Positive and negative aspects of Palliative Care in Perinatology and Neonatology from the perspective of a multi-professional team

Authors

DOI:

https://doi.org/10.33448/rsd-v11i5.28010

Keywords:

Palliative care; Perinatology; Neonatology; Patient care team.

Abstract

Objetives: to identify positive and negative aspects in the palliative care assistance of pregnant women with detected fetal abnormalities and/or newborns with poor prognosis, according to the perception of a multidisciplinary team in a university hospital. Methods: descriptive study with a qualitative approach with professionals from the maternity unit, obstetric emergency room and neonatal intensive care unit. Data collection took place from June 2018 to May 2019, through semi-structured interviews. The Critical Incident Technique was used. Results: the study sample consisted of 56 professionals from the multidisciplinary team. 236 critical incidents emerged, 88 with positive aspects and 148 with negative ones. Conclusion: it was possible to identify a more significant number of negative references to the detriment of positive ones regarding palliative care, demonstrating that such approach involves more difficulties for its proper implementation. This study provided information that might enable the development of measures to improve palliative for this population and to promote a perinatal and neonatal palliative care group implementation with periodic training and education for the multidisciplinary team.

Author Biographies

Fernanda Pegoraro de Godoi Melo, Londrina State University

Mestre em Ciencias da Reabilitaçao pela UEL. Professor Assistente da UEL, Medico Plantonista da Unidade de Terapia Intensiva Neonatal do Hospital Universitario de Londrina - UEL

Marcelle de Oliveira Peripolli, Londrina State University

Medica Neonatologista. Professor da Universidade Positivo. 

Nilson Willamy Bastos de Souza Junior, Londrina State University

Fisioterapeuta. Doutorando em Ciencias da Reabilitaçao da UEL.

Vanessa Suziane Probst, Londrina State University

Fisioterapeuta. Professora Adjunto do Departamento de Fisioterapia da UEL.

References

Almeida, F. D. A., & Moraes, M. S. De. (2016). Cuidando do neonato que está morrendo e sua família: vivências do enfermeiro de terapia intensiva neonatal. Revista Da Escola de Enfermagem Da USP, 50(spe), 122–129.

Almeida, F. de A., de Moraes, M. S., Cunha, M. L. da R., & Baldoino, A. S. (2016). Taking care of the newborn dying and their families: Nurses’ experiences of neonatal intensive care. Revista Da Escola de Enfermagem, 50(Specialissue), 118–124. https://doi.org/10.1590/S0080-623420160000300018

Bateman, L. B., Clair, J. M., Inquiry, N., Bateman, L. B., & Clair, J. M. (2019). Physician Religion and End – of – Life Pediatric Care : A Qualitative Examination of Physicians ’ Perspectives Physician Religion and End – of – Life Pediatric Care : A Qualitative Examination of Physicians ’ Perspectives. 5(3), 251–269.

Beltran, S. J., & Hamel, M. N. (2020). Caring for Dying Infants: A Systematic Review of Healthcare Providers’ Perspectives of Neonatal Palliative Care. American Journal of Hospice and Palliative Medicine. https://doi.org/10.1177/1049909120965949

Bernardes, L. S., Jesus, R. C. D. A., Oliveira, F. F., Benute, G. R. G., Gibelli, M. A. B. C., Nascimento, N. B., … Francisco, R. P. (2020). Family Conferences in Prenatal Palliative Care. Journal of Palliative Medicine, 23(10), 1349–1356. https://doi.org/10.1089/jpm.2019.0579

Cortezzo, D. E., Sanders, M. R., Brownell, E. A., & Moss, K. (2014). End-of-Life Care in the Neonatal Intensive Care Unit: Experiences of Staff and Parents. American Journal of Perinatology, 32(8), 713–723. https://doi.org/10.1055/s-0034-1395475

Currie, E. R., Christian, B. J., Hinds, P. S., Perna, S. J., Robinson, C., Day, S., & Meneses, K. (2016). Parent Perspectives of Neonatal Intensive Care at the End-of-Life. Journal of Pediatric Nursing, 31(5), 478–489. https://doi.org/10.1016/j.pedn.2016.03.023

Da Silva, G. D., Silvino, Z. R., Dos Santos, M. F. de O., Dias, P. S. C., Dela Coleta, M. F., & Matos, P. B. de C. (2016). Técnica de Incidentes Críticos: Aplicabilidade nas Pesquisas de Enfermagem Critical incident technique: applicability in nursing research. Revista de Pesquisa: Cuidado é Fundamental Online, 8(2), 4142. https://doi.org/10.9789/2175-5361.2016.v8i2.4142-4153

Erikson, A., & Davies, B. (2017). Maintaining Integrity: How Nurses Navigate Boundaries in Pediatric Palliative Care. Journal of Pediatric Nursing, 35, 42–49. https://doi.org/10.1016/j.pedn.2017.02.031

Feltman, D. M., Du, H., & Leuthner, S. R. (2012). Survey of neonatologists attitudes toward limiting life-sustaining treatments in the neonatal intensive care unit. Journal of Perinatology, 32(11), 886–892. https://doi.org/10.1038/jp.2011.186

Figueredo, C. (n.d.). Concepções da equipe multiprofissional sobre a implementação dos cuidados paliativos na unidade de terapia intensiva Perceptions of the multi-professional team on the implementation of palliative care in intensive care units. 2597–2604.

Flaig, F., Lotz, J. D., Knochel, K., Borasio, G. D., Führer, M., & Hein, K. (2019). Perinatal Palliative Care: A qualitative study evaluating the perspectives of pregnancy counselors. Palliative Medicine, 33(6), 704–711. https://doi.org/10.1177/0269216319834225

Flanagan, J. (1973). A técnica do incidente crítico. Arquivos Brasileiros de Psicologia Aplicada, 25(2), 99–141.

