Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design
Background:Neonatal death often occurs in tertiary Neonatal Intensive Care Units (NICUs). In China, end-of-life-care (EOLC) does not always involve parents.AimThe aim of this study is to evaluate a parent support intervention to integrate parents at the end of life of their infant in the NICU.Method...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-07-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.870382/full |
| _version_ | 1818190409196634112 |
|---|---|
| author | Rong Zhang Qian Tang Qian Tang Li-hui Zhu Xiao-ming Peng Na Zhang Na Zhang Yue-e Xiong Yue-e Xiong Mu-hua Chen Ke-liang Chen Dan Luo Xun Li Jos M. Latour Jos M. Latour |
| author_facet | Rong Zhang Qian Tang Qian Tang Li-hui Zhu Xiao-ming Peng Na Zhang Na Zhang Yue-e Xiong Yue-e Xiong Mu-hua Chen Ke-liang Chen Dan Luo Xun Li Jos M. Latour Jos M. Latour |
| author_sort | Rong Zhang |
| collection | DOAJ |
| description | Background:Neonatal death often occurs in tertiary Neonatal Intensive Care Units (NICUs). In China, end-of-life-care (EOLC) does not always involve parents.AimThe aim of this study is to evaluate a parent support intervention to integrate parents at the end of life of their infant in the NICU.MethodsA quasi-experimental study using a non-randomized clinical trial design was conducted between May 2020 and September 2021. Participants were infants in an EOLC pathway in the NICU and their parents. Parents were allocated into a family supportive EOLC intervention group or a standard EOLC group based on their wishes. The primary outcomes depression (Edinburgh Postnatal Depression Scale for mothers; Hamilton Depression rating scale for fathers) and Satisfaction with Care were measured 1 week after infants' death. Student t-test for continuous variables and the Chi-square test categorical variables were used in the statistical analysis.ResultsIn the study period, 62 infants died and 45 infants and 90 parents were enrolled; intervention group 20 infants, standard EOLC group 25 infants. The most common causes of death in both groups were congenital abnormalities (n = 20, 44%). Mean gestational age of infants between the family supportive EOLC group and standard EOLC group was 31.45 vs. 33.8 weeks (p = 0.234). Parents between both groups did not differ in terms of age, delivery of infant, and economic status. In the family support group, higher education levels were observed among mother (p = 0.026) and fathers (p = 0.020). Both mothers and fathers in the family supportive EOLC group had less depression compared to the standard EOLC groups; mothers (mean 6.90 vs. 7.56; p = 0.017) and fathers (mean 20.7 vs. 23.1; p < 0.001). Parents reported higher satisfaction in the family supportive EOLC group (mean 88.9 vs. 86.6; p < 0.001).ConclusionsSupporting parents in EOLC in Chinese NICUs might decreased their depression and increase satisfaction after the death of their infant. Future research needs to focus on long-term effects and expand on larger populations with different cultural backgrounds.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT05270915. |
| first_indexed | 2024-12-11T23:58:15Z |
| format | Article |
| id | doaj.art-0500519f1b354c1d907b3f8d783a6f73 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-11T23:58:15Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-0500519f1b354c1d907b3f8d783a6f732022-12-22T00:45:18ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-07-011010.3389/fped.2022.870382870382Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial DesignRong Zhang0Qian Tang1Qian Tang2Li-hui Zhu3Xiao-ming Peng4Na Zhang5Na Zhang6Yue-e Xiong7Yue-e Xiong8Mu-hua Chen9Ke-liang Chen10Dan Luo11Xun Li12Jos M. Latour13Jos M. Latour14Department of Neonatology, Hunan Children's Hospital, Changsha, ChinaDepartment of Nursing, Hunan Children's Hospital, Changsha, ChinaDepartment of Nursing, Hunan University of Chinese Medicine, Changsha, ChinaDepartment of Nursing, Hunan Children's Hospital, Changsha, ChinaDepartment of Neonatology, Hunan Children's Hospital, Changsha, ChinaDepartment of Nursing, Hunan Children's Hospital, Changsha, ChinaDepartment of Nursing, Hunan University of Chinese Medicine, Changsha, ChinaDepartment of Nursing, Hunan Children's Hospital, Changsha, ChinaDepartment of Nursing, Hunan University of Chinese Medicine, Changsha, ChinaDepartment of Neonatology, Hunan Children's Hospital, Changsha, ChinaDepartment of Neonatology, Hunan Children's Hospital, Changsha, ChinaDepartment of Nursing, Hunan Children's Hospital, Changsha, ChinaDepartment of Clinical Research Center, Hunan Children's Hospital, Changsha, ChinaDepartment of Nursing, Hunan Children's