ArticleThe American journal of hospice & palliative care2018
Physicians Perceptions of Shared Decision-Making in Neonatal and Pediatric Critical Care.
Article in The American journal of hospice & palliative care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Ethics and end-of-life in pediatric and neonatal ICUs: a systematic review of recommendations.BMC palliative care · 2025Pooled it
- Considerations for Practice in Supporting Parental Bereavement in the Neonatal Intensive Care Unit-a Systematic Review.Journal of palliative care · 2024Pooled it
- Parents' experiences of being involved in medical decision-making for their child with a life-limiting condition: A systematic review with narrative synthesis.Palliative medicine · 2024Pooled it
- Physicians' attitudes and experiences about withholding/withdrawing life-sustaining treatments in pediatrics: a systematic review of quantitative evidence.BMC palliative care · 2023Pooled it
- Physician decision-making process about withholding/withdrawing life-sustaining treatments in paediatric patients: a systematic review of qualitative evidence.BMC palliative care · 2022Pooled it
- Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence.Palliative medicine · 2019Pooled it
- Acute and Posttraumatic Stress in Family Members of Children With a Prolonged Stay in a PICU: Secondary Analysis of a Randomized Trial.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2022Trial
- How parents derive their informed role preferences for end-of-life medical decision-making for (unborn) children in perinatology: a meta-ethnography of qualitative interview studies.BMC medical ethics · 2026Article
- Informed nondissent: an underutilized tool for the NICU context.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- What Does Family-Centered Care Mean to You? A Qualitative Study Examining Perceptions of Mothers of Children With Medical Complexity.Journal of family nursing · 2026Article
- Experiences and challenges in perinatal palliative care: a qualitative study among parents and healthcare providers in regional and tertiary hospitals.BMC palliative care · 2025Article
- Enhancing shared decision-making for infants in the intensive care unit: lessons from parents.Pediatric research · 2025Article
- Feasibility of an Intervention to Support Shared Decision-Making for Critically Ill Infants.The Journal of pediatrics · 2025Article
- The effect of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit.Nursing in critical care · 2025Article
- Chinese and Belgian pediatricians' perspectives toward pediatric palliative care: an online survey.BMC palliative care · 2024Article
- Article
- Exploring and Supporting Parents' Stories of Loss in the NICU: A Narrative Study.Qualitative health research · 2023Article
- Seminars in Fetal & neonatal medicine: Palliative and end of life care in the NICU.Seminars in fetal & neonatal medicine · 2023Review
- Modified NEOMOD score as a neonatal mortality prediction tool in a medium-income country: A validation diagnostic test study.Health science reports · 2023Article
- Shared decision-making for children with medical complexity in community health services: a scoping review.BMJ paediatrics open · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundMost children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family.
objectiveTo understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments.
methodsSemistructured interviews were conducted with 22 physicians from neonatal, pediatric, and cardiothoracic intensive care units in a single quaternary care pediatric hospital. Transcribed interviews were analyzed using content and thematic analysis.
resultsWe identified 3 main themes: (1) beliefs about child and family interests; (2) disagreement about the child's best interest; and (3) decision-making strategies, including limiting options, being directive, staying neutral, and allowing parents to come to their own conclusions. Physicians described challenges to implementing shared decision-making including unequal power and authority, clinical uncertainty, and complexity of balancing child and family interests. They acknowledged determining the level of engagement in shared decision-making with parents (vs routine engagement) based on their perceptions of the best interests of the child and parent.
conclusionsDue to power imbalances, families' values and preferences may not be integrated in decisions or families may be excluded from discussions about goals of care. We suggest that a systematic approach to identify parental preferences and needs for decisional roles and information may reduce variability in parental involvement.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.