Exploring implicit bias in the perceived consequences of prematurity amongst health care providers in North Queensland – a constructivist grounded theory study

Ireland, Susan, Ray, Robin, Larkins, Sarah, and Woodward, Lynn (2021) Exploring implicit bias in the perceived consequences of prematurity amongst health care providers in North Queensland – a constructivist grounded theory study. BMC Pregnancy and Childbirth, 21. 55.

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Background: A study was done to explore the attitudes of relevant health care professionals (HCP) towards the provision of intensive care for periviable and extremely premature babies.

Methods/design: Applying a constructivist grounded theory methodology, HCP were interviewed about their attitudes towards the provision of resuscitation and intensive care for extremely premature babies. These babies are at increased risk of death and neurodisability when compared to babies of older gestations. Participants included HCP of varying disciplines at a large tertiary centre, a regional centre and a remote centre. Staff with a wide range of experience were interviewed.

Results: Six categories of i) who decides, ii) culture and context of families, iii) the life ahead, iv) to treat a bit or not at all, v) following guidelines and vi) information sharing, emerged. Role specific implicit bias was found as a theoretical construct, which depended on the period for which care was provided relative to the delivery of the baby. This implicit bias is an underlying cause for the negativity seen towards extreme prematurity and is presented in this paper. HCP caring for women prior to delivery have a bias towards healthy term babies that involves overestimation of the risks of extreme prematurity, while neonatal staff were biased towards suffering in the neonatal period and paediatricians recognise positivity of outcomes regardless of neurological status of the child. The implicit bias found may explain negativity towards intensive care of periviable neonates.

Conclusion: Understanding the presence and origins of role specific implicit bias may enable HCP to work together to improve care for parents preparing for the delivery of extremely premature babies.

Item ID: 66852
Item Type: Article (Research - C1)
ISSN: 1471-2393
Keywords: Attitudes, Counselling, Extreme prematurity, Implicit bias, Pregnancy, Resuscitation
Copyright Information: © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Funders: Townsville Health and Hospital Service
Date Deposited: 19 Sep 2021 22:28
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3213 Paediatrics > 321303 Neonatology @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3215 Reproductive medicine > 321501 Foetal development and medicine @ 50%
SEO Codes: 20 HEALTH > 2002 Evaluation of health and support services > 200202 Evaluation of health outcomes @ 50%
20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200506 Neonatal and child health @ 50%
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