Abstract:
OBJECTIVES:To pilot-test a visual aid developed to help counsel pregnant women. METHODS:After agreeing to participate, pregnant women at >28 weeks of gestation were assigned randomly to counseling with or without a visual aid. The visual aid contained pictures, graphics, and short messages about delivery room resuscitation, chances of survival, anticipated neonatal course, and long-term neurodevelopmental disabilities. A neonatal fellow performed counseling with a standardized script for an anticipated delivery at 23 weeks of gestation. In precounseling and postcounseling sessions, women were given a structured interview to assess their knowledge of chances of survival and disability and attitudes toward resuscitation. RESULTS:Of the 89 women who participated, 76% were black and 59% read below a 9th-grade level. Compared with the no-visual aid group, women in the visual aid group recalled more disabilities and predicted longer neonatal stays (P = .01). For both groups, mothers' perceptions of the chances of survival were lower after counseling; the decrease was greater in the visual aid group (P = .03). The majority of women in each group opted for resuscitation, which was not affected by counseling. In multivariate analyses, use of the visual aid was a significant independent factor in explaining before/after differences in survival chances and recall of a long NICU stay and number of disabilities; higher literacy levels also were significant for recalling the number of disabilities. CONCLUSIONS:Use of a visual aid improved mothers' knowledge and showed promise as a decision aid for counseling at the threshold of viability.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Kakkilaya V,Groome LJ,Platt D,Kurepa D,Pramanik A,Caldito G,Conrad L,Bocchini JA Jr,Davis TCdoi
10.1542/peds.2011-0597subject
Has Abstractpub_date
2011-12-01 00:00:00pages
e1511-9issue
6eissn
0031-4005issn
1098-4275pii
peds.2011-0597journal_volume
128pub_type
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