Behaviors used by neonatologists in face of patients without curative possibilities in Santa Catarina in 2021
DOI:
https://doi.org/10.33448/rsd-v11i14.35758Keywords:
Palliative care; Infant, newborn; Neonatal Intensive Care Units.Abstract
Objective: The aim of this study was avaliate the conduct of neonatologists in the Neonatal Intensive Care Unit (NICU), facing newborns without curative possibilities, comparing with the sociodemographic characteristics of professionals and the existence of guidelines in the NICU, in Santa Catarina (SC) in 2021. Methods: This is a cross-sectional study carried out with neonatologists from the NICU of SC, from March to June 2021. Data collection was performed through an electronic questionnaire, built on a Likert scale (n=110). Spearman's Correlation Test was used to determine whether the variable knowledge about neonatal palliative care differed statistically according to the views, practices and sociodemographic characteristics of the research participants, achieving a significance level of p ≤ 0.05. Results: The total number of participants, 100% affirmed need mandatory training PC training during medical residency, 85.5% revealed differences in the application of PC, 46.4% considered there was no favorable NICU environment for the provision of PC, 70% claimed that the participation of parents in decisions about PC does not happened. The use of guidelines in the NICU (Rho= -0.332) and confidence in the application of the PC (Rho= -0.375) showed a negative correlation with the frequency of application of the PC. Conclusion: The frequency of PC application influenced in trust level, the use of guidelines and less differences in the provision of this care. Furthermore, the lack of trust, guidelines and a NICU with an adequate environment confirmed the need for measures to fill in the gaps in neonatal palliative care.
References
Aujoulat, I., Henrard, S., Charon, A., Johansson, A., Langhendries, J., Mostaert, A. et al. (2018) End-of-life decisions and practices for very preterm infants in the Wallonia-Brussels Federation of Belgium. BMC Pediatrics. 18 (1).
Blakeley, C., Smith, D.M., Johnstone, E.D. et al. (2019) Parental decision-making following a prenatal diagnosis that is lethal, life-limiting, or has long term implications for the future child and family: a meta-synthesis of qualitative literature. BMC Med Ethics. 20:56.
Benini, F., Congedi, S., Rusalen, F., Cavicchiolo, M., & Lago, P. (2020) Barriers to Perinatal Palliative Care Consultation. Frontiers in pediatrics. 8.
Boan Pion, A., Baenziger, J., Fauchère, J., Gubler, D., & Hendriks, M. (2021) National Divergences in Perinatal Palliative Care Guidelines and Training in Tertiary NICUs. Frontiers in Pediatrics.9.
Bucher, H., Klein, S., Hendriks, M., Baumann-Hölzle, R., Berger, T., Streuli, J. et al. (2018) Decision-making at the limito f viability: differing perceptions and opinions between neonatal physicians and nurses. BMC Pediatrics.18 (1).
Carter, B., Howenstein, M., Gilmer, M.J., Throop, P., France, D., & Whitlock, J.A. (2004) Circumstances surrounding the deaths of hospitalized children: Opportunities for pediatric palliative care. Pediatrics.; 114:e361-e366.
Carter, B.S. (2018) Pediatric Palliative Care in Infants and Neonates. Children (Basel).;5(2):21.
Carvalhais, M., Pereira, A.C., Pinho, A.M., Gonçalves, A.P., Caldeira, Â., Silva, C.P., & Soares, L.S. (2019) Morte em neonatologia: Vivências dos profissionais de saúde na prestação de cuidados paliativos neonatais. Millenium. 2(9):103-110.
Chatziioannidis, I., Iliodromiti, Z., Boutsikou, T., Pouliakis, A., Giougi, E., Sokou, R. et al. (2020) Atitudes dos médicos em relação às decisões de fim de vida em Unidades de Terapia Intensiva Neonatal: uma pesquisa multicêntrica nacional. BMC Medical Ethics. 21 (1).
Conselho Regional de Enfermagem de Santa Catarina. COREN. (2016) Enfermagem em cuidados paliativos. COREN/SC orienta. http://www.corensc.gov.br/wp- content/uploads/2016/11/Cuidados-Paliativos-Parte-1-Site.pdf
European Association for Palliative Care. EAPC. (2013) Core of competencies for education in Pediatric Palliative Care.
Escola de Educação Permanente do Hospital das Clínicas - Faculdade de Medicina da Universidade de São Paulo. EEP HCFM-USP (2018) Cuidados paliativos tratam da vida, e não da morte. https://eephcfmusp.org.br/portal/online/cuidados-paliativos-tratam-vida-nao- morte/
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. Palliat Med. 33(6):704-711.
Haug, S., Farooqi, S.G., Wilson, C., Hopper, A., Oei, G., & Carter, B. (2018) Survey on Neonatal End-of-Life Comfort Care Guidelines Across America. J Pain and Symptom Management. 55:979-984e2.
Kyc, S., Bruno, C., Shabanova, V., & Montgomery, A. (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.
Marc-Aurele, K.L., Hull, A.D., Jones, M.C., & Pretorius, D.H. (2018) A fetal diagnostic center’s referral rate for perinatal palliative care. Ann Palliat Med 7(2): 177-185.
Maruyama, H., Shibata, Y., Xia, X., Sun, Y., He, S., & Ito, Y. (2018) Comparison of decision-making in neonatal care between China and Japan. World Journal of Pediatrics. 15 (1): 85-91.
Niehaus, J.Z., Palmer, M.M., Slaven, J. et al. (2020) Neonatal palliative care: perception differences between providers. J Perinatol.
Nguyen, L.T., Cooperberg, D.B., & Spear, M.L. (2018) Introduction of triggers for palliative care consultation improves utilization and satisfaction within a level four NICU. J Perinatol. 38:574–579.
Oliveira, F.C., Cleveland, L.M., Darilek, U., Borges Silva, A.R., & Carmona, E.V. (2018) Brazilian Neonatal Nurses' Palliative Care Experiences. J Perinat Neonatal Nurs.32(4):E3-E10.
Oswald, W. (2013) Sobre a morte e o Morrer. 6.ed. Lisboa: Fundação Francisco Manuel dos Santos. 88p.
Peng, N., Liu, H., Wang, T., Chang, Y., Lee, H., & Liang, H. (2018) Journal of Palliative Medicine. 21 (11): 1558-1565.
Quinn, M., Gephart, S. (2016) Evidence of Implementation Strategies to Provide Palliative Care in the Neonatal Intensive Care Unit. Adv Neonatal Care.; 16 (6): 430-438.
Silva, E.M.B., Silva Maria, J.M., & Silva, D.M. (2019) Perceção dos profissionais de saúde sobre os cuidados paliativos neonatais. Rev. Bras. Enferm. 72(6):1707-1714.
Stenekes, S., Penner, J.L., Harlos, M., et al. (2019) Development and Implementation of a Survey to Assess Health-Care Provider's Competency, Attitudes, and Knowledge About Perinatal Palliative Care. J Palliat Care.34(3):151-159.
Trowbridge, A., Bamat, T., Griffis, H., McConathey, E., Feudtner, C., & Walter, J. (2020) Pediatric Resident Experience Caring for Childen at the End of Life in a Children’s Hospital. 20 (1): 81-88.
World Palliative Care Alliance; World Health Organization. WHO. (2014) Global Atlas of Palliative Care at the End of Life. https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf
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