Psychological support in end-of-life decision-making in neonatal intensive care units: Full population survey among neonatologists and neonatal nurses

NICU consortium; Laure Dombrecht; Joachim Cohen; Filip Cools; Luc Deliens; Linde Goossens; Gunnar Naulaers; Kim Beernaert; Kenneth Chambaere

doi:10.1177/0269216319888986

Psychological support in end-of-life decision-making in neonatal intensive care units: Full population survey among neonatologists and neonatal nurses

NICU consortium, Laure Dombrecht, Joachim Cohen, Filip Cools, Luc Deliens, Linde Goossens, Gunnar Naulaers, Kim Beernaert, Kenneth Chambaere

Onderzoeksoutput: Article › peer review

17 Citaten (Scopus)

289 Downloads (Pure)

Samenvatting

BACKGROUND: Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking.

AIM: To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient.

DESIGN/PARTICIPANTS: A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support.

RESULTS: About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support.

CONCLUSION: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.

Originele taal-2	English
Pagina's (van-tot)	430-434
Aantal pagina's	5
Tijdschrift	Palliative Medicine
Volume	34
Nummer van het tijdschrift	3
Vroegere onlinedatum	19 nov 2019
DOI's	https://doi.org/10.1177/0269216319888986
Status	Published - mrt 2020

Bibliografische nota

Funding Information:
Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support. Perinatal death end-of-life care decision-making questionnaire design psychological support system intensive care units neonatal Fonds Wetenschappelijk Onderzoek https://doi.org/10.13039/501100003130 G041716N Bijzonder Onderzoeksfonds https://doi.org/10.13039/501100007229 01J06915 edited-state corrected-proof The authors would like to thank all neonatologists, nurses and neonatal intensive care unit wards that participated in this study, as well as the neonatologists and nurses who aided in testing and validating the questionnaire. Furthermore, they would like to thank Saskia Baes for her help in developing the questionnaire and collecting the data. Finally, they would like to thank Roos Colman for her statistical expertise, Helen White for translating the items used in their questionnaire and Jane Ruthven for her language editing. Collaborators in the consortium: Sabrina Laroche, Claire Theyskens, Christine Vandeputte, Luc Cornette and Hilde Van de Broek. Availability of data and material Questionnaires and detailed research protocols (in Dutch) are available upon written request to the corresponding author ( [email protected] ). Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is funded by the Research Foundation Flanders (FWO; grant no. G041716N to J.C.) and the special research fund of Ghent University (BOF; grant no. 01J06915 to L.De.). K.B. is a postdoctoral fellow of the Research Foundation Flanders (FWO). The study sponsors had no role in study design, the collection, analysis and interpretation of data, the writing of the report and the decision to submit the manuscript for publication. ORCID iD Laure Dombrecht https://orcid.org/0000-0002-7174-4678

Funding Information:
The authors would like to thank all neonatologists, nurses and neonatal intensive care unit wards that participated in this study, as well as the neonatologists and nurses who aided in testing and validating the questionnaire. Furthermore, they would like to thank Saskia Baes for her help in developing the questionnaire and collecting the data. Finally, they would like to thank Roos Colman for her statistical expertise, Helen White for translating the items used in their questionnaire and Jane Ruthven for her language editing. Collaborators in the consortium: Sabrina Laroche, Claire Theyskens, Christine Vandeputte, Luc Cornette and Hilde Van de Broek. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is funded by the Research Foundation Flanders (FWO; grant no. G041716N to J.C.) and the special research fund of Ghent University (BOF; grant no. 01J06915 to L.De.). K.B. is a postdoctoral fellow of the Research Foundation Flanders (FWO). The study sponsors had no role in study design, the collection, analysis and interpretation of data, the writing of the report and the decision to submit the manuscript for publication.

