Life-sustaining treatment decisions in pediatric intensive care: an Italian survey on ethical concerns
| Autor: | Angela Amigoni, Andrea Pettenazzo, Paolo Biban, Alberto Giannini, Franco A. Carnevale, Chiara Tosin, Costanza Cecchi, Amabile Bonaldi, Silvia Maria Modesta Pulitano, Elena Bravi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Attitude of Health Personnel Life-sustaining treatment decisions Clinical Decision-Making education Intensive Care Units Pediatric Pediatrics RJ1-570 03 medical and health sciences 0302 clinical medicine Life sustaining treatment Nursing Surveys and Questionnaires 030225 pediatrics Intensive care Ethics Nursing Humans Medicine Ethics Medical Child Ethics Pediatric 030504 nursing business.industry Maternal and child health Research Legislature 3. Good health Life Support Care Critical care Withholding Treatment Italy Ethical concerns Female 0305 other medical science business Qualitative research |
| Zdroj: | Italian Journal of Pediatrics, Vol 47, Iss 1, Pp 1-13 (2021) Italian Journal of Pediatrics |
| ISSN: | 1824-7288 |
| Popis: | Objectives To investigate how life-sustaining treatment (LST) decisions are made and identify problematic ethical concerns confronted by physicians and nurses in pediatric intensive care within Italy. Methods An 88-question online survey was created, based on a previous qualitative study conducted by this team. The survey was designed to identify how LST decisions were managed; contrasting actual practices with what participants think practices should be. Replies from physicians and nurses were compared, to identify potential inter-professional ethical tensions. The study also identified participants’ principal ethical concerns. Moreover, open-ended questions elicited qualitative perspectives on participants’ views. The survey was pilot-tested and refined before initiation of the study. Results 31 physicians and 65 nurses participated in the study. Participants were recruited from pediatric intensive care units across five Italian cities; i.e., Florence, Milan, Padua, Rome, Verona. Statistically significant differences were identified for (a) virtually all questions contrasting actual practices with what participants think practices should be and (b) 14 questions contrasting physician replies with those of nurses. Physicians and nurses identified the absence of legislative standards for LST withdrawal as a highly problematic ethical concern. Physicians also identified bearing responsibility for LST decisions as a major concern. Qualitative descriptions further demonstrated that these Italian pediatric intensive care clinicians encounter significantly distressing ethical problems in their practice. Conclusions The results of this study highlight a need for the development of (a) strategies for improving team processes regarding LST decisions, so they can be better aligned with how clinicians think decisions should be made, and (b) Italian LST decision-making standards that can help ensure optimal ethical practices. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|