Swiss neonatal caregivers express diverging views on parental involvement in shared decision‐making for extremely premature infants

Aim Due to scarce available national data, this study assessed current attitudes of neonatal caregivers regarding decisions on life‐sustaining interventions, and their views on parents' aptitude to express their infant's best interest in shared decision‐making. Methods Self‐administered we...

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Veröffentlicht in:Acta Paediatrica 2021-07, Vol.110 (7), p.2074-2081
Hauptverfasser: Fauchère, Jean‐Claude, Klein, Sabine D., Hendriks, Manya J., Baumann‐Hölzle, Ruth, Berger, Thomas M.B., Bucher, Hans Ulrich
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container_end_page 2081
container_issue 7
container_start_page 2074
container_title Acta Paediatrica
container_volume 110
creator Fauchère, Jean‐Claude
Klein, Sabine D.
Hendriks, Manya J.
Baumann‐Hölzle, Ruth
Berger, Thomas M.B.
Bucher, Hans Ulrich
description Aim Due to scarce available national data, this study assessed current attitudes of neonatal caregivers regarding decisions on life‐sustaining interventions, and their views on parents' aptitude to express their infant's best interest in shared decision‐making. Methods Self‐administered web‐based quantitative empirical survey. All 552 experienced neonatal physicians and nurses from all Swiss NICUs were eligible. Results There was a high degree of agreement between physicians and nurses (response rates 79% and 70%, respectively) that the ability for social interactions was a minimal criterion for an acceptable quality of life. A majority stated that the parents' interests are as important as the child's best interest in shared decision‐making. Only a minority considered the parents as the best judges of what is their child's best interest. Significant differences in attitudes and values emerged between neonatal physicians and nurses. The language area was very strongly associated with the attitudes of neonatal caregivers. Conclusion Despite clear legal requirements and societal expectations for shared decision‐making, survey respondents demonstrated a gap between their expressed commitment to shared decision‐making and their view on parental aptitude to formulate their infant's best interest. National guidelines need to address these barriers to shared decision‐making to promote a more uniform nationwide practice.
doi_str_mv 10.1111/apa.15828
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Methods Self‐administered web‐based quantitative empirical survey. All 552 experienced neonatal physicians and nurses from all Swiss NICUs were eligible. Results There was a high degree of agreement between physicians and nurses (response rates 79% and 70%, respectively) that the ability for social interactions was a minimal criterion for an acceptable quality of life. A majority stated that the parents' interests are as important as the child's best interest in shared decision‐making. Only a minority considered the parents as the best judges of what is their child's best interest. Significant differences in attitudes and values emerged between neonatal physicians and nurses. The language area was very strongly associated with the attitudes of neonatal caregivers. Conclusion Despite clear legal requirements and societal expectations for shared decision‐making, survey respondents demonstrated a gap between their expressed commitment to shared decision‐making and their view on parental aptitude to formulate their infant's best interest. National guidelines need to address these barriers to shared decision‐making to promote a more uniform nationwide practice.</description><identifier>ISSN: 0803-5253</identifier><identifier>EISSN: 1651-2227</identifier><identifier>DOI: 10.1111/apa.15828</identifier><identifier>PMID: 33657661</identifier><language>eng</language><publisher>Norway: Wiley Subscription Services, Inc</publisher><subject>attitudes ; Caregivers ; Clinical decision making ; Decision making ; extremely premature infants ; Infants ; neonatal healthcare professionals ; Neonates ; Nurses ; Parent participation ; parental authority ; Quality of life ; shared decision‐making ; Social interactions</subject><ispartof>Acta Paediatrica, 2021-07, Vol.110 (7), p.2074-2081</ispartof><rights>2021 Foundation Acta Pædiatrica. Published by John Wiley &amp; Sons Ltd</rights><rights>2021 Foundation Acta Paediatrica. 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Conclusion Despite clear legal requirements and societal expectations for shared decision‐making, survey respondents demonstrated a gap between their expressed commitment to shared decision‐making and their view on parental aptitude to formulate their infant's best interest. 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subjects attitudes
Caregivers
Clinical decision making
Decision making
extremely premature infants
Infants
neonatal healthcare professionals
Neonates
Nurses
Parent participation
parental authority
Quality of life
shared decision‐making
Social interactions
title Swiss neonatal caregivers express diverging views on parental involvement in shared decision‐making for extremely premature infants
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