Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study
Objective To explore clinicians’ perspectives on supporting parents’ decision-making following diagnosis of a severe congenital anomaly, and how this is shaped by current policy.Methods This paper reports data collated as part of a larger project examining parents’ decision-making following antenata...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2017-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/7/5/e014716.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823857095961739264 |
|---|---|
| author | Lucy K Smith Natalie Armstrong Robyn Lotto |
| author_facet | Lucy K Smith Natalie Armstrong Robyn Lotto |
| author_sort | Lucy K Smith |
| collection | DOAJ |
| description | Objective To explore clinicians’ perspectives on supporting parents’ decision-making following diagnosis of a severe congenital anomaly, and how this is shaped by current policy.Methods This paper reports data collated as part of a larger project examining parents’ decision-making following antenatal diagnosis. The focus of this paper is the data arising from semistructured interviews conducted with 18 clinicians, with findings further supported by data generated from consultations between clinicians and parents. All interviews and consultations were audio-recorded and transcribed verbatim, with analysis based on the constant comparative approach.Results Three key themes emerged which together shape the practice of clinicians working in this area: first, the law governing termination of pregnancy (TOP) and how clinicians believe this influences the context in which decisions about whether to terminate or continue an affected pregnancy are made; second, approaches to the management of cases seen as particularly challenging; and third, how clinicians understand their role when working with parents. These themes combine to create a strong desire on the part of clinicians for parents to engage in a particular ‘rational’ form of decision-making and to be able to demonstrate the enactment of this. This is seen as important in order to ensure the ‘right’ decision has been reached and, particularly when the decision is to terminate, will withstand possible scrutiny.Conclusions The policy context in which these decisions are made strongly shapes how clinicians practise and what they want to see from the parents with whom they work. The ways in which they seek to overcome the difficulties in interpreting the law may result in variations in the offer of late TOP, both between and within units. This may inadvertently affect the options available to women least able to engage in this idealised form of decision-making. |
| format | Article |
| id | doaj-art-dcc800d6ce014370956622b98a420f52 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2017-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-dcc800d6ce014370956622b98a420f522025-02-12T01:00:11ZengBMJ Publishing GroupBMJ Open2044-60552017-06-017510.1136/bmjopen-2016-014716Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative studyLucy K Smith0Natalie Armstrong1Robyn Lotto2Department of Health Sciences, University of Leicester, Leicester, UK3 Department of Population Health Sciences, University of Leicester, Leicester, UK1 School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, UKObjective To explore clinicians’ perspectives on supporting parents’ decision-making following diagnosis of a severe congenital anomaly, and how this is shaped by current policy.Methods This paper reports data collated as part of a larger project examining parents’ decision-making following antenatal diagnosis. The focus of this paper is the data arising from semistructured interviews conducted with 18 clinicians, with findings further supported by data generated from consultations between clinicians and parents. All interviews and consultations were audio-recorded and transcribed verbatim, with analysis based on the constant comparative approach.Results Three key themes emerged which together shape the practice of clinicians working in this area: first, the law governing termination of pregnancy (TOP) and how clinicians believe this influences the context in which decisions about whether to terminate or continue an affected pregnancy are made; second, approaches to the management of cases seen as particularly challenging; and third, how clinicians understand their role when working with parents. These themes combine to create a strong desire on the part of clinicians for parents to engage in a particular ‘rational’ form of decision-making and to be able to demonstrate the enactment of this. This is seen as important in order to ensure the ‘right’ decision has been reached and, particularly when the decision is to terminate, will withstand possible scrutiny.Conclusions The policy context in which these decisions are made strongly shapes how clinicians practise and what they want to see from the parents with whom they work. The ways in which they seek to overcome the difficulties in interpreting the law may result in variations in the offer of late TOP, both between and within units. This may inadvertently affect the options available to women least able to engage in this idealised form of decision-making.https://bmjopen.bmj.com/content/7/5/e014716.full |
| spellingShingle | Lucy K Smith Natalie Armstrong Robyn Lotto Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study BMJ Open |
| title | Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study |
| title_full | Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study |
| title_fullStr | Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study |
| title_full_unstemmed | Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study |
| title_short | Clinicians’ perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study |
| title_sort | clinicians perspectives of parental decision making following diagnosis of a severe congenital anomaly a qualitative study |
| url | https://bmjopen.bmj.com/content/7/5/e014716.full |
| work_keys_str_mv | AT lucyksmith cliniciansperspectivesofparentaldecisionmakingfollowingdiagnosisofaseverecongenitalanomalyaqualitativestudy AT nataliearmstrong cliniciansperspectivesofparentaldecisionmakingfollowingdiagnosisofaseverecongenitalanomalyaqualitativestudy AT robynlotto cliniciansperspectivesofparentaldecisionmakingfollowingdiagnosisofaseverecongenitalanomalyaqualitativestudy |