Neonatologists' perspectives of palliative and end-of-life care in neonatal intensive care units

OBJECTIVE: Determine palliative and end-of-life care practices, barriers and beliefs among US neonatologists, and relationships between practice characteristics and palliative care delivery. STUDY DESIGN: A descriptive cross-sectional survey with ordinal measurements. The survey was sent to 1885 neonatologists. RESULTS: There were 725 responses (38.5%) with 653 (34.6%) completing the survey. Of those, 58.0% (n = 379) have palliative care teams and 72.0% (n = 470) have staff support groups or bereavement services. Palliative care education was deemed important (n = 623) and needed. Barriers include emotional difficulties, staff disagreements and difficulty forming palliative care teams. Palliative care teams or staff bereavement groups were significantly predictive of willingness to initiate palliative care and more positive views or experiences. CONCLUSION: Neonatologists believe that palliative care is important. Education and palliative care teams help provide quality care. Exploration of differing views of palliative care among team members is needed.