n South African Journal of Child Health - Attitudes of mothers and staff towards treatment and possible outcomes of very low-birth-weight (VLBW) infants in Bloemfontein




. In neonatal intensive care units (NICUs), difficult decisions about care and withdrawal of treatment sometimes have to be taken by parents and healthcare workers, especially when the infant will probably have a poor developmental outcome. Only one previous study conducted in South Africa investigated whether preferences in this regard differ between these groups. We aimed to acquire more information on the issue.

. A comparative cohort study comprising separate groups.
. Neonatal units of Universitas Academic and Pelonomi Regional hospitals.
. Mothers of very low-birth-weight (VLBW) babies and children with multiple disabilities; paediatricians (including registrars) and nurses working in these units.
. The preferences for developmental outcomes were compared between four groups: nurses, paediatricians, mothers of VLBW infants, and mothers of babies with multiple disabilities. Different scenarios were illustrated, and questionnaires were used to obtain the opinions on active treatment for babies with a poor developmental outcome.
. When asked whether doctors should attempt to save premature babies, even with a more than 50% chance of being handicapped, 100% of mothers agreed, as opposed to 23% of paediatricians. Similar results were obtained when respondents were asked whether they would prefer to have a severely handicapped child rather than no children at all. Seventy per cent of mothers of VLBW babies indicated that parents are the most important stakeholders in NICU decision making.
. Doctors may underestimate mothers' capacity to cope with handicapped children. The opinion and perspectives of mothers are therefore important factors in NICU decision making.


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