Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
The University of Chicago, Comer Children's Hospital, Chicago, IL, USA.
Semin Fetal Neonatal Med. 2018 Feb;23(1):30-34. doi: 10.1016/j.siny.2017.11.001. Epub 2017 Nov 20.
At the margins of viability, the interaction between physicians and families presents challenges but also opportunities for success. The counseling team often focuses on data: morbidity and mortality statistics and the course of a typical infant in the neonatal intensive care unit. Data that are generated on the population level can be difficult to align with the multiple facets of an individual infant's trajectory. It is also information that can be difficult to present because of framing biases and the complexities of intuiting statistical information on a personal level. Families also do not arrive as a blank slate but rather arrive with notions of prematurity generated from the culture they live in. Mothers and fathers often want to focus on hope, their changing role as parents, and in their desire to be a family. Multi-timepoint counseling provides the opportunity to address these goals and continue communication as the trajectories of infants, families and the counseling team change.
在极早产儿的边缘，医生和家庭之间的互动既带来了挑战，也带来了成功的机会。咨询团队通常关注数据：发病率和死亡率统计数据，以及新生儿重症监护病房中典型婴儿的病程。在人群层面生成的数据很难与个体婴儿轨迹的多个方面相吻合。由于框架偏见和个人层面推断统计信息的复杂性，这些数据也很难呈现。家庭也不是一张白纸，而是带着他们所处文化中对早产的观念而来。母亲和父亲通常希望关注希望、他们作为父母的角色变化，以及他们成为一个家庭的愿望。多次咨询提供了机会，可以解决这些目标，并在婴儿、家庭和咨询团队的轨迹发生变化时继续进行沟通。
