Parental input into treatment decisions for their low birth weight infants in neonatal intensive care units (NICUs) is both a legal and ethical imperative. For parents to collaborate with health care professionals in treatment decision making, however, they must comprehend complex medical facts and have opportunities to participate with professionals in decision processes. The long-term objective of this research program is to participate with professionals in decision processes. The long-term objective of this research program is to determine optimal ways to enhance parents' abilities to participate in collaborative ethical treatment decision making on behalf of their infants in NICUs. The proposed project tests an intervention to strengthen parent-professional collaborate treatment decision making. The intervention, directed by master's-prepared clinical nurse specialists and assisted by NICU staff nurses and neonatologists, includes: (1) the Infant Progress Chart (IPC) to increase parents' understanding of their infant's condition, treatment options and probable outcomes; and (2) scheduled care planning meetings (CPMs) for parents and professions to discuss relevant issues and to arrive at mutually agreed upon treatment decisions. Over the four-year study period, a total of 150 parents from two hospitals will be selected from NICU admission rosters. A quasi-experimental repeated measures design will be used. Control group members (Phase I, n=75) parents will receive usual care while experimental group members (Phase II, n=75 parents) will receive the intervention involving training in use of the IPC and participation in three CPMs during the first 28 days of admission of their infant to the NICU. Primary outcome variables will be indices of parent profession collaboration, such as parents' knowledge of their infant's condition/treatment options/probable outcomes, relationships with professionals, satisfaction with the decision making process and decisions made, and decision conflict. In addition, cultural and ethical analyses will be conducted on CPM transcripts of dilemmatic cases. ANOVA and regression analyses will be used to test intervention effects and to identify significant predictors of parent professional collaboration in order to target future interventions to those parents most likely to benefit.
| Penticuff, Joy H; Arheart, Kristopher L (2005) Effectiveness of an intervention to improve parent-professional collaboration in neonatal intensive care. J Perinat Neonatal Nurs 19:187-202 |
