babies admitted into the Neonatal Intensive Care Units.
Methods:
We analyzed the consent forms of center-north Italy NICUs. To this aim, we assessed if the forms had acceptable length and other features; we then asked some volunteers to simulate an information process and to score the forms for their easiness, comprehensibility and explicability to others.
Results:
Twenty-one NICUs accepted to participate. Only 7 out of 21 had an adequate information form; the other 14 could be described as "waiver of responsibility" (WOR), because they were too prolix and contained too many hypothetical procedures. The overall level of easiness, comprehensibility and explicability to others was suboptimal, being lower in those forms we defined WOR.
Conclusions:
The results are far to be optimal. More care should be devoted to the process of informing parents at the admission into the NICU: an information overload should be avoided and information should be tailored on the baby's state. Further analysis should be devoted to whether the use of WOR is routine in other countries.