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Filippa S, Jayaweera RT, Blanchard K, Grossman D. Do miscarriage care practice recommendations align with individuals' needs?: A scoping review. Contraception 2024; 136:110448. [PMID: 38588848 DOI: 10.1016/j.contraception.2024.110448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES Miscarriage is a common occurrence; yet individuals often have negative experiences when receiving miscarriage care, signaling a gap in the quality of miscarriage care. We explore the literature on individuals' experiences with miscarriage care across a variety of dimensions and assess how these experiences align with practice recommendations. STUDY DESIGN We conducted a scoping review of peer-reviewed studies in PubMed published in English through April 30, 2022, and focused on individuals' experiences with miscarriage care in healthcare settings and on practice recommendations for providing care in a variety of countries. The search returned 1812 studies; after screening, 41 studies were included in the analysis. RESULTS Included studies reported on individuals' experiences with miscarriage care settings and accessibility, information provision, emotional support, decision-making and follow-up. Overall, individuals are often dissatisfied with their miscarriage care experiences. Practice recommendations are generally responsive to these issues. CONCLUSIONS Individuals experiencing miscarriage are best served by care that is patient-centered, involves shared decision-making, and addresses individuals' informational and emotional needs. However, the prevalence of individuals' negative experiences with miscarriage care points to the need to address key gaps in and improve the implementation of practice recommendations. IMPLICATIONS Future research should focus on documenting the miscarriage experiences of and developing relevant practice recommendations for communities that face the greatest barriers to care, generating evidence on the dimensions that constitute high-quality miscarriage care from patients' perspectives and assessing the barriers and facilitators to effectively implementing existing practice recommendations.
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Affiliation(s)
| | | | | | - Daniel Grossman
- Ibis Reproductive Health, Cambridge, MA, USA; Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA, USA
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Callen S, Oxlad M. Support sought and offered online for miscarriage: content analysis of a Facebook miscarriage support group. Psychol Health 2024:1-20. [PMID: 39039665 DOI: 10.1080/08870446.2024.2382790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 07/17/2024] [Indexed: 07/24/2024]
Abstract
OBJECTIVE Responses to miscarriage can vary, with many, but not all, people describing inadequate support, feelings of isolation and significant psychological distress. Limited knowledge exists about the support that people seek and offer online following miscarriage. We aimed to explore how people impacted by miscarriage use an online Facebook support group to seek and offer support. METHODS AND MEASURES We employed directed content analysis to examine 270 opening posts and 3,484 responding comments within an 'open' Facebook support group for miscarriage. Opening posts and responding comments were coded into five social support categories using an existing support framework. RESULTS Informational Support, particularly medical information or advice, was the most commonly sought support in opening posts, followed by Emotional Support, where people expressed their grief-related feelings. In responding comments, Emotional Support and Informational Support were predominantly offered. CONCLUSION While not a substitute for appropriate medical care, people impacted by miscarriage seek and offer support online. Health professionals should be aware of this behaviour and discuss potential benefits and risks of online support with patients. A social support framework may usefully guide health professionals in identifying patients' support needs and in knowing how to support patients.
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Affiliation(s)
- Sophie Callen
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
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Emond T, de Montigny F, Webster J, Zeghiche S, Bossé M. Compassionate Care for Parents Experiencing Miscarriage in the Emergency Department: A Situation-Specific Theory. ANS Adv Nurs Sci 2024; 47:288-301. [PMID: 36928273 DOI: 10.1097/ans.0000000000000493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
In many countries, parents experiencing miscarriage seek treatment in the emergency department (ED). Parents frequently report dissatisfaction with ED care, while nurses report not knowing how to provide optimal care. This article describes the development of a situation-specific theory, Compassionate care for parents experiencing miscarriage in the ED , based on 4 concepts (change trigger, transition properties, conditions of change, and interventions). This theory evolved from a comprehensive review of the literature, 2 empirical studies, Transitions Theory, and collaborative efforts of an experienced team. The detailed theory development process facilitates its integration in practice and supports new theory development.
