title: Development and pretesting of a decision-aid to use when counseling parents facing imminent extreme premature delivery.
abstract: OBJECTIVE
  To develop and pretest a decision-aid to help parents facing extreme premature delivery during antenatal counseling regarding delivery room resuscitation.
  
  
  METHODS
  Semistructured interviews with 31 clinicians and with 30 parents of children born <26 weeks' gestation were conducted following standard methods of qualitative research. These characterized perceptions of prenatal counseling to identify information that parents value when making decisions regarding delivery room resuscitation. These parental needs were formatted into a decision-aid. We assessed the primary outcome of how effectively the decision-aid improved knowledge during a simulated counseling session. Two groups of women were studied: parents with a history of prematurity ("experienced") and healthy women without prior knowledge of prematurity ("naïve").
  
  
  RESULTS
  Interviewees thought that visual formats to present survival and short- and long-term outcome information facilitated their own preparation, recall, and understanding. Accordingly, we designed a decision-aid as a set of cards with pictures and pictographs to show survival rates and complications. There was significant improvement in knowledge in 13 "experienced" parents (P = .04) and 11 "naïve" women (P < .0001). Participants found the cards useful and easy to understand.
  
  
  CONCLUSIONS
  A decision-aid for parents facing extreme premature delivery may improve their understanding of complicated information during antenatal counseling.
authors: Division of Neonatology, Children's Hospital of Philadelphia, PA 19104, USA.
authors: Úrsula
authors: Ú
authors: Guillén
authors: Sanghee
authors: S
authors: Suh
authors: David
authors: D
authors: Munson
authors: Michael
authors: M
authors: Posencheg
authors: Elissa
authors: E
authors: Truitt
authors: John A F
authors: JA
authors: Zupancic
authors: Amiram
authors: A
authors: Gafni
authors: Haresh
authors: H
authors: Kirpalani
mesh_terms: D000328:Adult; D003376:Counseling; D003657:Decision Making; D003661:Decision Support Techniques; D003696:Delivery Rooms; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D047928:Premature Birth / Q000523:psychology*; D012151:Resuscitation / Q000523:psychology*; D055815:Young Adult