The authors report no conflict of interest or relevant financial relationships.
A Meta-Ethnography and Theory of Parental Ethical Decision Making in the Neonatal Intensive Care Unit
Version of Record online: 17 JUN 2013
© 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Volume 42, Issue 4, pages 492–502, July 2013
How to Cite
Rosenthal, S. A. and Nolan, M. T. (2013), A Meta-Ethnography and Theory of Parental Ethical Decision Making in the Neonatal Intensive Care Unit. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 42: 492–502. doi: 10.1111/1552-6909.12222
- Issue online: 16 JUL 2013
- Version of Record online: 17 JUN 2013
- Manuscript Accepted: FEB 2013
- National Institute of Nursing Research. Grant Number: 1 F31 NR011375
- National Institute of Health. Grant Number: T32 NR07968–05
- Johns Hopkins University School of Nursing
- parent decision making;
- provider communication;
To synthesize the existing qualitative literature about parent ethical decision making in the neonatal intensive care unit (NICU) and to investigate the potential impact of culture on parents’ decision making experiences.
PubMed, CINAHL plus, and PsychInfo using the search terms parental decision making, culture, race, decision making, and parental decisions.
Qualitative research studies investigating decision making for infants in the NICU from the parents’ perspective were included. Studies involving older pediatric populations were excluded.
Ten primary qualitative research articles were included. The primary author read all manuscripts and tabulated themes related to parents’ ethical decision making.
Study findings were synthesized using meta-ethnography involving translating concepts of separate studies into one another, exploring contradictions, and organizing these concepts into new theories. Key themes included parent involvement in decision making, parental role, necessity of good information, need for communication, desire for hope and compassion conveyed by providers, decision making satisfaction, and trust in caregiving team. A preliminary theoretical framework of ethical parent decision making was modeled based on the proposed relationships between the themes.
Parent preferences for their involvement in decision making, their perceptions of communication with providers, and their relationships with providers are all important factors in the experience of making decisions for their infants. Needs of parents were the same regardless the ethnic or racial diversity of study participants.