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新生儿重症监护病房中共同决策的重要性。

The importance of shared decision-making in the neonatal intensive care unit.

机构信息

Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine in St. Louis and St. Louis Children's Hospital, St. Louis, MO, USA.

Division of Public Health Science, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.

出版信息

J Perinatol. 2020 Mar;40(3):504-509. doi: 10.1038/s41372-019-0507-6. Epub 2019 Sep 30.

Abstract

OBJECTIVE

Neonatal intensive care unit (NICU) admissions are common and rising. Parents with infants in the NICU face difficult decisions about their infants' care. Few studies have investigated parents' engagement in NICU decisions and its effects on decision regret.

STUDY DESIGN

We surveyed parents of children who had a NICU stay in the past 3 years. We explored whether sociodemographic characteristics affected preferred decision involvement, shared decision-making with NICU clinicians, or decision regret. Multivariable linear regression analyses examined the relationship between shared decision-making and decision regret.

RESULTS

Most parents preferred an active (212/405, 52.3%) or shared (139/405, 34.3%) approach to decision-making. No sociodemographic characteristics related to preferred decision involvement or shared decision-making (p's > 0.05). In multivariable analyses, shared decision-making, education and health literacy related to less decision regret (p's < 0.05).

CONCLUSIONS

These data suggest the importance of shared decision-making during NICU stays. Studies should identify ways to support parents through NICU decision-making.

摘要

目的

新生儿重症监护病房(NICU)入院较为常见且呈上升趋势。NICU 中婴儿的父母面临着关于婴儿护理的艰难决策。很少有研究调查父母对 NICU 决策的参与情况及其对决策后悔的影响。

研究设计

我们调查了过去 3 年内有 NICU 住院经历的儿童的父母。我们探讨了社会人口统计学特征是否会影响父母对参与决策的偏好、与 NICU 临床医生共同决策或决策后悔。多变量线性回归分析考察了共同决策与决策后悔之间的关系。

结果

大多数父母更喜欢积极(212/405,52.3%)或共同(139/405,34.3%)的决策方法。没有社会人口统计学特征与偏好的决策参与或共同决策相关(p 值均>0.05)。在多变量分析中,共同决策、教育和健康素养与较少的决策后悔相关(p 值均<0.05)。

结论

这些数据表明,在 NICU 住院期间共同决策非常重要。研究应确定通过 NICU 决策支持父母的方法。

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