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Neonatologists and neonatal nurses have positive attitudes towards perinatal end‐of‐life decisions, a nationwide survey

Laure Dombrecht (UGent) , Luc Deliens (UGent) , Kenneth Chambaere (UGent) , Saskia Baes, Filip Cools, Linde Goossens (UGent) , Gunnar Naulaers, Ellen Roets (UGent) , Veerle Piette (UGent) , Joachim Cohen, et al.
(2020) ACTA PAEDIATRICA. 109(3). p.494-504
Author
Organization
Abstract
Aim Perinatal death is often preceded by an end-of-life decision (ELD). Disparate hospital policies, complex legal frameworks and ethically difficult cases make attitudes important. This study investigated attitudes of neonatologists and nurses towards perinatal ELDs. Methods A survey was handed out to all neonatologists and neonatal nurses in all eight neonatal intensive care units in Flanders, Belgium in May 2017. Respondents indicated agreement with statements regarding perinatal ELDs on a Likert-scale and sent back questionnaires via mail. Results The response rate was 49.5% (302/610). Most neonatologists and nurses found nontreatment decisions such as withholding or withdrawing treatment acceptable (90-100%). Termination of pregnancy when the foetus is viable in cases of severe or lethal foetal problems was considered highly acceptable in both groups (80-98%). Physicians and nurses do not find different ELDs equally acceptable, e.g. nurses more often than physicians (74% vs 60%, p = 0.017) agree that it is acceptable in certain cases to administer medication with the explicit intention of hastening death. Conclusion There was considerable support for both prenatal and neonatal ELDs, even for decisions that currently fall outside the Belgian legal framework. Differences between neonatologists' and nurses' attitudes indicate that both opinions should be heard during ELD-making.
Keywords
Attitude questionnaire, Attitudes of neonatologists and neonatal nurses, End-of-life decisions, Perinatal death, Termination of pregnancy, SELF-REPORTED PRACTICES, INTENSIVE-CARE, GRONINGEN PROTOCOL, PHYSICIANS, TERMINATION, EUTHANASIA, PREGNANCY, MORTALITY, ANOMALIES, INFANTS

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MLA
Dombrecht, Laure, et al. “Neonatologists and Neonatal Nurses Have Positive Attitudes towards Perinatal End‐of‐life Decisions, a Nationwide Survey.” ACTA PAEDIATRICA, vol. 109, no. 3, 2020, pp. 494–504, doi:10.1111/apa.14797.
APA
Dombrecht, L., Deliens, L., Chambaere, K., Baes, S., Cools, F., Goossens, L., … Beernaert, K. (2020). Neonatologists and neonatal nurses have positive attitudes towards perinatal end‐of‐life decisions, a nationwide survey. ACTA PAEDIATRICA, 109(3), 494–504. https://doi.org/10.1111/apa.14797
Chicago author-date
Dombrecht, Laure, Luc Deliens, Kenneth Chambaere, Saskia Baes, Filip Cools, Linde Goossens, Gunnar Naulaers, et al. 2020. “Neonatologists and Neonatal Nurses Have Positive Attitudes towards Perinatal End‐of‐life Decisions, a Nationwide Survey.” ACTA PAEDIATRICA 109 (3): 494–504. https://doi.org/10.1111/apa.14797.
Chicago author-date (all authors)
Dombrecht, Laure, Luc Deliens, Kenneth Chambaere, Saskia Baes, Filip Cools, Linde Goossens, Gunnar Naulaers, Ellen Roets, Veerle Piette, Joachim Cohen, and Kim Beernaert. 2020. “Neonatologists and Neonatal Nurses Have Positive Attitudes towards Perinatal End‐of‐life Decisions, a Nationwide Survey.” ACTA PAEDIATRICA 109 (3): 494–504. doi:10.1111/apa.14797.
Vancouver
1.
Dombrecht L, Deliens L, Chambaere K, Baes S, Cools F, Goossens L, et al. Neonatologists and neonatal nurses have positive attitudes towards perinatal end‐of‐life decisions, a nationwide survey. ACTA PAEDIATRICA. 2020;109(3):494–504.
IEEE
[1]
L. Dombrecht et al., “Neonatologists and neonatal nurses have positive attitudes towards perinatal end‐of‐life decisions, a nationwide survey,” ACTA PAEDIATRICA, vol. 109, no. 3, pp. 494–504, 2020.
@article{8612492,
  abstract     = {{Aim Perinatal death is often preceded by an end-of-life decision (ELD). Disparate hospital policies, complex legal frameworks and ethically difficult cases make attitudes important. This study investigated attitudes of neonatologists and nurses towards perinatal ELDs.

Methods A survey was handed out to all neonatologists and neonatal nurses in all eight neonatal intensive care units in Flanders, Belgium in May 2017. Respondents indicated agreement with statements regarding perinatal ELDs on a Likert-scale and sent back questionnaires via mail.

Results The response rate was 49.5% (302/610). Most neonatologists and nurses found nontreatment decisions such as withholding or withdrawing treatment acceptable (90-100%). Termination of pregnancy when the foetus is viable in cases of severe or lethal foetal problems was considered highly acceptable in both groups (80-98%). Physicians and nurses do not find different ELDs equally acceptable, e.g. nurses more often than physicians (74% vs 60%, p = 0.017) agree that it is acceptable in certain cases to administer medication with the explicit intention of hastening death.

Conclusion There was considerable support for both prenatal and neonatal ELDs, even for decisions that currently fall outside the Belgian legal framework. Differences between neonatologists' and nurses' attitudes indicate that both opinions should be heard during ELD-making.}},
  author       = {{Dombrecht, Laure and Deliens, Luc and Chambaere, Kenneth and Baes, Saskia and Cools, Filip and Goossens, Linde and Naulaers, Gunnar and Roets, Ellen and Piette, Veerle and Cohen, Joachim and Beernaert, Kim}},
  issn         = {{0803-5253}},
  journal      = {{ACTA PAEDIATRICA}},
  keywords     = {{Attitude questionnaire,Attitudes of neonatologists and neonatal nurses,End-of-life decisions,Perinatal death,Termination of pregnancy,SELF-REPORTED PRACTICES,INTENSIVE-CARE,GRONINGEN PROTOCOL,PHYSICIANS,TERMINATION,EUTHANASIA,PREGNANCY,MORTALITY,ANOMALIES,INFANTS}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{494--504}},
  title        = {{Neonatologists and neonatal nurses have positive attitudes towards perinatal end‐of‐life decisions, a nationwide survey}},
  url          = {{http://dx.doi.org/10.1111/apa.14797}},
  volume       = {{109}},
  year         = {{2020}},
}
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