Decisions About Periviable Babies in Dutch Neonatal Intensive Care Units; Quality-of-Life and Quality-of-Death Concerns

2013 ◽  
Vol 9 (1) ◽  
pp. 40-45
Author(s):  
A. A. Eduard Verhagen
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Quality Of Death

scholarly journals Physicians’ attitudes in relation to end-of-life decisions in Neonatal Intensive Care Units: a national multicenter survey

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in Neonatal Intensive Care Units and correlate them with self-reported practices of end-of-life decisions and with their background data. Methods A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians’ attitude and views ranging from value of life to quality of life approach (scale 1–5). Results Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p < 0.001) were factors that affected the attitude score. Conclusions Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.

scholarly journals Physicians’ attitudes in relation to End-of-life Decisions in Neonatal Intensive Care Units: a national multicenter survey

2020 ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensive care units and correlate them with self-reported practices of end-of-life decisions and with their background data. Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians’ attitude and views ranging from value of life to quality of life approach (scale 1 to 5). Results: Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p<0.001) were factors that affected the attitude score. Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.

scholarly journals Physicians’ Attitudes in Relation to End-of-Life Decisions in Neonatal Intensive Care Units: A National Multicenter Survey

2020 ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensive care units and correlate with self-reported practices of end-of-life decisions and with their background data.Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with an attitude questionnaire of 12 items measuring physicians’ views ranging from value of life to quality of life approach (scale 1 to 5).Results: Continuation of adverse prognosis neonates treatment without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to mechanical ventilation withdrawal. Physicians with a high attitude score (indicative of quality-of-life) were more likely to limit, while a low score (indicative of sanctity-of-life) was indicative for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p<0.001) affected the attitude score.Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief in Greek legal system reform.

scholarly journals Physicians’ attitudes in relation to End-of-life Decisions in Neonatal Intensive Care Units: a national multicenter survey

2020 ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensive care units and correlate them with self-reported practices of end-of-life decisions and with their background data.Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians’ attitude and views ranging from value of life to quality of life approach (scale 1 to 5).Results: Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p<0.001) were factors that affected the attitude score.Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.

scholarly journals Evaluating the quality of the processes of care and clinical outcomes of premature newborns admitted to neonatal intensive care units in Mexico

2018 ◽  
Vol 30 (8) ◽  
pp. 608-617 ◽  
Author(s):  
Svetlana V Doubova ◽  
Heladia Josefa-García ◽  
Irma Alejandra Coronado-Zarco ◽  
Sandra Carrera-Muiños ◽  
Guadalupe Cordero-Gonzalez ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Outcomes ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Premature Newborns ◽  
Processes Of Care

scholarly journals Interventions to reduce occupational stress and burn out within neonatal intensive care units: a systematic review

2020 ◽  
Vol 77 (8) ◽  
pp. 515-519 ◽  
Author(s):  
Ilia Bresesti ◽  
Laura Folgori ◽  
Paola De Bartolo
Keyword(s):  
Intensive Care ◽  
Occupational Stress ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Management Training ◽  
Neonatal Intensive Care Units ◽  
Free Text ◽  
Stress Management Training ◽  
Burn Out

Occupational stress is an emerging problem among physician and nurses, and those working in intensive care settings are particularly exposed to the risk of developing burnout. To verify what types of interventions to manage occupational stress and burn out within neonatal intensive care units (NICUs) have been introduced so far and to verify their efficacy among caregivers. PsycINFO (PsycINFO 1967–July week 3 2019), Embase (Embase 1996–2019 week 29) e Medline (Ovid MEDLINE(R) without revisions 1996–July week 2 2019) were systematically searched combining MeSH and free text terms for “burn out” AND “healthcare provider” AND “NICU”. Inclusion criteria were interventions directed to healthcare providers settled in NICUs. Only English language papers were included. Six articles were included in the final analysis. All the studies reported an overall efficacy of the interventions in reducing work-related stress, both when individual focused and organisation directed. The analysis revealed low quality of the studies and high heterogeneity in terms of study design, included populations, interventions and their evaluation assessment. There is currently very limited evidence regarding the management of occupational stress and burn out within NICUs. The quality of available studies was suboptimal. The peculiarities of the NICUs should be considered when developing strategies for occupational stress management. Training self-awareness of workers regarding their reactions to the NICU environment, also from the pre-employment stage, could be an additional approach to prevent and manage stress.

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