Parents' Experiences on Therapeutic Hypothermia for Neonates With Hypoxic-Ischemic Encephalopathy (HIE): A Single-Center Cross-Sectional Study.


Journal

Quality management in health care
ISSN: 1550-5154
Titre abrégé: Qual Manag Health Care
Pays: United States
ID NLM: 9306156

Informations de publication

Date de publication:
24 Jul 2023
Historique:
medline: 24 7 2023
pubmed: 24 7 2023
entrez: 24 7 2023
Statut: aheadofprint

Résumé

The purpose of the study is to assess parental experiences of therapeutic hypothermia for moderate to severe hypoxic-ischemic encephalopathy with the goal of improving local clinical practice guidelines and fostering family-integrated care in neonates with hypoxic-ischemic encephalopathy. This single-center retrospective cross-sectional study included neonates and their parents registered in the Swiss National Asphyxia and Cooling Register between 2011 and 2021. Based on a literature review, an anonymous survey of parents of neonates with hypoxic-ischemic encephalopathy was developed and conducted using an online survey tool. Descriptive statistics were used to analyze the survey results. The overall response rate to this survey was 64% (46/72). Sufficient information about hypoxic-ischemic encephalopathy was reported by 78% (36/46) of parents and sufficient information about the process of therapeutic hypothermia by 87% (40/46) of parents. The majority of parents indicated the need for, and at least a satisfactory perception of, professional (91%; 42/46) and emotional (87%; 40/46) support. Parents identified fostering family involvement and regular family communication that focuses on family integrated care as areas for improvement. There is still an unmet need for multidisciplinary teams to provide professional, empathetic, high quality, and family-integrated care to families with a neonate receiving therapeutic hypothermia for moderate or severe hypoxic-ischemic encephalopathy.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
The purpose of the study is to assess parental experiences of therapeutic hypothermia for moderate to severe hypoxic-ischemic encephalopathy with the goal of improving local clinical practice guidelines and fostering family-integrated care in neonates with hypoxic-ischemic encephalopathy.
METHODS METHODS
This single-center retrospective cross-sectional study included neonates and their parents registered in the Swiss National Asphyxia and Cooling Register between 2011 and 2021. Based on a literature review, an anonymous survey of parents of neonates with hypoxic-ischemic encephalopathy was developed and conducted using an online survey tool. Descriptive statistics were used to analyze the survey results.
RESULTS RESULTS
The overall response rate to this survey was 64% (46/72). Sufficient information about hypoxic-ischemic encephalopathy was reported by 78% (36/46) of parents and sufficient information about the process of therapeutic hypothermia by 87% (40/46) of parents. The majority of parents indicated the need for, and at least a satisfactory perception of, professional (91%; 42/46) and emotional (87%; 40/46) support. Parents identified fostering family involvement and regular family communication that focuses on family integrated care as areas for improvement.
CONCLUSIONS CONCLUSIONS
There is still an unmet need for multidisciplinary teams to provide professional, empathetic, high quality, and family-integrated care to families with a neonate receiving therapeutic hypothermia for moderate or severe hypoxic-ischemic encephalopathy.

Identifiants

pubmed: 37482641
doi: 10.1097/QMH.0000000000000414
pii: 00019514-990000000-00050
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

