Defining a Good Death for High-Risk Neonates in the NICU

描述(申请人提供)：新生儿重症监护病房(NICU)中的一些新生儿死亡是不可避免的。当新生儿进入NICU时，新生儿的管理重点是稳定和存活，但对许多新生儿来说，很明显的是，尽管有所有可用的巨大技术能力来管理新生儿疾病，但治疗是徒劳的，死亡是不可避免的。从研究的角度来看，临终关怀很少受到关注。缺乏经验证据来描述垂死新生儿表现出的体征和症状，以及所使用的治疗策略。垂死的新生儿应该得到一个好的死亡。这些新生儿是否经历了良好的死亡尚不清楚。有令人信服的证据表明，大多数垂死的新生儿在死亡过程中没有接受药物治疗。该项目的目的是确定新生儿在临终过程中通常表现出的体征和症状，以及照顾者所使用的策略的管理。数据将通过从医疗记录中提取数据以及从护理垂死新生儿的新生儿工作人员护士以及已死亡新生儿的父母的结构化访谈中获得。

DESCRIPTION (provided by applicant): Death is inevitable for some neonates in the neonatal intensive care unit (NICU). When a neonate is admitted to the NICU, the management of the neonate is focused on stabilization and survival, however for many neonates it becomes apparent that, despite all of the tremendous technical capabilities available to manage neonatal illness, treatment becomes futile and death is inevitable. End-of-life care has received very little attention from a research perspective. Empirical evidence is lacking that characterizes the signs and symptoms that the dying neonate exhibits, as well as the treatment strategies that are used. Dying neonates deserve a good death. Whether these neonates are experiencing a good death is unknown. There is compelling evidence that the majority of dying neonates are not medicated during the dying process. The purpose of this project is to determine the signs and symptoms that are commonly exhibited by the neonate during the dying process and the management of strategies used by caregivers. Data will be obtained by abstracting data from the medical records and from structured interviews with neonatal staff nurses who have cared for dying neonates, as well as parents of neonates who have died.