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极早产儿出生后治疗选择的产前决策中父母价值观的范围综述。

A scoping review of parental values during prenatal decisions about treatment options after extremely premature birth.

机构信息

Department of Neonatology, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands.

Department of Obstetrics & Gynecology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Acta Paediatr. 2023 May;112(5):911-918. doi: 10.1111/apa.16690. Epub 2023 Feb 10.

Abstract

AIM

To describe what is known in the literature about parental perspectives in making prenatal decisions regarding treatment after birth at the limit of viability, as a better understanding of parental values can help professionals support parents as they decide.

METHODS

PubMed, Cochrane, Embase, CINAHL, PsycINFO and Web of Science were searched to identify relevant literature from 1 January 2010 to 22 April 2022 on parental decision making. Data were extracted from selected studies and organised into themes. The final themes were formed through collaboration with the parents of a premature infant born at 24 weeks.

RESULTS

Of the 15,159 papers examined, 17 were included. Parental perspectives were described in terms of long-term outcomes for the infant, survival, protection against the burden of neonatal treatment, long-term impact on the family, religion and spiritual beliefs, to do everything possible, hope, sense of responsibility, wanting the best, doing what is right, giving a chance and the influence of experience.

CONCLUSION

The extracted parental perspectives show the complexity of these decisions. Some perspectives were clear, but others were multi-interpretable. Increasing the understanding of common parental perspectives can help improve shared prenatal decisions and lead to further improvement and personalisation of the process.

摘要

目的

描述文献中关于在极早产儿出生后有生机治疗的产前决策中父母观点的相关内容,因为更好地了解父母的价值观可以帮助专业人员在父母做出决策时提供支持。

方法

从 2010 年 1 月 1 日至 2022 年 4 月 22 日,在 PubMed、Cochrane、Embase、CINAHL、PsycINFO 和 Web of Science 上检索了关于父母决策的相关文献。从选定的研究中提取数据并组织成主题。最后通过与一名出生于 24 周的早产儿的父母合作形成了主题。

结果

在检查的 15159 篇论文中,纳入了 17 篇。父母观点从婴儿的长期结局、存活率、避免新生儿治疗负担、对家庭的长期影响、宗教和精神信仰、尽一切可能、希望、责任感、希望最好、做正确的事情、给机会以及经验的影响等方面进行了描述。

结论

提取的父母观点显示了这些决策的复杂性。一些观点很明确,但其他观点则可以有多种解释。增加对常见父母观点的理解有助于改善共同的产前决策,并进一步改进和个性化该过程。

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