Références

Douglas-Escobar M, Weiss MD. Hypoxic-ischemic encephalopathy: a review for the clinician. JAMA Pediatr. 2015;169(4):397–403.
Shankaran S, Laptook AR, Ehrenkranz RA, et al. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med. 2005;353(15):1574–1584.
Shankaran S, Pappas A, McDonald SA, et al. Childhood outcomes after hypothermia for neonatal encephalopathy. N Engl J Med. 2012;366(22):2085–2092.
Azzopardi DV, Strohm B, Edwards AD, et al. Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med. 2009;361(14):1349–1358.
Azzopardi D, Strohm B, Marlow N, et al. Effects of hypothermia for perinatal asphyxia on childhood outcomes. N Engl J Med. 2014;371(2):140–149.
Hagmann CF, Brotschi B, Bernet V, Latal B, Berger TM, Robertson NJ. Hypothermia for perinatal asphyxial encephalopathy. Swiss Med Wkly. 2011;141:w13145.
Brotschi B, Latal B, Rathke V, Hagmann C. National Asphyxia and Cooling Register in Switzerland. Paediatrica. 2014;25(5):11–12.
Biskop E, Paulsdotter T, Hellström Westas L, Ågren J, Blomqvist YT. Parental participation during therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy. Sex Reprod Healthc. 2019;20:77–80.
Heringhaus A, Dellenmark Blom M, Wigert H. Becoming a parent to a child with birth asphyxia - From a traumatic delivery to living with the experience at home. Int J Qual Stud Health and Well-being. 2013;8:1–13.
Pilon B, Craig AK, Lemmon ME, Goeller A; Newborn Brain Society Guidelines and Publications Committee. Supporting families in their child's journey with neonatal encephalopathy and therapeutic hypothermia. Semin Fetal Neonatal Med. 2021;26(5):101278.
Thyagarajan B, Baral V, Gunda R, Hart D, Leppard L, Vollmer B. Parental perceptions of hypothermia treatment for neonatal hypoxic-ischaemic encephalopathy. J Matern Fetal Neonatal Med. 2018;31(19):2527–2533.
Craig AK, James C, Bainter J, Evans S, Gerwin R. Parental perceptions of neonatal therapeutic hypothermia; emotional and healing experiences. J Matern Fetal Neonatal Med. 2020;33(17):2889–2896.
Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976;33(10):696–705.
LimeSurvey. Survey Service. Jory Nagel; 2021. http://www.limesurvey.org.
Baecke P, Hjelte B, Hellstroem Westas L, Ågren J, Thernstroem Blomqvist Y. When all I wanted was to hold my baby—the experiences of parents of infants who received therapeutic hypothermia. Acta Paediatr. 2021;110(2):480–486.
Servel AC, Rideau Batista Novais A. Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review. Arch Pediatr. 2016;23(9):921–926.
Nassef SK, Blennow M, Jirwe M. Parental viewpoints and experiences of therapeutic hypothermia in a neonatal intensive care unit implemented with family-centered care. J Clin Nurs. 2020;29(21-22):4194–4202.
Craig A, Deerwester K, Fox L, Jacobs J, Evans S. Maternal holding during therapeutic hypothermia for infants with neonatal encephalopathy is feasible. Acta Paediatr. 2019;108(9):1597–1602.
Heinemann AB, Hellstrom-Westas L, Hedberg Nyqvist K. Factors affecting parents' presence with their extremely preterm infants in a neonatal intensive care room. Acta Paediatr. 2013;102(7):695–702.
Lemmon ME, Donohue PK, Parkinson C, Northington FJ, Boss RD. Communication challenges in neonatal encephalopathy. Pediatrics. 2016;138(3):e20161234.
Cawley P, Chakkarapani E. Fifteen-minute consultation: Therapeutic hypothermia for infants with hypoxic ischaemic encephalopathy—translating jargon, prognosis and uncertainty for parents. Arch Dis Child. 2020;105(2):75–83.
Rasmussen LA, Cascio MA, Ferrand A, Shevell M, Racine E. The complexity of physicians' understanding and management of prognostic uncertainty in neonatal hypoxic-ischemic encephalopathy. J Perinatol. 2019;39(2):278–285.
Rasmussen LA, Bell E, Racine E. A qualitative study of physician perspectives on prognostication in neonatal hypoxic ischemic encephalopathy. J Child Neurol. 2016;31(11):1312–1319.
Craig AK, Gerwin R, Bainter J, Evans S, James C. Exploring parent experience of communication about therapeutic hypothermia in the neonatal intensive care unit. Adv Neonatal Care. 2018;18(2):136–143.
Allen KA, Kelley TF. The risks and benefits of conducting sensitive research to understand parental experiences of caring for infants with hypoxic-ischemic encephalopathy. J Neurosci Nurs. 2016;48(3):151–159.
Seshamani M, Nahum A, Decosmo J. How to effectively engage patients and families in quality improvement: a deep, transparent partnership. Int J Qual Health Care. 2021;33(3):mzab112.
Lemmon ME, Donohue PK, Parkinson C, Northington FJ, Boss RD. Parent experience of neonatal encephalopathy. J Child Neurol. 2017;32(3):286–292.

Auteurs

Beate Grass (B)

Division of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland (Drs Grass, Cippa, Hagmann, and Brotschi and Mss Erlach and Rathke); University of Zurich, Zurich, Switzerland (Drs Grass, Hagmann, and Brotschi); and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland (Drs Grass, Hagmann, and Brotschi).

Classifications MeSH