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Affiliation(s)
- Tina Emond
- Author Affiliations: Faculty of Nursing, Université de Moncton, Edmundston, New Brunswick, Canada (Dr Emond); Faculty of Nursing, Université du Québec en Outaouais, Québec, Canada (Dr de Montigny); Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada (Ms Webster); Department of Social Work, Université du Québec en Outaouais, Québec, Canada (Dr Zeghiche); and Emergency/ICU Department, Edmundston Regional Hospital, Vitalité Health Network, Edmundston, New Brunswick, Canada (Ms Bossé)
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Fernandez-Pineda M, Swift A, Dolbier C, Banasiewicz KG. Compounding stress: A mixed-methods study on the psychological experience of miscarriage amid the COVID-19 pandemic. BMC Pregnancy Childbirth 2024; 24:426. [PMID: 38872085 PMCID: PMC11170813 DOI: 10.1186/s12884-024-06610-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 05/29/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Experiencing a miscarriage can have profound psychological implications, and the added strain of the COVID-19 pandemic may have compounded these effects. This study aimed to explore the psychological experiences, assess the levels of psychological distress (depression, anxiety, and post-traumatic stress disorder), and examine the relationships of personal significance of miscarriage and perceived stress with psychological distress of women in North Carolina who suffered a miscarriage of a desired pregnancy between March 30, 2020, and February 24, 2021, of the COVID-19 pandemic, at 14 to 31 months after the loss. METHODS We conducted a cross-sectional mixed-methods study using a convergent parallel design. A total of 71 participants from North Carolina completed the online survey and 18 completed in-depth interviews. The survey assessed demographics, mental health and reproductive history, personal significance of miscarriage, perceived stress, anxiety, depression, and PTSD. Interview questions asked about the psychological experience of the miscarriage and how the COVID-19 pandemic affected them and their experience. RESULTS Findings indicated moderate to severe levels of depression, anxiety, and PTSD, which persisted 14 to 31 months post-miscarriage. After conducting hierarchical binary logistic regressions, we found that perceived stress and prior trauma increased the odds of depression, perceived stress increased the odds of anxiety, and personal significance and prior trauma increased the odds of PTSD symptoms 14-31 months post-miscarriage. Notably, a subsequent successful childbirth emerged as a protective factor against depression, anxiety, and PTSD. Qualitative findings depicted emotions such as profound isolation, guilt, and grief. Women noted that additional pandemic-specific stressors exacerbated their distress. The categories identified via conventional content analysis fell under five broader thematic groups: mental health disorders, negative emotions/feelings, positive emotions/feelings, thoughts, and other experiences. CONCLUSIONS Miscarriage during the COVID-19 pandemic intensified and added complexity to the psychological distress experienced by affected women. The study underscores the need for comprehensive mental health screenings, specialized support for vulnerable groups, and the necessity of trauma-informed care. Providers are strongly encouraged to adopt a multifaceted, individualized approach to patient care that is cognizant of the unique stressors introduced by the pandemic.
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Affiliation(s)
- Madeline Fernandez-Pineda
- College of Nursing, Department of Nursing Science, East Carolina University, 2205 W 5th St, Greenville, NC, 27834, USA.
| | - Alison Swift
- College of Nursing, Department of Advanced Nursing Practice and Education, East Carolina University, 2205 W 5th St, Greenville, NC, 27834, USA
| | - Christyn Dolbier
- Department of Psychology, East Carolina University, Thomas Harriot College of Arts and Sciences, 104 Rawl Building, Greenville, NC, 27858, USA
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Furtado-Eraso S, Marín-Fernández B, Escalada-Hernández P. "Perinatal loss, a devastating cyclone": A situation-specific nursing theory. J Nurs Scholarsh 2024. [PMID: 38828753 DOI: 10.1111/jnu.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE The aim of this paper is to develop a preliminary theory that explores in depth into understanding the experiences of women who have suffered a spontaneous perinatal loss during any trimester of their pregnancy regarding their emotional response to this loss. DESIGN A grounded theory approach was used, and 25 in-depth interviews were conducted with Spanish women who suffered a spontaneous perinatal loss. METHODS Theoretical sampling and constant comparative analysis were used to reach theoretical saturation. EQUATOR guidelines were followed, using the COREQ checklist. RESULTS The "Perinatal loss, a devastating cyclone," a situation-specific nursing theory, explains the process that a woman experiences when she loses her baby at any stage of pregnancy, drawing an analogy with tropical cyclones as natural disasters that destroy everything in their path. This situation-specific theory includes three dimensions, explaining the phases identified in the perinatal loss process (phase prior to impact [before the perinatal loss], impact phase [diagnostic moment], emergency phase [hospital care], relief or honeymoon phase [return home], disillusionment or stock-taking phase [after the first postloss days at home], reconstruction and recovery phase [grief construction process] and consequences [with an eye to the future]). Three intervention areas were described around the perinatal loss process: "rescue area" (partner, grandparents, and siblings of the deceased baby), "relief area" (healthcare professionals), and "base camp" (society). CONCLUSION The situation-specific nursing theory "Perinatal loss, a devastating cyclone" is the final product of a grounded theory study that provided an in-depth analysis of women's experiences when they suffer a spontaneous perinatal loss at any point in their pregnancy. CLINICAL RELEVANCE The situation-specific theory "Perinatal loss, a devastating cyclone" with the seven identified phases and the three areas of intervention could be used as a framework for healthcare professionals in their clinical practice as a guide to support women in this disfranchised grief.
