Abbonarsi

Information Order for Periviable Counseling: Does It Make a Difference? - 22/07/21

Doi : 10.1016/j.jpeds.2021.03.058 
Siobhan McDonnell, MS 1, Ke Yan, PhD 2, U. Olivia Kim, MD 1, Kathryn E. Flynn, PhD 3, Melodee Nugent Liegl, MA 2, Steven R. Leuthner, MD, MA 1, 4, Jennifer J. McIntosh, DO 5, Mir A. Basir, MD, MS 1,
1 Department of Pediatrics, Division of Neonatology, Medical College of Wisconsin, Milwaukee, WI 
2 Department of Pediatrics, Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI 
3 Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI 
4 Department of Population Health, Center for the Study of Bioethics, Medical College of Wisconsin, Milwaukee, WI 
5 Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Medical College of Wisconsin, Milwaukee, WI 

Reprint requests: Mir A. Basir, MD, MS, Department of Pediatrics, Medical College of Wisconsin, Children's Corporate Center, 999 N 92 St, Milwaukee, WI 53226Department of PediatricsMedical College of WisconsinChildren's Corporate Center999 N 92 StMilwaukeeWI53226

Abstract

Objectives

To examine whether the order of presenting survival vs disability information, with or without the description of infant neonatal intensive care unit (NICU) experiences would influence treatment choice during hypothetical periviable birth counseling.

Study design

An internet sample of childbearing-aged women (n = 839) viewed a pictograph displaying the chances of survival and a pictograph on the chances of disability for a baby resuscitated during the periviable period. The sample was randomized to the order of pictographs and level of description of infant NICU experiences. Participants selected between intensive care or comfort care and reported their personal values.

Results

The order of the information influenced treatment choices (P = .02); participants were more likely to choose intensive care if they saw the survival pictograph first (70%) than the disability pictograph first (62%). Level of description of premature infant NICU experiences did not influence treatment choice (P = .92). Participants who valued sanctity of life, autonomy in making decisions, who were more religious, and had adequate health literacy were more likely to choose intensive care. Such participant characteristics had greater explanatory power than the experimental manipulations.

Conclusions

Subtle differences in how information is presented may influence critical decisions. However, even among women with the same values, diversity in treatment choice remains.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : premature infant, premature birth, parent, decision-making, patient-centered care

Abbreviations : NICU, NICHD


Mappa


 Supported by the National Institute of Child Health and Human Development, United States (R21 HD092664 [to M.B. and K.F.]) and the Department of Pediatrics, Medical College of Wisconsin. The authors declare no conflicts of interest.


© 2021  Elsevier Inc. Tutti i diritti riservati.
Aggiungere alla mia biblioteca Togliere dalla mia biblioteca Stampare
Esportazione

    Citazioni Export

  • File

  • Contenuto

Vol 235

P. 100 - agosto 2021 Ritorno al numero
Articolo precedente Articolo precedente
  • Variation in Neonatal Transfusion Practice
  • Ravi M. Patel, Jeanne E. Hendrickson, Marianne E. Nellis, Rebecca Birch, Ruchika Goel, Oliver Karam, Matthew S. Karafin, Sheila J. Hanson, Bruce S. Sachais, Ronald George Hauser, Naomi L.C. Luban, Jerome Gottschall, Cassandra D. Josephson, Martha Sola-Visner, National Heart, Lung, and Blood Institute Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P), A.E. Mast, E.A. Hod, B.S. Custer, E.P. Vichinsky, B.R. Spencer, S.M. Mathew, D.R. Harris, M.P. Busch, P.J. Norris, P.M. Ness, S.H. Kleinman, R. Tamburro, S.A. Glynn, K. Malkin
| Articolo seguente Articolo seguente
  • Effect of Prophylactic Dextrose Gel on Continuous Measures of Neonatal Glycemia: Secondary Analysis of the Pre-hPOD Trial
  • Joanne E. Hegarty, Jane M. Alsweiler, Gregory G. Gamble, Caroline A. Crowther, Jane E. Harding

Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.

Già abbonato a @@106933@@ rivista ?

@@150455@@ Voir plus

Il mio account


Dichiarazione CNIL

EM-CONSULTE.COM è registrato presso la CNIL, dichiarazione n. 1286925.

Ai sensi della legge n. 78-17 del 6 gennaio 1978 sull'informatica, sui file e sulle libertà, Lei puo' esercitare i diritti di opposizione (art.26 della legge), di accesso (art.34 a 38 Legge), e di rettifica (art.36 della legge) per i dati che La riguardano. Lei puo' cosi chiedere che siano rettificati, compeltati, chiariti, aggiornati o cancellati i suoi dati personali inesati, incompleti, equivoci, obsoleti o la cui raccolta o di uso o di conservazione sono vietati.
Le informazioni relative ai visitatori del nostro sito, compresa la loro identità, sono confidenziali.
Il responsabile del sito si impegna sull'onore a rispettare le condizioni legali di confidenzialità applicabili in Francia e a non divulgare tali informazioni a terzi.


Tutto il contenuto di questo sito: Copyright © 2026 Elsevier, i suoi licenziatari e contributori. Tutti i diritti sono riservati. Inclusi diritti per estrazione di testo e di dati, addestramento dell’intelligenza artificiale, e tecnologie simili. Per tutto il contenuto ‘open access’ sono applicati i termini della licenza Creative Commons.