Gibson, K., Hofmeyer, A., & Warland, J. (2018). Nurses Providing End-of-Life Care for Infants and Their Families in the NICU: A Review of the Literature. Advances in Neonatal Care, 18(6), 471–479. https://doi.org/10.1097/ANC.0000000000000533

Gomes, B., Calanzani, N., Curiale, V., McCrone P., P., Higginson, I. J., & Brito, M. de. (2016). Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Sao Paulo Medical Journal, 134(1), 93. https://doi.org/10.1590/1516-3180.20161341T2

Hajery M, A., Mutairi H, A., A, A., & MK, A. (2018). Perception, Knowledge and Barriers to End of Life Palliative Care among Neonatal and Pediatric Intensive Care Physicians. Journal of Palliative Care & Medicine, 08(01). https://doi.org/10.4172/2165-7386.1000326

Haug, S., Farooqi, S., Wilson, C. G., Hopper, A., Oei, G., & Carter, B. (2018). Survey on Neonatal End-of-Life Comfort Care Guidelines Across America. Journal of Pain and Symptom Management, 55(3), 979-984.e2. https://doi.org/10.1016/j.jpainsymman.2017.10.023

Kenner, C., Press, J., & Ryan, D. (2015). Recommendations for palliative and bereavement care in the NICU : a family-centered integrative approach. Journal of Perinatology, 35(S1), S19–S23. https://doi.org/10.1038/jp.2015.145

Kilcullen, M. (2017). Palliative care in the neonatal unit : neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery. 1–12. https://doi.org/10.1186/s12904-017-0202-3

Koch, C. L., Rosa, A. B., & Bedin, S. C. (2017). Más notícias : significados atribuídos na prática assistencial neonatal / pediátrica. 25(3), 577–584.

Kyc, S. J., Bruno, C. J., Shabanova, V., & Montgomery, A. M. (2020). Perceptions of neonatal palliative care: Similarities and differences between medical and nursing staff in a level IV neonatal intensive care unit. Journal of Palliative Medicine, 23(5), 662–669. https://doi.org/10.1089/jpm.2019.0523

Lewis, S. L., & Ahern, K. (2017). Exploring NICU Nurses’ Affective Responses to End-of-Life Care. Advances in Neonatal Care, 17(2), 96–105. https://doi.org/10.1097/ANC.0000000000000355

Lima, K. M. de A., Maia, A. H. N., & Nascimento, I. R. C. do. (2019). Comunicação de más notícias em cuidados paliativos na oncopediatria. Revista Bioética, 27(4), 719–727. https://doi.org/10.1590/1983-80422019274355

Oliveira, F. D. C. De, Cleveland, L. M., Darilek, U., Regina, A., Silva, B., & Carmona, E. V. (2018). Brazilian Neonatal Nurses ’ Palliative Care Experiences. 32(4), 3–10. https://doi.org/10.1097/JPN.0000000000000361

Oliveira, F. F., Benute, G. R. G., Gibelli, M. A. B., Nascimento, N. B., Barbosa, T. V. A., Bolibio, R., … Bernardes, L. S. (2020). Breaking Bad News: A Study on Formal Training in a High-Risk Obstetrics Setting. Palliative Medicine Reports, 1(1), 50–57. https://doi.org/10.1089/pmr.2020.0014

Quinn, M., & Gephart, S. (2016). Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit. Advances in Neonatal Care, 16(6), 430–438. https://doi.org/10.1097/ANC.0000000000000354

Radbruch, L., De Lima, L., Knaul, F., Wenk, R., Ali, Z., Bhatnaghar, S., … Pastrana, T. (2020). Redefining Palliative Care—A New Consensus-Based Definition. Journal of Pain and Symptom Management, 60(4), 754–764. https://doi.org/10.1016/j.jpainsymman.2020.04.027

Richards, C. A., Starks, H., O’Connor, M. R., Bourget, E., Hays, R. M., & Doorenbos, A. Z. (2018). Physicians Perceptions of Shared Decision-Making in Neonatal and Pediatric Critical Care. American Journal of Hospice and Palliative Medicine, 35(4), 669–676. https://doi.org/10.1177/1049909117734843

Tosello, B., Dany, L., Bétrémieux, P., Le Coz, P., Auquier, P., Gire, C., & Einaudi, M. A. (2015). Barriers in referring neonatal patients to perinatal palliative care: A French multicenter survey. PLoS ONE, 10(5), 1–11. https://doi.org/10.1371/journal.pone.0126861

Wool, C. (n.d.). Barriers in perinatal palliative care. (February 2015).

Wool, C., Black, B. P., & Woods, A. B. N. (2016). Quality indicators and parental satisfaction with perinatal palliative care in the intrapartum setting after diagnosis of a life-limiting fetal condition. Advances in Nursing Science, 39(4), 346–357. https://doi.org/10.1097/ANS.0000000000000147

Downloads

Published

31/03/2022

How to Cite

MELO, F. P. de G. .; PERIPOLLI, M. de O. .; SOUZA JUNIOR, N. W. B. de .; ZANI, A. V. .; PROBST, V. S. . Positive and negative aspects of Palliative Care in Perinatology and Neonatology from the perspective of a multi-professional team. Research, Society and Development, [S. l.], v. 11, n. 5, p. e14111528010, 2022. DOI: 10.33448/rsd-v11i5.28010. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28010. Acesso em: 16 nov. 2024.

Issue

Section

Health Sciences