期刊论文详细信息
BMC Research Notes
A transdisciplinary approach to the decision-making process in extreme prematurity
Yves Tremblay1  Raymond D Lambert1  Anne-Marie Gagné1  Marc Simard2 
[1] Obstetrics, Gynecology & Reproduction, Faculty of Medicine, and Centre de Recherche en Biologie de la Reproduction, Laval University; Centre Hospitalier Universitaire de Québec (CHUQ) Research Center, Rm T-1-49, 2705 Laurier Blvd, Quebec City, QC G1V 4G2, Canada;Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia; Life Sciences Institute, Rm 2.320, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
关键词: Sex differences;    Prematurity;    Neonatology;    Web-based forum;    Transdisciplinarity;   
Others  :  1131923
DOI  :  10.1186/1756-0500-7-450
 received in 2014-01-09, accepted in 2014-07-03,  发布年份 2014
PDF
【 摘 要 】

Background

A wide range of dilemmas encountered in the health domain can be addressed more efficiently by a transdisciplinary approach. The complex context of extreme prematurity, which is raising important challenges for caregivers and parents, warrants such an approach.

Methods

In the present work, experts from various disciplinary fields, namely biomedical, epidemiology, psychology, ethics, and law, were enrolled to participate in a reflection. Gathering a group of experts could be very demanding, both in terms of time and resources, so we created a web-based discussion forum to facilitate the exchanges. The participants were mandated to solve two questions: “Which parameters should be considered before delivering survival care to a premature baby born at the threshold of viability?” and “Would it be acceptable to give different information to parents according to the sex of the baby considering that outcome differences exist between sexes?”

Results

The discussion forum was performed over a period of nine months and went through three phases: unidisciplinary, interdisciplinary and transdisciplinary, which required extensive discussions and the preparation of several written reports. Those steps were successfully achieved and the participants finally developed a consensual point of view regarding the initial questions. This discussion board also led to a concrete knowledge product, the publication of the popularized results as an electronic book.

Conclusions

We propose, with our transdisciplinary analysis, a relevant and innovative complement to existing guidelines regarding the decision-making process for premature infants born at the threshold of viability, with an emphasis on the respective responsabilities of the caregivers and the parents.

