McHaffie H E, Laing I A, Lloyd D J
Medical Ethics, Department of Medicine, University of Edinburgh, Edinburgh, Scotland, UK.
Arch Dis Child Fetal Neonatal Ed. 2001 Mar;84(2):F125-8. doi: 10.1136/fn.84.2.f125.
To explore parents' experiences of bereavement care after withdrawal of newborn intensive care.
Face to face interviews with 108 parents of 62 babies born over two calendar years in the East of Scotland.
Only 22% were seen by six weeks after the death, 10% were not recalled before 6-11 months, and 8% were not seen at all in the first year. All except one couple saw the neonatologist who had cared for their baby. Only 33% remembered a neonatal nurse being present. Most (88%) were seen in the study hospital. Parents highlighted a number of specific needs. Appointments should be: (a) scheduled soon after the death of the baby and certainly within two months of the death irrespective of whether or not autopsy results are available; (b) with the named neonatologist; (c) in a setting away from the hospital if possible. Parents value: (a) efforts to find out how they are coping; (b) full frank information given sensitively to enable them to build up a cohesive picture of what happened and assess their future risks; (c) reassurance where possible, but half truths, false reassurances, and broken promises are unacceptable.
Follow up care is a crucial part of the management of families from whose babies treatment has been withdrawn. Resources devoted to it should be re-examined to provide a service more in tune with parental need. In choosing the place, timing, and conduct of the meeting, staff should be sensitive to the expressed wishes of the parents themselves.
探讨新生儿重症监护撤离后父母的丧亲照护经历。
对在苏格兰东部两个日历年度出生的62名婴儿的108位父母进行面对面访谈。
死亡后六周内仅有22%的父母接受了访谈,10%的父母在6至11个月之前未被回访,8%的父母在第一年根本未被回访。除一对夫妇外,所有父母都见到了照料其婴儿的新生儿科医生。只有33%的父母记得有新生儿护士在场。大多数(88%)是在研究医院接受访谈的。父母们强调了一些具体需求。预约应:(a)在婴儿死亡后尽快安排,无论尸检结果是否可得,肯定要在死亡后两个月内安排;(b)与指定的新生儿科医生进行;(c)如果可能,在远离医院 的环境中进行。父母重视:(a)了解他们应对情况的努力;(b)敏感地提供全面、坦诚的信息,使他们能够全面了解所发生的事情并评估未来风险;(c)尽可能给予安慰,但半真半假、虚假安慰和食言是不可接受的。
后续照护是对其婴儿治疗已被撤离 的家庭管理的关键部分。应重新审视用于此的资源,以提供更符合父母需求的服务。在选择会面的地点、时间和方式时,工作人员应敏感地考虑父母自己表达的意愿。