Neonatal palliative care practices: an Indian perspective.

IF 1.4 4区医学 Q3 PEDIATRICS

Paediatrics and International Child Health Pub Date : 2022-02-01 Epub Date: 2022-06-21 DOI:10.1080/20469047.2022.2089821

Dwayne Mascarenhas, Medha Goyal, Ruchi Nanavati

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引用次数: 0

Abstract

Background: Neonatal palliative care (NPC) aims to prevent and relieve the suffering of neonates who are not going to recover. Although an integral part of neonatal care, it remains in nascent stages in many parts of the world.

Aim: To describe neonatologists' level of knowledge and understanding of NPC, and to describe current practices and barriers to its delivery.

Methods: The study, a cross-sectional web-based national survey, was undertaken between 2019 and 2020. A structured form of 22 questions about NPC was completed by neonatologists across level III neonatal intensive care units in India.

Results: Of the 145 questionnaires sent out, 65 responses were returned (44.8%). The participating units were in both public (38.5%) and private/corporate hospitals (61.5%). The concept of NPC was known to 90.8%, and 93.8% could identify conditions necessitating palliation. However, 81.5% of units lacked a palliative team, and few had teams of only neonatologists and neonatal nurses. Only 10.8% of the units had a structured policy, but none addressed all aspects of neonatal palliation. The creation of memories by parents spending time with their neonate (38.9%), photography (75.9%), footprints (13%) or collecting memorabilia was allowed at many centres. Frequently encountered barriers included inadequate knowledge (16.9%), poor infrastructure (21.5%), inadequate human resources (24.6%) and a lack of structured guidelines and legal support (15.4%).

Conclusion: This is the first study to highlight a large gap in neonatal end-of-life care in India and it reflects an urgent need to facilitate its incorporation into routine care.

Abbreviations: NICU: neonatal intensive care unit; NPC: neonatal palliative care.

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新生儿姑息治疗实践:印度的观点。

背景:新生儿姑息治疗(NPC)的目的是预防和减轻新生儿的痛苦谁是不会恢复。虽然它是新生儿护理的一个组成部分，但在世界许多地方仍处于初级阶段。目的:描述新生儿医生对鼻咽癌的知识和理解水平，并描述目前的做法和障碍。方法:该研究是一项基于网络的横断面全国调查，于2019年至2020年进行。印度三级新生儿重症监护病房的新生儿专家完成了一份包含22个NPC问题的结构化表格。结果:共发放问卷145份，回收65份，回收率为44.8%。参与调查的单位既有公立医院(38.5%)，也有私立/企业医院(61.5%)。90.8%的人知道NPC的概念，93.8%的人能识别需要姑息治疗的病情。然而，81.5%的单位缺乏姑息治疗团队，很少有只有新生儿医生和新生儿护士的团队。只有10.8%的单位有结构化的政策，但没有一个涉及新生儿姑息治疗的所有方面。许多中心允许父母与新生儿共度时光(38.9%)、拍照(75.9%)、留下脚印(13%)或收集纪念品来创造记忆。经常遇到的障碍包括知识不足(16.9%)、基础设施差(21.5%)、人力资源不足(24.6%)以及缺乏结构化指导方针和法律支持(15.4%)。结论:这是第一项研究，突出了印度新生儿临终关怀的巨大差距，它反映了迫切需要促进其纳入日常护理。缩写:NICU:新生儿重症监护病房;新生儿姑息治疗。

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

Paediatrics and International Child Health PEDIATRICS-

CiteScore

3.30

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Paediatrics and International Child Health is an international forum for all aspects of paediatrics and child health in developing and low-income countries. The international, peer-reviewed papers cover a wide range of diseases in childhood and examine the social and cultural settings in which they occur. Although the main aim is to enable authors in developing and low-income countries to publish internationally, it also accepts relevant papers from industrialised countries. The journal is a key publication for all with an interest in paediatric health in low-resource settings.