Development of a video decision aid to inform parents on potential outcomes of extreme prematurity

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Abstract

OBJECTIVE:

The objective of the study is to develop and validate a video-based parental decision aid about the outcomes of extremely premature infants.

STUDY DESIGN:

Thirty-one clinicians and 30 parents of extremely premature infants (< 26 weeks gestation) previously underwent semi-structured interviews to assess perceptions of antenatal counseling. Interviewees recommended a video. A video was iteratively developed, with final validation by three groups: clinicians (n = 16), parents with a history of extreme prematurity (n = 14) and healthy ‘naïve' women without prior knowledge of prematurity (n = 13). Two iterations of the video were created. Following a simulated counseling session, an eight-question survey and the State-Trait Anxiety Inventory (STAI) were administered to parents and ‘naïve' participants to assess usefulness and stress provocation.

RESULTS:

The final 10-min video shows six children/parent dyads of former 23 to 25 week premature children with a wide range of outcomes. This video was well accepted by clinicians as well as parent and ‘naïve' participants, who perceived it as ‘balanced' with a ‘neutral' message. The video was felt to provide useful information and insight on prematurity. The final version of the video did not induce anxiety: parents STAI-S 36.1 ± 12.1; ‘naïve' 30.2 ± 8.9.

CONCLUSIONS:

A short video showing the range of outcomes of extreme prematurity has been produced. It is well accepted and does not increase levels of anxiety as measured by the STAI. This video may be a useful and non-stress-inducing aid at the time of counseling parents facing extreme prematurity.

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