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Affiliation(s)
- Sara Furtado-Eraso
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
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Shaw J, Bannister C, Ariyibi A, Fothergill R. Emergency medical dispatchers' experiences of using the Medical Priority Dispatch System telephone triage to identify maternity emergencies: a qualitative focus group study. BMJ Open 2024; 14:e078787. [PMID: 38508612 PMCID: PMC10952860 DOI: 10.1136/bmjopen-2023-078787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES The ambulance service plays a pivotal role in the provision of care in out-of-hospital maternity emergencies. Telephone triage of this patient group is complex and must be sensitive to an emergency situation to prevent unnecessary delays in treatment. This study aimed to explore emergency medical dispatchers' (EMDs) perceptions of the structured protocol they use. DESIGN Voluntary participation in semistructured phenomenological focus groups. The participants were asked to discuss their experiences of using Medical Priority Dispatch System Protocol 24 (pregnancy, childbirth and miscarriage). Thematic analysis was applied to code and group topics. Discussion between the EMDs is presented for each theme and their experiences, including quotes, are presented to offer an overview of the maternity protocol and its use. SETTING A large urban UK ambulance service. PARTICIPANTS 23 control room staff. RESULTS Perceptions of maternity emergencies, challenges with key questions, the need for sensitivity surrounding miscarriage, using prearrival instructions and postdispatch instructions to help patients and ideas for additional ProQA functionality emerged as the five overarching themes. Protocol 24 was considered to reflect many of the clinical factors EMDs associate with maternity emergencies although further factors, including some non-clinical, were suggested for inclusion. Miscarriage and termination-related calls were thought to be challenging as the language of the protocol is designed for pregnancy. However, instructions were generally considered well written and user-friendly, although some were thought to be unnecessary. EMDs were largely positive regarding the ProQA software, but felt backward navigation was difficult if a situation changed. CONCLUSIONS Maternity calls were considered rewarding but complex by EMDs. We suggest changes including the use of more sensitive language in response to miscarriage and termination and make recommendations for the omission and inclusion of specific instructions, as well as enhancements to key questions and functionality. Further research is needed to ensure focus group findings are generalisable to other services, particularly in other countries.
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Affiliation(s)
- Joanna Shaw
- Clinical Audit and Research Unit, London Ambulance Service NHS Trust, London, UK
| | | | | | - Rachael Fothergill
- Clinical Audit and Research Unit, London Ambulance Service NHS Trust, London, UK
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
- Faculty of Health, Social Care and Education, Kingston University of London and St George's University of London, London, UK
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Kuforiji O, Mills TA, Lovell K. An exploration of women's lived experiences of care and support following perinatal death in South-Western Nigeria: A hermeneutic phenomenological study. Women Birth 2024; 37:348-354. [PMID: 38030416 DOI: 10.1016/j.wombi.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Perinatal death results in long-lasting intense grief for bereaved mothers with a potential to negatively impact on their short- and long-term outcomes and quality of life if inadequately supported in coping with and managing their experience. AIM This study aimed at exploring the lived experience of women, of care and support following perinatal death in South-Western, Nigeria. METHODS A qualitative methodology using Heideggerian phenomenology was used. Fourteen women who had experienced perinatal death in South-Western Nigeria within the last (5) five years were interviewed, and Van Manen's approach to hermeneutic phenomenology was used in data analysis. FINDINGS Four main themes were identified: "they did not tell me the baby died", "response of health care professionals after the baby died", "moving on from hospital", and "support from family". The physical health status of mothers determined how they were informed of perinatal death. Health care professionals were distant, rude, nonempathetic and did not offer emotional support, in some cases. Mothers were given opportunity to see and hold their babies. There was no routine follow-up support in the community, besides a postnatal check-up appointment offered to all mothers regardless of their birth outcome. Family provided emotional support for mothers on discharge. CONCLUSION This study was the first to explore the lived experience of women of the care and support following perinatal death in South-Western, Nigeria. There is a need for healthcare systems to review bereavement care and support provisions for women who experience perinatal death.
