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Parent Preferences and Experiences in Advance Care Planning in the Neonatal Intensive Care Unit

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Abstract Objective  Our objective was to evaluate the preferences and experiences of bereaved parents around advance care planning (ACP) in the neonatal intensive care unit (NICU). Study Design  Single-center cross-sectional… Click to show full abstract

Abstract Objective  Our objective was to evaluate the preferences and experiences of bereaved parents around advance care planning (ACP) in the neonatal intensive care unit (NICU). Study Design  Single-center cross-sectional survey of bereaved parents who experienced the death of a child in the Boston Children's Hospital NICU between 2010 and 2021 was carried out. Chi-square, Fisher's exact, Fisher Freeman Halton, and Wilcoxin rank sum tests were used to evaluate differences between parents who did and did not receive ACP. Results  Out of eligible parents, 40 out of 146 (27%) responded to our survey. Most parents (31 out of 33, 94%) rated ACP as being very important and 27 out of 33 (82%) reported having ACP discussions during their child's admission. Parents preferred initial ACP discussions to occur early in their child's illness trajectory with members of the primary NICU team, with most parents' experiences aligning with these preferences. Conclusion  Parents value ACP discussions suggesting a further role for ACP in the NICU. Key Points NICU parents value and participate in advance care planning discussions Parents prefer advance care planning with members of the primary NICU, specialty, and palliative care teams Parents prefer advance care planning early in their child's illness trajectory

Keywords: neonatal intensive; advance care; preferences experiences; care planning; care

Journal Title: American Journal of Perinatology
Year Published: 2023

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