Impact of Palliative Care on Psychosocial and Spiritual Outcomes in the Neonatal Intensive Care Unit.

CONTEXT: Pediatric palliative care (PPC) consultation for infants with life-limiting conditions provides parents and caregivers with opportunities to participate in advance care planning, shared decision-making, and to receive appropriate psychosocial and spiritual supports.

OBJECTIVES

To evaluate the impact of PPC consultation on spiritual, psychosocial, and communication outcomes for infants that died in the NICU.

METHODS

Retrospective chart review of infants who died in a level IV NICU over a 10-year period (2014-2024). Mann-Whitney U and Chi-square or Fisher's exact tests were used to evaluate demographic and medical differences between infants with and without PPC consultation. Regression analyses were used to evaluate the impact of PPC on psychosocial, spiritual, and communication outcomes after adjusting for relevant covariates.

RESULTS

There were significant medical and demographic differences between infants with PPC and no PPC consultation. Infants with PPC consultation had significantly higher odds of referral to child life, participation in memory making activities, documentation of family meetings and advance care planning discussions, and a higher incidence rate ratio of NICU social work visits and family meetings during their admission after adjusting for potential confounders.

CONCLUSION

PPC consultation is associated with improved psychosocial, spiritual, and communication support utilization for seriously ill NICU infants and their families.