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Affiliation(s)
- Omotewa Kuforiji
- Faculty of Biology, Medicine and Health, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, United Kingdom.
| | - Tracey A Mills
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Karina Lovell
- Faculty of Biology, Medicine and Health, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, United Kingdom
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Duhalde H, Bjuresäter K, Karlsson I, Bååth C. Missed nursing care in emergency departments: A scoping review. Int Emerg Nurs 2023; 69:101296. [PMID: 37352646 DOI: 10.1016/j.ienj.2023.101296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/18/2023] [Accepted: 04/17/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Patient safety is a global health priority. Errors of omission, such as missed nursing care in hospitals, are frequent and may lead to adverse events. Emergency departments (ED) are especially vulnerable to patient safety errors, and the significance missed nursing care has in this context is not as well known as in other contexts. AIM The aim of this scoping review was to summarize and disseminate research about missed nursing care in the context of EDs. METHOD A scoping review following the framework suggested by Arksey and O'Malley was used to (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; (5) collate, summarize, and report the results; and (6) consultation. RESULTS In total, 20 themes were derived from the 55 included studies. Missed or delayed assessments or other fundamental care were examples of missed nursing care characteristics. EDs not staffed or dimensioned in relation to the patient load were identified as a cause of missed nursing care in most included studies. Clinical deteriorations and medication errors were described in the included studies in relation to patient safety and quality of care deficiencies. Registered nurses also expressed that missed nursing care was undignified and unsafe. CONCLUSION The findings from this scoping review indicate that patients' fundamental needs are not met in the ED, mainly because of the patient load and how the ED is designed. According to registered nurses, missed nursing care is perceived as undignified and unsafe.
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Affiliation(s)
- Henrik Duhalde
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
| | - Kaisa Bjuresäter
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Ingela Karlsson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Carina Bååth
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden; Faculty of Health, Welfare and Organisation, Østfold University College, Halden, Norway
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Benson LS, Holt SK, Gore JL, Callegari LS, Chipman AK, Kessler L, Dalton VK. Early Pregnancy Loss Management in the Emergency Department vs Outpatient Setting. JAMA Netw Open 2023; 6:e232639. [PMID: 36920395 PMCID: PMC10018323 DOI: 10.1001/jamanetworkopen.2023.2639] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
IMPORTANCE Early pregnancy loss (EPL), or miscarriage, is the most common complication of early pregnancy, and many patients experiencing EPL present to the emergency department (ED). Little is known about how patients who present to the ED with EPL differ from those who present to outpatient clinics and how their management and outcomes differ. OBJECTIVE To compare the management and outcomes of patients with EPL who present to the ED vs outpatient clinics. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used the IBM MarketScan Research Database, a national insurance claims database. Participants were pregnant people aged 15 to 49 years in the US who presented to either an ED or outpatient clinic for initial diagnosis of EPL from October 2015 through December 2019. Data analysis was performed from May 2021 to March 2022. EXPOSURES The primary exposure was location of service (ED vs outpatient clinic). Other exposures of interest included demographic characteristics, current pregnancy history, and comorbidities. MAIN OUTCOMES AND MEASURES The primary outcome was EPL management type (surgical, medication, or expectant management). Complications, including blood transfusion and hospitalization, and characteristics associated with location of service were also evaluated. Bivariable analyses and multivariable logistic regression were used for data analysis. RESULTS A total of 117 749 patients with EPL diagnoses were identified, with a mean (SD) age of 31.8 (6.1) years. Of these patients, 20 826 (17.7%) initially presented to the ED, and 96 923 (82.3%) presented to outpatient clinics. Compared with the outpatient setting, patients in the ED were less likely to receive surgical (2925 patients [14.0%] vs 23 588 patients [24.3%]) or medication (1116 patients [5.4%] vs 10 878 patients [11.2%]) management. In the adjusted analysis, characteristics associated with decreased odds of active (surgical or medication) vs expectant management included ED (vs outpatient) presentation (adjusted odds ratio [aOR], 0.46; 95% CI, 0.44-0.47), urban location (aOR, 0.87; 95% CI, 0.82-0.91), and being a dependent on an insurance policy (vs primary policy holder) (aOR, 0.71; 95% CI, 0.67-0.74); whereas older age (aOR per 1-year increase 1.01; 95% CI, 1.01-1.01), established prenatal care (aOR, 2.35; 95% CI, 2.29-2.42), and medical comorbidities (aOR, 1.05; 95% CI, 1.02-1.09) were associated with increased odds of receiving active management. Patients in the ED were more likely than those in outpatient clinics to need a blood transfusion (287 patients [1.4%] vs 202 patients [0.2%]) or hospitalization (463 patients [2.2%] vs 472 patients [0.5%]), but complications were low regardless of location of service. CONCLUSIONS AND RELEVANCE In this cohort study of privately insured patients with EPL, differences in management between the ED vs outpatient setting may reflect barriers to accessing comprehensive EPL management options. More research is needed to understand these significant differences in management approaches by practice setting, and to what extent EPL management reflects patient preferences in both outpatient and ED settings.
