Division of Newborn Medicine, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Harvard Medical School, Boston, MA; South Shore Hospital, Weymouth, MA.
J Pediatr. 2022 Dec;251:17-23.e2. doi: 10.1016/j.jpeds.2022.09.003. Epub 2022 Sep 9.
To determine parental preferred language, terminology, and approach after prenatal counseling for an anticipated extremely preterm delivery.
Pregnant persons (and their partners) admitted at 22-25 weeks of estimated gestation participated in post antenatal-counseling semistructured interviews to explore preferred language and decision-making approaches of their antenatal counseling session. Interviews were audio-recorded and transcribed, and thematic analysis of the data was performed.
Thirty-nine interviews were conducted representing 28 total prenatal consults. Analysis identified 2 overarching themes impacting the whole counseling experience: the need for reassurance and compassionate communication, while parents traveled along a dynamic decision-making journey they described as fluid and ever-changing. Related themes included the following: (1) Finding Balance: parents reported the importance of balancing positivity and negativity as well as tailoring the amount of information, (2) The Unspoken: parents described assumptions and inferences surrounding language, resuscitation options, and values that can cloud the counseling process, (3) Making the Intangible Tangible: parents reported the importance of varied communication strategies, for example, visuals to better anticipate and prepare, and (4) Team Synergism: Parents expressed desire for communication and consistency among and between teams, which increased trust.
Parents facing extremely premature delivery generally did not report remembering specific terminology used during prenatal consultation but rather how the language and counseling approach made them feel and affected the decision-making process. These findings have implications for further research and educational intervention design to improve clinicians' counseling practices to better reflect parental preferences and ultimately improve counseling outcomes.
确定极早产儿产前咨询后父母的首选语言、术语和方法。
在估计妊娠 22-25 周入院的孕妇（及其伴侣）参加了产前咨询后的半结构化访谈，以探讨他们的产前咨询会议的首选语言和决策方法。访谈进行了录音和转录，并对数据进行了主题分析。
共进行了 39 次访谈，代表了 28 次完整的产前咨询。分析确定了影响整个咨询体验的 2 个总体主题：需要安慰和富有同情心的沟通，同时父母沿着他们描述为流畅且不断变化的动态决策之旅前行。相关主题包括以下几点：（1）寻找平衡：父母报告说平衡积极性和消极性以及调整信息量很重要，（2）不言而喻：父母描述了围绕语言、复苏选项和价值观的假设和推断，这些假设和推断会使咨询过程变得复杂，（3）使无形有形化：父母报告了多种沟通策略的重要性，例如，使用视觉效果更好地预测和准备，以及（4）团队协同作用：父母表示希望团队之间以及团队内部的沟通和一致性，这增加了信任。
面临极早产儿分娩的父母通常不会报告记住产前咨询中使用的特定术语，而是报告语言和咨询方法如何使他们感到并影响决策过程。这些发现对进一步的研究和教育干预设计具有影响，以改善临床医生的咨询实践，更好地反映父母的偏好，并最终改善咨询结果。
