Kavanaugh Karen, Moro Teresa T, Savage Teresa A, Reyes Maria, Wydra Marguerite
Department of Women, Children, and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois 60612, USA.
J Perinat Neonatal Nurs. 2009 Apr-Jun;23(2):159-70. doi: 10.1097/JPN.0b013e3181a2cacc.
Parents who are at risk for giving birth to an extremely premature infant, defined as 22 to 25 weeks' gestation, can find themselves faced with urgent treatment decisions for their unborn infant that have life-altering consequences. Despite the recommendation for involving parents in decision making for these infants, there is limited evidence regarding guidelines for involving parents. In this article, we describe a case from a larger collective case study that examines the decision making and the decision support needs of parents regarding life support decisions made over time (prenatally and postnatally) for extremely premature infants from the perceptions of parents, physicians, and nurses. For this case study, we describe decisions that were made during the antenatal hospitalization of the mother whose infant was stillborn, the support the parents received, and advice for healthcare professionals for improving care to families. For this case, the mother and father, a physician, and 2 nurses were interviewed before the birth of the infant. The findings in this case study demonstrate the importance of the nurse being present when information is given to parents, of informing with compassion, and helping parents to understand treatment options and decisions.
有生下极早产儿风险的父母(极早产儿定义为妊娠22至25周),可能会面临为其未出生婴儿做出紧急治疗决定的情况,这些决定会改变婴儿的一生。尽管建议让父母参与这些婴儿的决策制定,但关于让父母参与的指导方针的证据有限。在本文中,我们描述了一个来自更大规模集体案例研究的案例,该研究从父母、医生和护士的角度,审视了随着时间推移(产前和产后)为极早产儿做出生命支持决策时父母的决策过程及决策支持需求。对于这个案例研究,我们描述了在母亲产前住院期间做出的决定,当时她的婴儿胎死腹中,描述了父母得到的支持,以及对医疗保健专业人员改善对家庭护理的建议。对于这个案例,在婴儿出生前对母亲、父亲、一名医生和两名护士进行了访谈。该案例研究的结果表明,当向父母提供信息时护士在场、富有同情心地告知并帮助父母理解治疗选择和决定的重要性。