2026 Volume 14 Pages 16-29
This study aimed to clarify the nursing support provided to parents when deciding on whether to withhold or withdraw treatment for their critically ill infants and to determine the individual and organizational factors influencing this support. Nurses with at least one year of neonatal intensive care unit (NICU) experience participated in a questionnaire survey, which achieved a response rate of 24.3％. Frequently implemented nursing support interventions included “understanding and confirming parent’s thoughts and values” and “adjusting the care and environment for the infant and parents.” Support implementation was associated with the following individual factors : Managerial position, parenting experience, and experience caring for critically ill infants. Nurses with higher ethical behavior scale were more likely to help parents reflect on and understand their personal values. Organizational factors that are associated with support implementation were NICU bed capacity, hospital type, and ethical climate scores. Notably, higher ethical climate survey were linked to more frequent support for “discussion of treatment decisions.” Therefore, enhancing nurse’s ethical behavior and promoting interdisciplinary discussions that consider parent’s situation and feelings may help improve nursing support and develop a positive ethical climate in the NICU.