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Affiliation(s)
- Lyndsey S. Benson
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle
| | - Sarah K. Holt
- Department of Urology, University of Washington School of Medicine, Seattle
| | - John L. Gore
- Department of Urology, University of Washington School of Medicine, Seattle
| | - Lisa S. Callegari
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle
- US Department of Veterans Affairs Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
| | - Anne K. Chipman
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle
| | - Larry Kessler
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
| | - Vanessa K. Dalton
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
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Cuenca D. Pregnancy loss: Consequences for mental health. Front Glob Womens Health 2023; 3:1032212. [PMID: 36817872 PMCID: PMC9937061 DOI: 10.3389/fgwh.2022.1032212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
Pregnancy loss, in all its forms (miscarriage, abortion, and fetal death), is one of the most common adverse pregnancy outcomes, but the psychological impact of such loss is often underestimated. The individual response to this outcome may vary between women-and could be influenced by age, race, culture, or religious beliefs-but most experience anxiety, stress, and symptoms of depression. Because pregnancy loss is not uncommon, health providers are used to dealing with this diagnosis, however the correct management of the process of diagnosis, information-gathering, and treatment can greatly ameliorate the adverse mental consequences for these women. The aim of this review is to examine the different types of pregnancy loss, and consider how each can influence the mental health of the women affected and their partners-in both the short- and long-term; to review the risk factors with the aim of identifying the women who may be at risk of consequential mental health problems; and to provide some advice for health providers to help these women better cope with pregnancy loss. Finally, we provide some points for health providers to follow in order to aid the management of a pregnancy loss, particularly for spontaneous, induced, or recurrent miscarriage, or stillbirth.
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Delgado L, Cobo J, Giménez C, Fucho-Rius GF, Sammut S, Martí L, Lesmes C, Puig S, Obregón N, Canet Y, Palao DJ. Initial Impact of Perinatal Loss on Mothers and Their Partners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1304. [PMID: 36674059 PMCID: PMC9858910 DOI: 10.3390/ijerph20021304] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Perinatal Loss affects one in ten women worldwide. It is known to have a deep impact on the physical and psychological wellbeing of the mother. Moreover, there is a lack of information in regard to gender differences. The role of culture, environment, personal characteristics, and gender is yet to be determined in most reports; (2) Objective and Methods: Our aim is to study the initial impact of perinatal losses in an unselected sample of couples, focusing on gender differences. We conducted a longitudinal prospective study with 29 mothers and 17 fathers. Upon discharge from the hospital, they filled out the Edinburgh Postnatal Depression Scale (EPDS), among others. After one-month post-loss, they performed the EPDS and the Short Version of the Perinatal Grief Scale. We used descriptive statistics for the sample and non-parametric tests for the comparison of gender; (3) Results: We found no gender differences in initial depressive symptoms, nor in depressive symptoms, perinatal grief symptoms, or grief level (total scores or complicated grief) one month after the loss; (4) Conclusions: we need to better understand the psychological evolution of couples in cases of perinatal loss without falling into preconceived ideas about the influence of gender.
