Palliative Care in the Neonatal Intensive Care Unit
Bibliographic record
Abstract
In much of the so-called developed world, palliative care for infants occurs in the context of Neonatal Intensive Care Units (NICUs). Scholars and practitioners identified a clear need for coherent delivery of neonatal palliative care; however, it remains an often overlooked aspect of medical care in the NICU. This thesis explores ethical principles involved in decision-making, as well as the barriers, facilitators, and models of care delivery of neonatal palliative care in the literature. It also examines health care practitioner perspectives on these subjects revealed during focus groups. In the context of this qualitative descriptive study, ten focus groups were held with a total of forty-five multidisciplinary participants to collect data on the study question. Identified barriers were: (1) communication challenges, (2) inconsistency of care, (3) discomfort with parental decisions and moral distress, (4) lack of support for NICU team members, (5) lack of education or training for staff, and (6) material and personnel resources for provision of palliative care. Identified facilitators were: (1) compassionate support of families, (2) good communication within teams, (3) consistency of the care team, (4) respect for patient-family differences, and (5) individual expertise within teams. An integrative model was heavily favoured by focus group participants. The implications of this research pursue practical application of findings concerning identified barriers and facilitators towards development of a neonatal-perinatal palliative program in Edmonton. Related recommendations are offered for: communication and collaboration, education and training, support and resources, physical space and environment, and piloting a model of care.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".