How nurses assist parents regarding life support decisions for extremely premature infants.
OBJECTIVE
To describe nurse behaviors that assisted parents to make life-support decisions for an extremely premature infant before and after the infant's birth.


METHODS
Qualitative, longitudinal, collective case study where interviews were done pre- and postnatally and medical chart data were collected.


METHODS
Interviews were conducted face-to-face in a private room in the hospital, in the mother's home, or over the telephone.


METHODS
A sample of 40 cases (40 mothers, 14 fathers, 42 physicians, 17 obstetric nurses, 6 neonatal nurses, and 6 neonatal nurse practitioners) was recruited from three hospitals that provided high-risk perinatal care. Parents were at least 18 years of age, English speaking, and had participated in a prenatal discussion with a physician regarding treatment decisions for their infant due to threatened preterm delivery. Physicians and nurses were those identified by parents who had spoken to them about life-support treatment decisions for the infant.


METHODS
Using a semistructured interview guide, a total of 203 interviews were conducted (137 prenatal, 51 postnatal, and 15 end-of-life). For this analysis, all coded data related to the nurse's role were analyzed and summarized.


RESULTS
Parents and nurses described several nurse behaviors: providing emotional support, giving information, and meeting the physical care needs of mothers, infants, and fathers. Physicians' description of the nurse behaviors focused on the way nurses provided emotional support and gave information.


CONCLUSIONS
Nurses play a critical role in assisting parents surrounding life-support decisions.
Kavanaugh
Karen
K
Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois 60612-7350, USA. karenk@uic.edu
Moro
Teresa T
TT
Savage
Teresa A
TA
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006379:Helping Behavior; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000523:psychology; D008020:Life Support Care / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D017283:Neonatal Nursing / Q000379:methods; D024802:Nurse's Role / Q000523:psychology*; D015404:Nursing Methodology Research; D010290:Parents / Q000193:education / Q000523:psychology*; D011368:Professional-Family Relations; D036301:Qualitative Research; D012944:Social Support; D011795:Surveys and Questionnaires
Pediatrics. 2009 Feb;123(2):595-7
19171626
MCN Am J Matern Child Nurs. 2000 Jul-Aug;25(4):204-10
10994310
Arch Dis Child Fetal Neonatal Ed. 2002 Sep;87(2):F113-7
12193517
Semin Fetal Neonatal Med. 2008 Feb;13(1):8-15
17993295
Int J Nurs Pract. 2005 Jun;11(3):108-17
15853789
J Perinatol. 2006 Jan 1;26(1):44-8
16292336
MCN Am J Matern Child Nurs. 2005 Mar-Apr;30(2):121-6
15775808
J Med Ethics. 2001 Apr;27(2):104-9
11314152
Res Nurs Health. 2006 Jun;29(3):244-52
16676343
J Perinatol. 2004 Jan;24(1):4-10
14726930
J Pediatr Nurs. 2005 Oct;20(5):347-59
16182094
J Perinat Neonatal Nurs. 2000 Sep;14(2):73-86
11930462
Pediatrics. 2009 Jul;124(1):422-7
19564329
Soc Sci Med. 2007 Apr;64(7):1487-500
17196312
Pediatrics. 2008 Sep;122(3):583-9
18762529
Eur J Pediatr. 2001 Jun;160(6):339-44
11421412
MCN Am J Matern Child Nurs. 2004 May-Jun;29(3):144-50
15123969
J Pediatr Nurs. 2005 Oct;20(5):311-25
16182091
J Obstet Gynecol Neonatal Nurs. 2007 Jan-Feb;36(1):63-70
17238948
J Obstet Gynecol Neonatal Nurs. 2007 Jul-Aug;36(4):313-8
17594405
Image J Nurs Sch. 1993 Winter;25(4):352-7
8288305
Birth. 2003 Jun;30(2):109-15
12752168
Patient Educ Couns. 1998 Mar;33(3):267-79
9731164