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Affiliation(s)
- Laia Delgado
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
| | - Jesus Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), CERCA, 08208 Sabadell, Spain
| | - Cristina Giménez
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
| | - Genís Felip Fucho-Rius
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
| | - Stephanie Sammut
- Perinatal Mental Health Program, Cerdanyola-Ripollet Outpatient Department, Sant Joan de Dèu Serveis de Salut Mental, 08291 Ripollet, Spain
| | - Laia Martí
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Cristina Lesmes
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Salut Puig
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Noemí Obregón
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Yolanda Canet
- Gynaecology and Obstetrics Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Diego J. Palao
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, CIBERSAM, 08208 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), CERCA, 08208 Sabadell, Spain
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Lee L, Ma W, Davies S, Kammers M. Toward Optimal Emotional Care During the Experience of Miscarriage: An Integrative Review of the Perspectives of Women, Partners, and Health Care Providers. J Midwifery Womens Health 2023; 68:52-61. [PMID: 36370053 PMCID: PMC10098777 DOI: 10.1111/jmwh.13414] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 08/18/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Miscarriage is frequently associated with significant emotional impact, causing psychological distress, trauma, and grief. Unfortunately, women and partners frequently report dissatisfaction with care around miscarriage, and health care providers report feeling ill-prepared and underequipped to provide emotional support. This integrative review synthesizes the individual perspectives of the woman experiencing the miscarriage, the partner, and the different health care provider roles involved in the care to better understand what future research is necessary to improve the experiences of bereaved parents and their health care providers. METHODS Electronic databases were searched for studies that covered emotional care around miscarriage from the perspective of women, partners, or health care providers. The review included studies published in English between 2015 and 2022, using either quantitative or qualitative methods. Thematic analysis was carried out, and conclusions from these articles were integrated into themes and subthemes. RESULTS A total of 60 studies met the inclusion criteria. Two main themes were identified for women: (1) a need for more information and (2) a need for acknowledgment of their loss. Two main themes were likewise identified for partners: (1) a need for more information and (2) a need for recognition. Three main themes were identified for health care providers: (1) a need for additional training, (2) components of quality care, and (3) perceived barriers to providing care. DISCUSSION There is broad overlap in the needs identified by bereaved parents and their health care providers, as well as general agreement regarding the barriers to providing effective care. Five areas of future research priority were identified to understand how best to meet these needs: empirical evaluation of strategies to meet identified needs, investigation of setting-specific needs, integrated consideration of all relevant roles, investigation of the care needs of diverse groups, and an investigation of the predictors of emotional impact.
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Affiliation(s)
- Lysha Lee
- Melbourne School of Psychological Science, University of Melbourne, Melbourne, Australia
| | - Winn Ma
- Melbourne School of Psychological Science, University of Melbourne, Melbourne, Australia
| | - Sidney Davies
- Melbourne School of Psychological Science, University of Melbourne, Melbourne, Australia
| | - Marjolein Kammers
- Melbourne School of Psychological Science, University of Melbourne, Melbourne, Australia
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Galeotti M, Mitchell G, Tomlinson M, Aventin Á. Factors affecting the emotional wellbeing of women and men who experience miscarriage in hospital settings: a scoping review. BMC Pregnancy Childbirth 2022; 22:270. [PMID: 35361132 PMCID: PMC8974061 DOI: 10.1186/s12884-022-04585-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Miscarriage can be a devastating event for women and men that can lead to short- and long-term emotional distress. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner's miscarriage. While numerous studies have reported hospital-related factors impacting the emotional wellbeing of parents experiencing miscarriage, there is a lack of review evidence which synthesises the findings of current research. AIMS The aim of this review was to synthesise the findings of studies of emotional distress and wellbeing among women and men experiencing miscarriage in hospital settings. METHODS A systematic search of the literature was conducted in October 2020 across three different databases (CINAHL, MEDLINE and PsycInfo) and relevant charity organisation websites, Google, and OpenGrey. A Mixed Methods appraisal tool (MMAT) and AACODS checklist were used to assess the quality of primary studies. RESULTS Thirty studies were included in this review representing qualitative (N = 21), quantitative (N = 7), and mixed-methods (N = 2) research from eleven countries. Findings indicated that women and men's emotional wellbeing is influenced by interactions with health professionals, provision of information, and the hospital environment. Parents' experiences in hospitals were characterised by a perceived lack of understanding among healthcare professionals of the significance of their loss and emotional support required. Parents reported that their distress was exacerbated by a lack of information, support, and feelings of isolation in the aftermath of miscarriage. Further, concerns were expressed about the hospital environment, in particular the lack of privacy. CONCLUSION Women and men are dissatisfied with the emotional support received in hospital settings and describe a number of hospital-related factors as exacerbators of emotional distress. IMPLICATIONS FOR PRACTICE This review highlights the need for hospitals to take evidence-informed action to improve emotional support services for people experiencing miscarriage within their services.
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Affiliation(s)
- Martina Galeotti
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Gary Mitchell
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Mark Tomlinson
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.,Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Áine Aventin
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
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Chichester M, Harding KM. Early pregnancy loss: Invisible but real. Nursing 2021; 51:28-32. [PMID: 34807858 DOI: 10.1097/01.nurse.0000800080.92781.c5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT One of every five pregnancies ends in miscarriage, disputing the common misconception that miscarriage is rare. Early pregnancy loss has a complex impact on women's mental health, requiring compassionate, trauma-informed care. This article explores the emotional and psychological impacts of miscarriage, and strategies for nurses to support the needs of patients after a miscarriage.
