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Concern for mortality in the neonatal intensive care unit (NICU): parent and physician perspectives

Journal of Perinatology volume 38, pages 718–727 (2018)Cite this article

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Abstract

OBJECTIVE:

The objectives of this study are as follows: (1) to determine the incidence of parental concern for mortality (PCM) and any potential predictors for it among parents of infants admitted to the Neonatal Intensive Care Unit (NICU), and (2) to explore physicians’ perspectives with respect to PCM in the NICU and to examine current practices of addressing it.

STUDY DESIGN:

Separate questionnaires were distributed to members of the AAP Section on Perinatal–Neonatal Medicine District I and to NICU parents post discharge, to gather perspectives from each group. A χ2-analysis and linear regression were performed.

RESULTS:

Response rate was 29% for the physician survey and 63% for the parent survey. Physician respondents believed that PCM increased with decreasing gestational age (GA) and reported having fewer discussions with parents of older infants about PCM. Parental report of PCM incidence was 48% overall. PCM was not associated with GA. PCM was associated with infant length of stay and occurrence of at least one discussion about PCM with physicians. Fifty-three percent of parents reported never having a discussion regarding PCM.

CONCLUSION:

Although physicians believe that PCM increases with decreasing GA, parental report suggests that PCM is not associated with GA. Parents of full-term infants in particular may experience more PCM and desire for discussion than is currently recognized.

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Acknowledgements

We thank all the parents and physicians who took the time to participate in this study, as well as the Division of Newborn Medicine at Tufts Medical Center.

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Authors and Affiliations

  1. Division of Newborn Medicine, The Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA

    Jaclyn Boulais & Jennifer McGuirl

  2. Tufts Medical School, Boston, MA, USA

    Jaclyn Boulais & Jennifer McGuirl

  3. Department of Pediatrics, Tufts Floating Hospital for Children, Tufts Medical Center, Boston, MA, USA

    Teresa Vente & Mary Daley

  4. Office of Educational Affairs, Tufts University School of Medicine, Boston, MA, USA

    Saradha Ramesh

  5. Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA, USA

    Bonnie Arzuaga

  6. Harvard Medical School, Boston, MA, USA

    Bonnie Arzuaga

Authors
  1. Jaclyn Boulais
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  2. Teresa Vente
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  4. Saradha Ramesh
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  5. Jennifer McGuirl
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Correspondence to Jaclyn Boulais.

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The authors declare that they have no conflict of interest.

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Boulais, J., Vente, T., Daley, M. et al. Concern for mortality in the neonatal intensive care unit (NICU): parent and physician perspectives. J Perinatol 38, 718–727 (2018). https://doi.org/10.1038/s41372-018-0076-0

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  • DOI: https://doi.org/10.1038/s41372-018-0076-0

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