【 授权许可】

   
2014 Simard et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150303120232889.pdf 222KB PDF download
【 参考文献 】
  • [1]Rosenfield PL: The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences. Soc Sci Med 1992, 35(11):1343-1357.
  • [2]Stokols D, Fuqua J, Gress J, Harvey R, Phillips K, Baezconde-Garbanati L, Unger J, Palmer P, Clark MA, Colby SM, Morgan G, Trochim W: Evaluating transdisciplinary science. Nicotine Tob Res 2003, 5(Suppl 1):S21-S39.
  • [3]Lambert RD, Monnier-Barbarino P: Transdisciplinary training in reproductive health through online multidisciplinary problem-solving: a proof of concept. Eur J Obstet Gynecol Reprod Biol 2005, 123(1):82-86.
  • [4]Stokols D, Hall KL, Taylor BK, Moser RP: The science of team science: overview of the field and introduction to the supplement. Am J Prev Med 2008, 35(2 Suppl):S77-S89.
  • [5]Nicolescu B: Transdisciplinarity - Theory and Practice. Cresskill: Hampton Press, Inc.; 2008.
  • [6]Boucher E, Simard M, Gagné AM, Tremblay Y: Influence of Prematurity and Sex on the Health of a Child - A Transdisciplinary Approach - Version 2.0. Quebec City: Laval University Faculty of Medicine; 2013. http://www.fmed.ulaval.ca/prema/ webcite
  • [7]Gagné AM, Simard M, Boucher E, Tremblay Y: Impact de la Prématurité et du Sexe sur la Santé de l’Enfant - Une Approche Transdisciplinaire - Version 2.0. Québec: Faculté de médecine de l’Université Laval; 2013. http://www.fmed.ulaval.ca/prema/ webcite
  • [8]Klein JT: Evaluation of interdisciplinary and transdisciplinary research: a literature review. Am J Prev Med 2008, 35(2 Suppl):S116-S123.
  • [9]Likert R: A technique for the measurement of attitudes. Arch Psychol 1932, 140:1-55.
  • [10]DeVellis RF: Scale Development: Theory and Application (Second Edition). Thousand Oaks: Sage Publications, Inc.; 2003.
  • [11]Hall KL, Stokols D, Moser RP, Taylor BK, Thornquist MD, Nebeling LC, Ehret CC, Barnett MJ, McTiernan A, Berger NA, Goran MI, Jeffery RW: The collaboration readiness of transdisciplinary research teams and centers findings from the National Cancer Institute’s TREC Year-One evaluation study. Am J Prev Med 2008, 35(2 Suppl):S161-S172.
  • [12]Misra S, Harvey RH, Stokols D, Pine KH, Fuqua J, Shokair SM, Whiteley JM: Evaluating an interdisciplinary undergraduate training program in health promotion research. Am J Prev Med 2009, 36(4):358-365.
  • [13]Masse LC, Moser RP, Stokols D, Taylor BK, Marcus SE, Morgan GD, Hall KL, Croyle RT, Trochim WM: Measuring collaboration and transdisciplinary integration in team science. Am J Prev Med 2008, 35(2 Suppl):S151-S160.
  • [14]Griswold KJ, Fanaroff JM: An evidence-based overview of prenatal consultation with a focus on infants born at the limits of viability. Pediatrics 2010, 125(4):e931-e937.
  • [15]Batton D: Resuscitation of extremely low gestational age infants: an advisory committee’s dilemmas. Acta Paediatr 2010, 99(6):810-811.
  • [16]Kaempf JW, Tomlinson MW, Campbell B, Ferguson L, Stewart VT: Counseling pregnant women who may deliver extremely premature infants: medical care guidelines, family choices, and neonatal outcomes. Pediatrics 2009, 123(6):1509-1515.
  • [17]Kent AL, Casey A, Lui K: Collaborative decision-making for extreme premature delivery. J Paediatr Child Health 2007, 43(6):489-491.
  • [18]Pignotti MS, Donzelli G: Perinatal care at the threshold of viability: an international comparison of practical guidelines for the treatment of extremely preterm births. Pediatrics 2008, 121(1):e193-e198.
  • [19]Sexson WR, Cruze DK, Escobedo MB, Brann AW: Report of an international conference on the medical and ethical management of the neonate at the edge of viability: a review of approaches from five countries. HEC Forum 2011, 23(1):31-42.
  • [20]Chiswick M: Infants of borderline viability: ethical and clinical considerations. Semin Fetal Neonatal Med 2008, 13(1):8-15.
  • [21]Schroeder J: Ethical issues for parents of extremely premature infants. J Paediatr Child Health 2008, 44(5):302-304.
  • [22]Tyson JE, Parikh NA, Langer J, Green C, Higgins RD: Intensive care for extreme prematurity–moving beyond gestational age. N Engl J Med 2008, 358(16):1672-1681.
  • [23]Nadeau L, Tessier R, Lefebvre F, Robaey P: Victimization: a newly recognized outcome of prematurity. Dev Med Child Neurol 2004, 46(8):508-513.
  • [24]Guillen U, Suh S, Munson D, Posencheg M, Truitt E, Zupancic JA, Gafni A, Kirpalani H: Development and pretesting of a decision-aid to use when counseling parents facing imminent extreme premature delivery. J Pediatr 2012, 160(3):382-387.
  • [25]Khan RA, Burgoyne L, O’Connell MP, Dempsey EM: Resuscitation at the limits of viability–an Irish perspective. Acta Paediatr 2009, 98(9):1456-1460.
  • [26]Lavoie PM, Keidar Y, Albersheim S: Attitudes of Canadian neonatologists in delivery room resuscitation of newborns at threshold of viability. J Obstet Gynaecol Can 2007, 29(9):719-725.
  • [27]Haward MF, Murphy RO, Lorenz JM: Message framing and perinatal decisions. Pediatrics 2008, 122(1):109-118.
  • [28]Boss RD, Hutton N, Sulpar LJ, West AM, Donohue PK: Values parents apply to decision-making regarding delivery room resuscitation for high-risk newborns. Pediatrics 2008, 122(3):583-589.
  • [29]Grobman WA, Kavanaugh K, Moro T, DeRegnier RA, Savage T: Providing advice to parents for women at acutely high risk of periviable delivery. Obstet Gynecol 2010, 115(5):904-909.
  • [30]Lam HS, Wong SP, Liu FY, Wong HL, Fok TF, Ng PC: Attitudes toward neonatal intensive care treatment of preterm infants with a high risk of developing long-term disabilities. Pediatrics 2009, 123(6):1501-1508.
  • [31]Payot A, Gendron S, Lefebvre F, Doucet H: Deciding to resuscitate extremely premature babies: how do parents and neonatologists engage in the decision? Soc Sci Med 2007, 64(7):1487-1500.
  • [32]Jobe AH, Ikegami M: Lung development and function in preterm infants in the surfactant treatment era. Annu Rev Physiol 2000, 62:825-846.
  • [33]Myatt L, Eschenbach DA, Lye SJ, Mesiano S, Murtha AP, Williams SM, Pennell CE: A standardized template for clinical studies in preterm birth. Reprod Sci 2012, 19(5):474-482.
  文献评价指标  
  下载次数:4次 浏览次数:0次