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Affiliation(s)
- Melanie Chichester
- Melanie Chichester is a clinical nurse in the Labor & Delivery unit at ChristianaCare in Newark, Del. Kimberly M. Harding is an executive assistant
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15
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Benson LS, Magnusson SL, Gray KE, Quinley K, Kessler L, Callegari LS. Early pregnancy loss in the emergency department, 2006-2016. J Am Coll Emerg Physicians Open 2021; 2:e12549. [PMID: 34766105 PMCID: PMC8571073 DOI: 10.1002/emp2.12549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Women experiencing early pregnancy loss (EPL) frequently present to the emergency department (ED), but little is known about who receives EPL care in these settings. We aimed to estimate the proportion of ED visits for EPL-related care and determine characteristics associated with seeking care for EPL in the ED in a national sample. METHODS We conducted a secondary analysis of the 2006-2016 National Hospital Ambulatory Medical Care Survey (NHAMCS), a nationally representative survey of US ED visits. We identified women ages 15-44 years who presented to the ED for threatened or confirmed EPL based on diagnosis code or chief complaint. We estimated the proportion of ED visits attributable to EPL-related care among all ED visits and among women 15-44 years old. Using multivariable logistic regression, we evaluated patient and visit characteristics associated with receiving EPL-related care versus all other care. RESULTS The 2006-2016 NHAMCS dataset included 325,037 visits (weighted n = 1,447,144,423), including 82,871 visits among women ages 15-44 years (weighted n = 371,016,125). Of all ED visits for women ages 15-44 years, 2.7% (95% confidence interval, 2.5-2.9) were for EPL-related care. This equates to ≈900,000 visits annually. Compared with women ages 15-44 years presenting to the ED for other reasons, those presenting for EPL-related care were younger and more likely to be Black or Hispanic. CONCLUSIONS EPL-related care accounts for over 900,000 ED visits in the United States each year. These findings highlight the current burden of EPL visits upon EDs nationally.
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Affiliation(s)
- Lyndsey S. Benson
- Department of Obstetrics and GynecologyUniversity of Washington School of MedicineSeattleWashingtonUSA
| | - Sara L. Magnusson
- Department of Health ServicesUniversity of Washington School of Public HealthSeattleWashingtonUSA
| | - Kristen E. Gray
- Department of Health ServicesUniversity of Washington School of Public HealthSeattleWashingtonUSA
- Department of Veterans Affairs (VA) Puget Sound Health Care SystemHealth Services Research and DevelopmentSeattleWashingtonUSA
| | - Kelly Quinley
- Department of Emergency MedicineThe Permanente Medical GroupRichmondVirginiaUSA
| | - Larry Kessler
- Department of Health ServicesUniversity of Washington School of Public HealthSeattleWashingtonUSA
| | - Lisa S. Callegari
- Department of Obstetrics and GynecologyUniversity of Washington School of MedicineSeattleWashingtonUSA
- Department of Health ServicesUniversity of Washington School of Public HealthSeattleWashingtonUSA
- Department of Veterans Affairs (VA) Puget Sound Health Care SystemHealth Services Research and DevelopmentSeattleWashingtonUSA
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Devall A, Chu J, Beeson L, Hardy P, Cheed V, Sun Y, Roberts T, Ogwulu CO, Williams E, Jones L, Papadopoulos JLF, Bender-Atik R, Brewin J, Hinshaw K, Choudhary M, Ahmed A, Naftalin J, Nunes N, Oliver A, Izzat F, Bhatia K, Hassan I, Jeve Y, Hamilton J, Deb S, Bottomley C, Ross J, Watkins L, Underwood M, Cheong Y, Kumar C, Gupta P, Small R, Pringle S, Hodge F, Shahid A, Gallos I, Horne A, Quenby S, Coomarasamy A. Mifepristone and misoprostol versus placebo and misoprostol for resolution of miscarriage in women diagnosed with missed miscarriage: the MifeMiso RCT. Health Technol Assess 2021; 25:1-114. [PMID: 34821547 DOI: 10.3310/hta25680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
TRIAL DESIGN A randomised, parallel-group, double-blind, placebo-controlled multicentre study with health economic and nested qualitative studies to determine if mifepristone (Mifegyne®, Exelgyn, Paris, France) plus misoprostol is superior to misoprostol alone for the resolution of missed miscarriage. METHODS Women diagnosed with missed miscarriage in the first 14 weeks of pregnancy were randomly assigned (1 : 1 ratio) to receive 200 mg of oral mifepristone or matched placebo, followed by 800 μg of misoprostol 2 days later. A web-based randomisation system allocated the women to the two groups, with minimisation for age, body mass index, parity, gestational age, amount of bleeding and randomising centre. The primary outcome was failure to pass the gestational sac within 7 days after randomisation. The prespecified key secondary outcome was requirement for surgery to resolve the miscarriage. A within-trial cost-effectiveness study and a nested qualitative study were also conducted. Women who completed the trial protocol were purposively approached to take part in an interview to explore their satisfaction with and the acceptability of