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Health professionals' perceptions about the decision-making process in the care of pediatric patients

OBJECTIVE: To evaluate the perceptions of physicians, nurses and nursing technicians of their participation in the decision-making process surrounding life support limitation in terminally ill pediatric patients, with comparisons by professional category. METHODS: A cross-sectional study was conduct...

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Autores principales: Trotta, Eliana de Andrade, Scarpa, Fernanda Cristina, Halal, Michel George El, Goldim, José Roberto, Carvalho, Paulo Roberto Antonacci
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação de Medicina Intensiva Brasileira - AMIB 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051194/
https://www.ncbi.nlm.nih.gov/pubmed/27737415
http://dx.doi.org/10.5935/0103-507X.20160057
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author Trotta, Eliana de Andrade
Scarpa, Fernanda Cristina
Halal, Michel George El
Goldim, José Roberto
Carvalho, Paulo Roberto Antonacci
author_facet Trotta, Eliana de Andrade
Scarpa, Fernanda Cristina
Halal, Michel George El
Goldim, José Roberto
Carvalho, Paulo Roberto Antonacci
author_sort Trotta, Eliana de Andrade
collection PubMed
description OBJECTIVE: To evaluate the perceptions of physicians, nurses and nursing technicians of their participation in the decision-making process surrounding life support limitation in terminally ill pediatric patients, with comparisons by professional category. METHODS: A cross-sectional study was conducted in the pediatric intensive care unit of a tertiary public university hospital with the participation of physicians, nurses and nursing technicians. The MacArthur Admission Experience Survey Voice Scale was used to assess and quantify the perceptions of professionals who assisted 17 pediatric patients with life support limitation within 24 hours after the outcome of each patient was determined. All professionals working in the unit (n = 117) who were potentially eligible for the study received a free and informed consent form prior to the occurrence of the cases studied. RESULTS: Study participants included 25/40 (62.5%) physicians, 10/17 (58.8%) nurses and 41/60 (68.3%) nursing technicians, representing 65% of the eligible professionals identified. The questionnaire return rate was higher for physicians than technicians (p = 0.0258). A perceived lack of voice was reported in all three professional categories at varying rates that were lower for physicians than for nurses and nursing technicians (p < 0.00001); there was no difference between the latter (p = 0.7016). In the three professional categories studied, three subscale items were reported. For two of the three statements, there were significant differences between physicians and nurses (p = 0.004) and between physicians and nursing technicians (p = 0.001). For one of the statements, there was no difference among the three professional categories. CONCLUSION: Respondents perceived a lack of voice in the decision-making process at varying rates across the three categories of studied professionals who assisted terminally ill pediatric patients with life support limitation, with physicians expressing lowered rates of perceived coercion.
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spelling pubmed-50511942016-10-06 Health professionals' perceptions about the decision-making process in the care of pediatric patients Trotta, Eliana de Andrade Scarpa, Fernanda Cristina Halal, Michel George El Goldim, José Roberto Carvalho, Paulo Roberto Antonacci Rev Bras Ter Intensiva Original Articles OBJECTIVE: To evaluate the perceptions of physicians, nurses and nursing technicians of their participation in the decision-making process surrounding life support limitation in terminally ill pediatric patients, with comparisons by professional category. METHODS: A cross-sectional study was conducted in the pediatric intensive care unit of a tertiary public university hospital with the participation of physicians, nurses and nursing technicians. The MacArthur Admission Experience Survey Voice Scale was used to assess and quantify the perceptions of professionals who assisted 17 pediatric patients with life support limitation within 24 hours after the outcome of each patient was determined. All professionals working in the unit (n = 117) who were potentially eligible for the study received a free and informed consent form prior to the occurrence of the cases studied. RESULTS: Study participants included 25/40 (62.5%) physicians, 10/17 (58.8%) nurses and 41/60 (68.3%) nursing technicians, representing 65% of the eligible professionals identified. The questionnaire return rate was higher for physicians than technicians (p = 0.0258). A perceived lack of voice was reported in all three professional categories at varying rates that were lower for physicians than for nurses and nursing technicians (p < 0.00001); there was no difference between the latter (p = 0.7016). In the three professional categories studied, three subscale items were reported. For two of the three statements, there were significant differences between physicians and nurses (p = 0.004) and between physicians and nursing technicians (p = 0.001). For one of the statements, there was no difference among the three professional categories. CONCLUSION: Respondents perceived a lack of voice in the decision-making process at varying rates across the three categories of studied professionals who assisted terminally ill pediatric patients with life support limitation, with physicians expressing lowered rates of perceived coercion. Associação de Medicina Intensiva Brasileira - AMIB 2016 /pmc/articles/PMC5051194/ /pubmed/27737415 http://dx.doi.org/10.5935/0103-507X.20160057 Text en http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Trotta, Eliana de Andrade
Scarpa, Fernanda Cristina
Halal, Michel George El
Goldim, José Roberto
Carvalho, Paulo Roberto Antonacci
Health professionals' perceptions about the decision-making process in the care of pediatric patients
title Health professionals' perceptions about the decision-making process in the care of pediatric patients
title_full Health professionals' perceptions about the decision-making process in the care of pediatric patients
title_fullStr Health professionals' perceptions about the decision-making process in the care of pediatric patients
title_full_unstemmed Health professionals' perceptions about the decision-making process in the care of pediatric patients
title_short Health professionals' perceptions about the decision-making process in the care of pediatric patients
title_sort health professionals' perceptions about the decision-making process in the care of pediatric patients
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051194/
https://www.ncbi.nlm.nih.gov/pubmed/27737415
http://dx.doi.org/10.5935/0103-507X.20160057
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