Publisher Copyright:
© The Author(s) 2019.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

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10.1177/0269216319888986

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SRP4: Palliatieve zorg bij kankerpatiënten en niet-kankerpatiënten: volksgezondheid, gezondheidsdiensten en klinisch onderzoek
Deliens, L., Cohen, J., Van den Block, L., Pardon, K., Deliens, L., Cohen, J., Van den Block, L., Chambaere, K., Bilsen, J., Deschepper, R., Rietjens, J. A. C., Sterckx, S., Theuns, P., Vander Stichele, R. & Mortier, F.
1/11/12 → 31/10/24
Project: Fundamenteel

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NICU consortium ; Dombrecht, Laure ; Cohen, Joachim ; Cools, Filip ; Deliens, Luc ; Goossens, Linde ; Naulaers, Gunnar ; Beernaert, Kim ; Chambaere, Kenneth. / Psychological support in end-of-life decision-making in neonatal intensive care units : Full population survey among neonatologists and neonatal nurses. In: Palliative Medicine. 2020 ; Vol. 34, Nr. 3. blz. 430-434.

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title = "Psychological support in end-of-life decision-making in neonatal intensive care units: Full population survey among neonatologists and neonatal nurses",

abstract = "BACKGROUND: Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking.AIM: To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient.DESIGN/PARTICIPANTS: A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support.RESULTS: About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support.CONCLUSION: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.",

keywords = "Perinatal death, decision-making, end-of-life care, intensive care units, neonatal, psychological support system, questionnaire design",

author = "{NICU consortium} and Laure Dombrecht and Joachim Cohen and Filip Cools and Luc Deliens and Linde Goossens and Gunnar Naulaers and Kim Beernaert and Kenneth Chambaere",

note = "Funding Information: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support. Perinatal death end-of-life care decision-making questionnaire design psychological support system intensive care units neonatal Fonds Wetenschappelijk Onderzoek https://doi.org/10.13039/501100003130 G041716N Bijzonder Onderzoeksfonds https://doi.org/10.13039/501100007229 01J06915 edited-state corrected-proof The authors would like to thank all neonatologists, nurses and neonatal intensive care unit wards that participated in this study, as well as the neonatologists and nurses who aided in testing and validating the questionnaire. Furthermore, they would like to thank Saskia Baes for her help in developing the questionnaire and collecting the data. Finally, they would like to thank Roos Colman for her statistical expertise, Helen White for translating the items used in their questionnaire and Jane Ruthven for her language editing. Collaborators in the consortium: Sabrina Laroche, Claire Theyskens, Christine Vandeputte, Luc Cornette and Hilde Van de Broek. Availability of data and material Questionnaires and detailed research protocols (in Dutch) are available upon written request to the corresponding author ( [email protected] ). Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is funded by the Research Foundation Flanders (FWO; grant no. G041716N to J.C.) and the special research fund of Ghent University (BOF; grant no. 01J06915 to L.De.). K.B. is a postdoctoral fellow of the Research Foundation Flanders (FWO). The study sponsors had no role in study design, the collection, analysis and interpretation of data, the writing of the report and the decision to submit the manuscript for publication. ORCID iD Laure Dombrecht https://orcid.org/0000-0002-7174-4678 Funding Information: The authors would like to thank all neonatologists, nurses and neonatal intensive care unit wards that participated in this study, as well as the neonatologists and nurses who aided in testing and validating the questionnaire. Furthermore, they would like to thank Saskia Baes for her help in developing the questionnaire and collecting the data. Finally, they would like to thank Roos Colman for her statistical expertise, Helen White for translating the items used in their questionnaire and Jane Ruthven for her language editing. Collaborators in the consortium: Sabrina Laroche, Claire Theyskens, Christine Vandeputte, Luc Cornette and Hilde Van de Broek. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is funded by the Research Foundation Flanders (FWO; grant no. G041716N to J.C.) and the special research fund of Ghent University (BOF; grant no. 01J06915 to L.De.). K.B. is a postdoctoral fellow of the Research Foundation Flanders (FWO). The study sponsors had no role in study design, the collection, analysis and interpretation of data, the writing of the report and the decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} The Author(s) 2019. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

month = mar,

doi = "10.1177/0269216319888986",

language = "English",

volume = "34",

pages = "430--434",

journal = "Palliative Medicine",

issn = "0269-2163",

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Psychological support in end-of-life decision-making in neonatal intensive care units : Full population survey among neonatologists and neonatal nurses. / NICU consortium ; Dombrecht, Laure ; Cohen, Joachim ; Cools, Filip ; Deliens, Luc; Goossens, Linde; Naulaers, Gunnar; Beernaert, Kim ; Chambaere, Kenneth.

