Dutch professionals' discussion preferences with the parents of extremely premature infants varied, but the trend was towards shared decision-making.

Autor: Geurtzen R; Department of Neonatology, Radboud University Medical Centre, Radboud Institute for Health Sciences, Amalia Children's Hospital, Nijmegen, The Netherlands., De Proost L; Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, The Netherlands.; Department of Neonatology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.; Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, Rotterdam, The Netherlands., Verhagen AAE; Department of Paediatrics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., Reiss IKM; Department of Neonatology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands., Hogeveen M; Department of Neonatology, Radboud University Medical Centre, Radboud Institute for Health Sciences, Amalia Children's Hospital, Nijmegen, The Netherlands., Verweij EJT; Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, The Netherlands.; Department of Obstetrics, LUMC, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2023 Jun; Vol. 112 (6), pp. 1200-1208. Date of Electronic Publication: 2023 Mar 06.
DOI: 10.1111/apa.16721
Abstrakt: Aim: We explored professionals' views on sharing decision-making with parents before and after an extremely preterm birth and what healthcare professionals considered severe outcomes.
Methods: A nationwide, multi-centre online survey was carried out among a wide range of perinatal healthcare professionals in the Netherlands from 4 November 2020 to 10 January 2021. The medical chairs of all nine Dutch Level III and IV perinatal centres helped to disseminate the survey link.
Results: We received 769 survey responses. Most respondents (53%) preferred to place equal emphasis on two treatment options during shared prenatal decision-making: early intensive care or palliative comfort care. The majority (61%) wanted to include a conditional intensive care trial as a third treatment option, but 25% disagreed. Most (78%) felt that healthcare professionals were responsible for initiating postnatal conversations to justify continuing or withdrawing neonatal intensive care if complications were associated with poor outcomes. Finally, 43% were satisfied with the current definitions of severe long-term outcomes, 41% were unsure and there were numerous for a broader definition.
Conclusion: Although Dutch professionals expressed diverse preferences on how to reach decisions about extremely premature infants, we observed a trend towards shared decision-making with parents. These results could inform future guidelines.
(© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)
Databáze: MEDLINE
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