Hospital, Changsha, ChinaFaculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, United KingdomBackground:Neonatal death often occurs in tertiary Neonatal Intensive Care Units (NICUs). In China, end-of-life-care (EOLC) does not always involve parents.AimThe aim of this study is to evaluate a parent support intervention to integrate parents at the end of life of their infant in the NICU.MethodsA quasi-experimental study using a non-randomized clinical trial design was conducted between May 2020 and September 2021. Participants were infants in an EOLC pathway in the NICU and their parents. Parents were allocated into a family supportive EOLC intervention group or a standard EOLC group based on their wishes. The primary outcomes depression (Edinburgh Postnatal Depression Scale for mothers; Hamilton Depression rating scale for fathers) and Satisfaction with Care were measured 1 week after infants' death. Student t-test for continuous variables and the Chi-square test categorical variables were used in the statistical analysis.ResultsIn the study period, 62 infants died and 45 infants and 90 parents were enrolled; intervention group 20 infants, standard EOLC group 25 infants. The most common causes of death in both groups were congenital abnormalities (n = 20, 44%). Mean gestational age of infants between the family supportive EOLC group and standard EOLC group was 31.45 vs. 33.8 weeks (p = 0.234). Parents between both groups did not differ in terms of age, delivery of infant, and economic status. In the family support group, higher education levels were observed among mother (p = 0.026) and fathers (p = 0.020). Both mothers and fathers in the family supportive EOLC group had less depression compared to the standard EOLC groups; mothers (mean 6.90 vs. 7.56; p = 0.017) and fathers (mean 20.7 vs. 23.1; p < 0.001). Parents reported higher satisfaction in the family supportive EOLC group (mean 88.9 vs. 86.6; p < 0.001).ConclusionsSupporting parents in EOLC in Chinese NICUs might decreased their depression and increase satisfaction after the death of their infant. Future research needs to focus on long-term effects and expand on larger populations with different cultural backgrounds.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT05270915.https://www.frontiersin.org/articles/10.3389/fped.2022.870382/fullneonatal deathend-of-life careinfantsparentsNeonatal Intensive Care Unitfamily-centered care |
| spellingShingle | Rong Zhang Qian Tang Qian Tang Li-hui Zhu Xiao-ming Peng Na Zhang Na Zhang Yue-e Xiong Yue-e Xiong Mu-hua Chen Ke-liang Chen Dan Luo Xun Li Jos M. Latour Jos M. Latour Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design Frontiers in Pediatrics neonatal death end-of-life care infants parents Neonatal Intensive Care Unit family-centered care |
| title | Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design |
| title_full | Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design |
| title_fullStr | Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design |
| title_full_unstemmed | Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design |
| title_short | Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design |
| title_sort | testing a family supportive end of life care intervention in a chinese neonatal intensive care unit a quasi experimental study with a non randomized controlled trial design |
| topic | neonatal death end-of-life care infants parents Neonatal Intensive Care Unit family-centered care |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.870382/full |
| work_keys_str_mv | AT rongzhang testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT qiantang testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT qiantang testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT lihuizhu testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT xiaomingpeng testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT nazhang testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT nazhang testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT yueexiong testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT yueexiong testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT muhuachen testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT keliangchen testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT danluo testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT xunli testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT josmlatour testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign AT josmlatour testingafamilysupportiveendoflifecareinterventioninachineseneonatalintensivecareunitaquasiexperimentalstudywithanonrandomizedcontrolledtrialdesign |