Professionals' preferences in prenatal counseling at the limits of viability: a nationwide qualitative Dutch study

Autor: Rosella P.M.G. Hermens, Laura Ouwerkerk, Mallory Woiski, Arno van Heijst, Marije Hogeveen, Jos M. T. Draaisma, Rosa Geurtzen, Hubertina C.J. Scheepers
Přispěvatelé: RS: GROW - R4 - Reproductive and Perinatal Medicine, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Counseling
Male
Pediatrics
Prenatal counseling
Personalization
0302 clinical medicine
Neonatologists
PARENTS
Pregnancy
Professional-Family Relations
Health care
Medicine
030212 general & internal medicine
Qualitative Research
Netherlands
Prenatal Care
Focus Groups
Middle Aged
Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
Obstetrics
Premature Birth
Original Article
Female
Infant
Premature
Adult
Limits of viability
medicine.medical_specialty
Attitude of Health Personnel
Clinical Decision-Making
EXTREME PREMATURITY
Perinatal care
Delivery room care
INTENSIVE-CARE
Directive Counseling
EXTREMELY PRETERM BIRTH
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
03 medical and health sciences
DELIVERY
Nursing
Physicians
030225 pediatrics
Intensive care
Humans
business.industry
Other Research Radboud Institute for Health Sciences [Radboudumc 0]
Infant
Newborn
Focus group
EXTREMELY PREMATURE-INFANTS
HIGH-RISK
PERINATAL-CARE
Pediatrics
Perinatology and Child Health
HEALTH-CARE
Intensive Care
Neonatal
Quality of Life
business
SHARED DECISION-MAKING
Decision making
Zdroj: European Journal of Pediatrics, 176(8), 1107-1119. Springer, Cham
European Journal of Pediatrics, 176, 1107-1119
European Journal of Pediatrics, 176, 8, pp. 1107-1119
European Journal of Pediatrics
ISSN: 0340-6199
Popis: Contains fulltext : 177240.pdf (Publisher’s version ) (Open Access) Prenatal counseling practices at the limits of viability do vary, and constructing a counseling framework based on guidelines, professional and parental preferences, might achieve more homogeneity. We aimed to gain insight into professionals' preferences on three domains of counseling, particularly content, organization, and decision making and their influencing factors. A qualitative, nationwide in-depth exploration among Dutch perinatal professionals by semi-structured interviews in focus groups was performed. Regarding content of prenatal counseling, preparing parents on the short-term situation (delivery room care) and revealing their perspectives on "quality of life" were considered important. Parents should be informed on the kind of decision, on the difficulty of individual outcome predictions, on survival and mortality figures, short- and long-term morbidity, and the burden of hospitalization. For organization, the making of and compliance with agreements between professionals may promote joint counseling by neonatologists and obstetricians. Supportive materials were considered useful but only when up-to-date, in addition to the discussion and with opportunity for personalization. Regarding decision making, it is not always clear to parents that a prenatal decision needs to be made and they can participate, influencing factors could be, e.g., unclear language, directive counseling, overload of information, and an immediate delivery. There is limited familiarity with shared decision making although it is the preferred model. CONCLUSION: This study gained insight into preferred content, organization, and decision making of prenatal counseling at the limits of viability and their influencing factors from a professionals' perspective. What is Known: * Heterogeneity in prenatal counseling at the limits of viability exists * Differences between preferred counseling and actual practice also exists What is New: * Insight into preferred content, organization, and decision making of prenatal periviability counseling and its influencing factors from a professionals' perspective. Results should be taken into account when performing counseling. * Particularly the understanding of true shared decision making needs to be improved. Furthermore, implementation of shared decision making in daily practice needs more attention.
Databáze: OpenAIRE
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