How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions
Background: As the infant's best interests are determined through the perinatal decisions of family members and physicians, it is important to understand the factors that affect such decisions. This paper investigated the separate and combined effects of various factors related to perinatal dec...
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doaj-5a240627a1764f42bda0ef0099d0ad972020-11-24T22:03:06ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602018-11-01610.3389/fped.2018.00348405514How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal DecisionsJingjing Gong0Wei Xiao1Hongyan Gao2Wei Wei3Weiwei Zhang4Jing Lv5Lijun Xiao6Lida Duan7Yan Zhang8Hongyun Liu9Yonghua Huang10Department of Neurology, PLA Army General Hospital, Beijing, ChinaDepartment of Medical Psychology, Air Force Medical University, Xi'an, ChinaDepartment of Medical Administration, PLA Army General Hospital, Beijing, ChinaDepartment of Neurology, PLA Army General Hospital, Beijing, ChinaDepartment of Neurology, PLA Army General Hospital, Beijing, ChinaDepartment of Psychology, PLA General Hospital, Beijing, ChinaDepartment of Paediatrics, PLA Army General Hospital, Beijing, ChinaDepartment of Medical Administration, PLA Zhurihe Base Hospital, Zhurihe, ChinaCenter of Psychology, Air Force Aviation Medicine Research Institute, Beijing, ChinaSchool of Psychology, Beijing Normal University, Beijing, ChinaDepartment of Neurology, PLA Army General Hospital, Beijing, ChinaBackground: As the infant's best interests are determined through the perinatal decisions of family members and physicians, it is important to understand the factors that affect such decisions. This paper investigated the separate and combined effects of various factors related to perinatal decision making and sought to determine the best way to convey information in an unbiased manner to family members.Methods: In total, 613 participants were consecutively recruited. Each participant completed a series of surveys. All responses to four items were examined via a latent class analysis (LCA) to identify subgroups of participants with similar preferences for intensive care (IC) and comfort care (CC) regarding their potentially premature infant. Multiple logistic regression analyses were applied to identify the sociodemographic predictors for the classification of participants into different subgroups.Results: χ2-tests indicated that perinatal decision making for Item 2 was influenced by framing information, whereas decision making wasn't affected by presentation modes. Furthermore, the endorsement rates of IC significantly decreased with the information increased from brief to detailed, regardless of framing or presentation mode. The LCA indicated that a 3-subgroup model, which included the IC, CC, and variation subgroups, was optimal. Logistic regression analyses demonstrated that, compared with the IC subgroup, negative framing, higher education, parenthood, and poor numeracy predicted participants' preferences for CC. Meanwhile, worrying about physical or mental disabilities predicted preferences for CC and sensitivity to the amount of information provided regarding treatment options (variation subgroup).Conclusions: Perinatal decision making is affected by many factors, suggesting that more detailed information, improved understandability of numerical data, and a neutral tone of voice regarding therapeutic outcomes would be helpful for the families of premature infants to make unbiased decisions. Our findings should be replicated in future research.https://www.frontiersin.org/article/10.3389/fped.2018.00348/fullintensive careperinatal decision makingframing effectlatent class analysisdecision model |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jingjing Gong Wei Xiao Hongyan Gao Wei Wei Weiwei Zhang Jing Lv Lijun Xiao Lida Duan Yan Zhang Hongyun Liu Yonghua Huang |
spellingShingle |
Jingjing Gong Wei Xiao Hongyan Gao Wei Wei Weiwei Zhang Jing Lv Lijun Xiao Lida Duan Yan Zhang Hongyun Liu Yonghua Huang How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions Frontiers in Pediatrics intensive care perinatal decision making framing effect latent class analysis decision model |
author_facet |
Jingjing Gong Wei Xiao Hongyan Gao Wei Wei Weiwei Zhang Jing Lv Lijun Xiao Lida Duan Yan Zhang Hongyun Liu Yonghua Huang |
author_sort |
Jingjing Gong |
title |
How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions |
title_short |
How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions |
title_full |
How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions |
title_fullStr |
How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions |
title_full_unstemmed |
How to Best Convey Information About Intensive/Comfort Care to the Family Members of Premature Infants to Enable Unbiased Perinatal Decisions |
title_sort |
how to best convey information about intensive/comfort care to the family members of premature infants to enable unbiased perinatal decisions |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2018-11-01 |
description |
Background: As the infant's best interests are determined through the perinatal decisions of family members and physicians, it is important to understand the factors that affect such decisions. This paper investigated the separate and combined effects of various factors related to perinatal decision making and sought to determine the best way to convey information in an unbiased manner to family members.Methods: In total, 613 participants were consecutively recruited. Each participant completed a series of surveys. All responses to four items were examined via a latent class analysis (LCA) to identify subgroups of participants with similar preferences for intensive care (IC) and comfort care (CC) regarding their potentially premature infant. Multiple logistic regression analyses were applied to identify the sociodemographic predictors for the classification of participants into different subgroups.Results: χ2-tests indicated that perinatal decision making for Item 2 was influenced by framing information, whereas decision making wasn't affected by presentation modes. Furthermore, the endorsement rates of IC significantly decreased with the information increased from brief to detailed, regardless of framing or presentation mode. The LCA indicated that a 3-subgroup model, which included the IC, CC, and variation subgroups, was optimal. Logistic regression analyses demonstrated that, compared with the IC subgroup, negative framing, higher education, parenthood, and poor numeracy predicted participants' preferences for CC. Meanwhile, worrying about physical or mental disabilities predicted preferences for CC and sensitivity to the amount of information provided regarding treatment options (variation subgroup).Conclusions: Perinatal decision making is affected by many factors, suggesting that more detailed information, improved understandability of numerical data, and a neutral tone of voice regarding therapeutic outcomes would be helpful for the families of premature infants to make unbiased decisions. Our findings should be replicated in future research. |
topic |
intensive care perinatal decision making framing effect latent class analysis decision model |
url |
https://www.frontiersin.org/article/10.3389/fped.2018.00348/full |
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