Impact of neonatal palliative care on neonates, their parents, and nurses: a systematic review.

Abstract

Background: Neonatal palliative care (NPC) is a comprehensive approach that addresses the physical, mental, social, and spiritual well-being of neonates in need of palliative care.

Objective and design: The objective of this systematic review was to examine the impact of NPC on the management of symptoms and conditions in neonates admitted to the neonatal intensive care unit, as well as its effects on their parents and nurses.

Methods: This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases, including Scopus, PubMed, Web of Science (WoS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library, were searched up to July 30, 2024. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool.

Results: A total of 10 studies that met the inclusion criteria were included in the review. The results indicated that the implementation of an NPC program led to an increased use of analgesic drugs, a reduction in invasive therapeutic and diagnostic procedures for newborns, an increase in withdrawal of life support, more do-not-resuscitate orders, and greater parental involvement in the care of newborns. These findings suggest that providing NPC can improve parents' quality of life, as well as enhance symptom management and pain relief in newborns.

Conclusion: The implementation of an NPC program can benefit both neonates and parents. It can improve the quality of life and reduce stress for parents, enhance the quality of newborn care, foster better inter-team collaboration, and prevent unnecessary invasive procedures, leading to greater comfort for newborns and improved pain and symptom management.