In: Palliative Medicine, Vol. 34, Nr. 3, 03.2020, blz. 430-434.

Onderzoeksoutput: Article › peer review

TY - JOUR

T1 - Psychological support in end-of-life decision-making in neonatal intensive care units

T2 - Full population survey among neonatologists and neonatal nurses

AU - NICU consortium

AU - Dombrecht, Laure

AU - Cohen, Joachim

AU - Cools, Filip

AU - Deliens, Luc

AU - Goossens, Linde

AU - Naulaers, Gunnar

AU - Beernaert, Kim

AU - Chambaere, Kenneth

N1 - Funding Information: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support. Perinatal death end-of-life care decision-making questionnaire design psychological support system intensive care units neonatal Fonds Wetenschappelijk Onderzoek https://doi.org/10.13039/501100003130 G041716N Bijzonder Onderzoeksfonds https://doi.org/10.13039/501100007229 01J06915 edited-state corrected-proof The authors would like to thank all neonatologists, nurses and neonatal intensive care unit wards that participated in this study, as well as the neonatologists and nurses who aided in testing and validating the questionnaire. Furthermore, they would like to thank Saskia Baes for her help in developing the questionnaire and collecting the data. Finally, they would like to thank Roos Colman for her statistical expertise, Helen White for translating the items used in their questionnaire and Jane Ruthven for her language editing. Collaborators in the consortium: Sabrina Laroche, Claire Theyskens, Christine Vandeputte, Luc Cornette and Hilde Van de Broek. Availability of data and material Questionnaires and detailed research protocols (in Dutch) are available upon written request to the corresponding author ( [email protected] ). Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is funded by the Research Foundation Flanders (FWO; grant no. G041716N to J.C.) and the special research fund of Ghent University (BOF; grant no. 01J06915 to L.De.). K.B. is a postdoctoral fellow of the Research Foundation Flanders (FWO). The study sponsors had no role in study design, the collection, analysis and interpretation of data, the writing of the report and the decision to submit the manuscript for publication. ORCID iD Laure Dombrecht https://orcid.org/0000-0002-7174-4678 Funding Information: The authors would like to thank all neonatologists, nurses and neonatal intensive care unit wards that participated in this study, as well as the neonatologists and nurses who aided in testing and validating the questionnaire. Furthermore, they would like to thank Saskia Baes for her help in developing the questionnaire and collecting the data. Finally, they would like to thank Roos Colman for her statistical expertise, Helen White for translating the items used in their questionnaire and Jane Ruthven for her language editing. Collaborators in the consortium: Sabrina Laroche, Claire Theyskens, Christine Vandeputte, Luc Cornette and Hilde Van de Broek. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is funded by the Research Foundation Flanders (FWO; grant no. G041716N to J.C.) and the special research fund of Ghent University (BOF; grant no. 01J06915 to L.De.). K.B. is a postdoctoral fellow of the Research Foundation Flanders (FWO). The study sponsors had no role in study design, the collection, analysis and interpretation of data, the writing of the report and the decision to submit the manuscript for publication. Publisher Copyright: © The Author(s) 2019. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/3

Y1 - 2020/3

N2 - BACKGROUND: Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking.AIM: To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient.DESIGN/PARTICIPANTS: A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support.RESULTS: About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support.CONCLUSION: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.

AB - BACKGROUND: Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking.AIM: To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient.DESIGN/PARTICIPANTS: A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support.RESULTS: About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support.CONCLUSION: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.

KW - Perinatal death

KW - decision-making

KW - end-of-life care

KW - intensive care units

KW - neonatal

KW - psychological support system

KW - questionnaire design

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U2 - 10.1177/0269216319888986

DO - 10.1177/0269216319888986

M3 - Article

C2 - 31739740

VL - 34

SP - 430

EP - 434

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 3

ER -

Psychological support in end-of-life decision-making in neonatal intensive care units: Full population survey among neonatologists and neonatal nurses

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