Parent Preferences Regarding Home Oxygen Use for Infants with Bronchopulmonary Dysplasia. J Pediatr 2019 Oct;213:30-37.e3
Date
07/02/2019Pubmed ID
31256913Pubmed Central ID
PMC6765432DOI
10.1016/j.jpeds.2019.05.069Scopus ID
2-s2.0-85067887641 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
OBJECTIVES: To determine parent preferences for discharge with home oxygen in infants with bronchopulmonary dysplasia.
STUDY DESIGN: This was a prospective study of parents of infants born at <32 weeks' gestation with established bronchopulmonary dysplasia and approaching neonatal intensive care unit (NICU) discharge. Parents were presented a hypothetical scenario of an infant who failed weaning to room air and 2 options: discharge with home oxygen or try longer to wean oxygen. The initial scenario risks reflected a 1.5-week difference in NICU length of stay and no differences in other outcomes. Length of stay and readmission outcomes were increased or decreased until the parent switched preference. Three months after discharge, parents were asked to reconsider their preference. Differences were analyzed by χ2 or Kruskal-Wallis tests.
RESULTS: Of 125 parents, 50% preferred home oxygen. For parents preferring home oxygen, the most important reason was comfort at home (79%). Forty percent switched preference when the length of stay difference decreased by 1 week; 35% switched when readmission increased by 5%. For parents preferring to stay in NICU, the most important reason was fear of taking care of the child at home (73%). Thirty-two percent switched preference when the length of stay difference increased by 1 week; 31% switched when readmission decreased by 5%. One hundred ten parents completed the 3-month follow-up; 80 were discharged with home oxygen. Seventy-eight percent would prefer home oxygen (97% who initially preferred home oxygen and 60% who initially preferred to stay in the NICU).
CONCLUSIONS: Parents weigh differences in NICU length of stay and readmission risk similarly. After discharge, most prefer earlier discharge with home oxygen. Earlier education to increase comfort with home technology may facilitate NICU discharge planning.
Author List
Lau R, Crump RT, Brousseau DC, Panepinto JA, Nicholson M, Engel J, Lagatta JAuthor
Joanne M. Lagatta MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Bronchopulmonary DysplasiaFemale
Home Care Services
Humans
Infant
Infant, Newborn
Infant, Premature
Length of Stay
Male
Oxygen Inhalation Therapy
Parents
Patient Discharge
Patient Preference
Prospective Studies
