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American Journal of Critical Care. 2004;13: 489-498
Copyright © 2004 by the American Association of Critical-Care Nurses.
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Neonatal Staff and Advanced Practice Nurses’ Perceptions of Bereavement/End-of-Life Care of Families of Critically Ill and/or Dying Infants

By Arthur J. Engler, RNC, DNSc, APRN, Regina M. Cusson, RNC, PhD, APRN, Renee T. Brockett, RNC, MS, APRN, NNP, Charlene Cannon-Heinrich, RN, MS, NNP, Michelle A. Goldberg, RNC, APRN, NNP, Margaret Gorzkowski West, RNC, MS, APRN, NNP and Wendy Petow, RNC, MS, APRN, NNP. From University of Connecticut School of Nursing, Storrs, Conn (AJE, RMC), Bridgeport Hospital, Bridgeport, Conn (RTB), Babies and Children’s Hospital, New York, NY (CCH), Mid-State Medical Center, Meriden Conn (MAG), St. Elizabeth’s Hospital, Boston, Mass (MGW), and University of Connecticut Health Center, Farmington, Conn (WP).

Background Parents need compassionate care when an infant dies. Nurses can provide such care and possibly facilitate grieving, yet often have inadequate preparation in bereavement/end-of-life care.

Objective To describe neonatal nurses’ perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants.

Methods A cross-sectional, descriptive, correlational mailed survey design was used. The 55-item Bereavement End-of-Life Attitudes About Care: Neonatal Nurses Scale containing 4 sections (comfort, roles, involvement, and demographics) was mailed to 240 hospitals in the United States.

Results The final response rate was 52% (190 completed data sets from 125 hospitals). Respondents were comfortable with many aspects of bereavement/end-of-life care. Comfort and roles scores correlated significantly with number of years as a neonatal intensive care nurse. Respondents agreed about many important aspects of their roles with patients’ families, especially the importance of providing daily support to the families. Most respondents identified caring for a dying infant, the actual death of an infant, and language or cultural differences as influential factors in the level of their involvement with families.

Conclusions Education on bereavement/end-of-life care could affect nurses’ comfort with caring for families of critically ill and/or dying infants. Additional education on cultural competence would be helpful. Educators must promote the inclusion of content on bereavement/end-of-life care in nursing curricula. Finally, researchers must focus more attention on factors that promote and inhibit bereavement/end-of-life care of families of critically ill and/or dying infants.




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Copyright © 2004 by the American Association of Critical-Care Nurses.