What Pediatricians Say to Mothers of Sick Newborns: An Indirect Evaluation of the Counseling Process

[摘要] We examined what physicians tell mothers about their premature infants' chances of survival in the first hours after birth and how mothers interpret the physicians' remarks. Thirty-seven physicians (8 neonatologists, 29 pediatric house officers) and 21 mothers completed forms about hypothetical situations; from these forms, quantitative information was obtained about what each physician thought the chances of survival for a hypothetical infant were, what each physician would tell a parent about the child's chances of survival, and how a mother would interpret the physician's statement about her child. Mothers heard poorer prognoses for their infants than current nursery survival rates would predict; in addition, mothers heard poorer prognoses when counseled by house officers than by neonatologists. The physicians' lack of appreciation of their own nursery's survival rates was the major factor that accounted for the mothers' poorer estimation of the prognoses. House officers, inexperienced in newborn care, had a significantly worse estimation of an infant's actual prognosis than did neonatologists; this difference in knowledge of actual survival rates accounted for the worse prognosis that mothers heard when counseled by a house officer versus a neonatologist. Training programs in neonatology need to ensure that their physicians are aware of the changing experiences that are occurring in the field so that they have the information to counsel parents appropriately.

[学科分类] 儿科学