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Introduction :
The birth of a child is usually a happy event that caregivers working in delivery rooms share with families.
Unfortunately, newborns sometimes need palliative care as soon as birth occurs.
In France, neonates who were liveborn under 24+0 weeks amenorrhea (date of last mentrual period) or weighing less than 500 grams) usually have non resuscitation in delivery room [Ancel 2020]. Some of them are considered as viable (referring to World Health Organisation definition : either term ≥ 22 + 0 amenorrhea week or birth weight ≥ 500 grams), others as nonviable (term < 22 AW and birth weight ≤500 grams).
In France, legislative development over last two decades have allowed the emergence of palliative care in delivery room. In a French survey in 2016, 83% of maternities were confronted at least once a year with this situation.
In France as in other countries, published studies concerning palliative care for extremely premature babies focused on the " grey zon " period, but not on the nonviable preterm infants (also called late miscarriage) who have signs of life at birth. Only a fairly recent French book of 735 pages exclusively dedicated to the palliative approach in perinatal medicine, reports in a single chapter the existence of palliative care in extremely non-viable premature newborns.
There is a paucity of articles about the actual experience of caregivers confronted to palliative care of extremely preterm babies, viable or non viable, primarily studies in the so-called "gray" literature. Thus, a midwifery graduation thesis describes the experience of midwives in a French university hospital following the care of babies born alive between 18 and 24 weeks old . Two recent reviews explore the notion of resilience of caregivers who have been involved in perinatal palliative care . A nursing graduation dissertation explores the emotions of caregivers faced with perinatal bereavement .
Primary objective: the primary objective of this both qualitative and quantitative monocentric study is to explore the feelings of caregivers (doctors, midwifes, nurse's aids, pediatric nurses) within 2 months of a palliative situation for an extremely preterm baby in a delivery room, viable or not, and not eligible for resuscitation.
Secondary objective: the secondary objective of the study is to quantify the impact of this stressful event:
Expected impact of the study:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Assessment of caregiver feeling | Other | The study group includes any caregiver who supported an extremely preterm newborn in a palliative care approach in the delivery room with as intervention type a questionnaire and individual semi-structured interview. |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of caregiver feeling | Semi-directional interviews will be carried out with the identification of the main themes during the verbatim transcription (qualitative study). | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of stress | Revised Impact of Event Scale (IES-R) [Weiss, Brunet] scale | 1 month |
| Assessment of stress | Revised Impact of Event Scale (IES-R) [Weiss, Brunet] scale |
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Inclusion Criteria:
Exclusion Criteria : none
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The study group includes any caregiver who supported an extremely preterm newborn in a palliative care approach in the delivery room. Caregivers can be : senior pediatricians, senior obstetricians, midwifes, nurse's aides, pediatric nurses, pediatrician student, midwife student.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chu Reims | Recruiting | Reims | 51092 | France |
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| 2 months |