Who decides? Exploring decisional dynamics for periviable resuscitation among diverse family structures.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-04-16 DOI:10.1038/s41372-025-02290-5

Erika R Cheng, Shelley M Hoffman, Victoria Schultz, Naomi Castellon-Perez, Hannah Witting, Carli King, Brownsyne Tucker Edmonds

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引用次数: 0

Abstract

Objective: To investigate conflict resolution and decisional authority among diverse family structures in periviable resuscitation decision-making.

Methods: We recruited 60 parent dyads, including 30 with prior periviable delivery experience and 30 first-time expecting dyads between 22 and 26 weeks gestation. Our diverse sample included heterosexual and same-sex partnerships, married and unmarried partners. Virtual interviews explored decision-making, engagement, and conflict resolution.

Results: Four themes emerged: "Mom is the priority," highlighting maternal decisional authority; "partner involvement is crucial," emphasizing engagement; "parents prioritize who will be caring for the child," indicating caregiver considerations; and "parents want empathy and support," underscoring emotional needs.

Conclusions: Findings reveal maternal priority in decision-making, the importance of partner involvement, and a challenges with lacking inclusive legal and ethical guidance for non-heteronormative families. The study highlights the need for shared decision-making that considers family structures, legal aspects, and emotional complexities to enhance inclusive, informed decision-making processes for parents facing periviable delivery.

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谁决定?探索不同家庭结构中围生期复苏的决策动力学。

目的：探讨不同家庭结构在围生期复苏决策中的冲突解决和决策权。方法：我们招募了60对父母，其中30对有孕周分娩经验，30对在妊娠22 ~ 26周首次怀孕。我们多样化的样本包括异性恋和同性伴侣，已婚和未婚伴侣。虚拟访谈探讨了决策、参与和冲突解决。结果：出现了四个主题：“妈妈优先”，突出了母亲的决策权；“合作伙伴的参与至关重要”，强调参与；“父母优先考虑谁来照顾孩子”，表明照顾者的考虑；“父母需要同情和支持”，强调情感需求。结论：研究结果揭示了孕产妇在决策中的优先地位，伴侣参与的重要性，以及缺乏包容性法律和伦理指导的挑战。该研究强调了共同决策的必要性，考虑到家庭结构、法律方面和情感复杂性，以增强面临难产的父母的包容性和知情决策过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.