medical management of missed miscarriage. RESULTS A total of 711 women, from 28 hospitals in the UK, were randomised to receive either mifepristone plus misoprostol (357 women) or placebo plus misoprostol (354 women). The follow-up rate for the primary outcome was 98% (696 out of 711 women). The risk of failure to pass the gestational sac within 7 days was 17% (59 out of 348 women) in the mifepristone plus misoprostol group, compared with 24% (82 out of 348 women) in the placebo plus misoprostol group (risk ratio 0.73, 95% confidence interval 0.54 to 0.98; p = 0.04). Surgical intervention to resolve the miscarriage was needed in 17% (62 out of 355 women) in the mifepristone plus misoprostol group, compared with 25% (87 out of 353 women) in the placebo plus misoprostol group (risk ratio 0.70, 95% confidence interval 0.52 to 0.94; p = 0.02). There was no evidence of a difference in the incidence of adverse events between the two groups. A total of 42 women, 19 in the mifepristone plus misoprostol group and 23 in the placebo plus misoprostol group, took part in an interview. Women appeared to have a preference for active management of their miscarriage. Overall, when women experienced care that supported their psychological well-being throughout the care pathway, and information was delivered in a skilled and sensitive manner such that women felt informed and in control, they were more likely to express satisfaction with medical management. The use of mifepristone and misoprostol showed an absolute effect difference of 6.6% (95% confidence interval 0.7% to 12.5%). The average cost per woman was lower in the mifepristone plus misoprostol group, with a cost saving of £182 (95% confidence interval £26 to £338). Therefore, the use of mifepristone and misoprostol for the medical management of a missed miscarriage dominated the use of misoprostol alone. LIMITATIONS The results from this trial are not generalisable to women diagnosed with incomplete miscarriage and the study does not allow for a comparison with expectant or surgical management of miscarriage. FUTURE WORK Future work should use existing data to assess and rank the relative clinical effectiveness and safety profiles for all methods of management of miscarriage. CONCLUSIONS Our trial showed that pre-treatment with mifepristone followed by misoprostol resulted in a higher rate of resolution of missed miscarriage than misoprostol treatment alone. Women were largely satisfied with medical management of missed miscarriage and would choose it again. The mifepristone and misoprostol intervention was shown to be cost-effective in comparison to misoprostol alone. TRIAL REGISTRATION Current Controlled Trials ISRCTN17405024. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 68. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Adam Devall
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Justin Chu
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Leanne Beeson
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Pollyanna Hardy
- National Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Versha Cheed
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Yongzhong Sun
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Tracy Roberts
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Chidubem Okeke Ogwulu
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Eleanor Williams
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Laura Jones
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | | | | | - Kim Hinshaw
- Sunderland Royal Hospital, South Tyneside & Sunderland NHS Foundation Trust, Sunderland, UK
| | - Meenakshi Choudhary
- Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Amna Ahmed
- Sunderland Royal Hospital, South Tyneside & Sunderland NHS Foundation Trust, Sunderland, UK
| | - Joel Naftalin
- University College Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Natalie Nunes
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Isleworth, UK
| | - Abigail Oliver
- St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Feras Izzat
- University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Kalsang Bhatia
- Burnley General Hospital, East Lancashire Hospitals NHS Trust, Burnley, UK
| | - Ismail Hassan
- Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Yadava Jeve
- Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Judith Hamilton
- Guy's and St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Shilpa Deb
- Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Cecilia Bottomley
- Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Jackie Ross
- King's College Hospital, King's College Hospital NHS Foundation Trust, London, UK
| | - Linda Watkins
- Liverpool Women's Hospital, Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martyn Underwood
- Princess Royal Hospital, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
| | - Ying Cheong
- Department of Reproductive Medicine, University of Southampton, Southampton, UK
| | - Chitra Kumar
- Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Pratima Gupta
- Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Rachel Small
- Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Stewart Pringle
- Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Frances Hodge
- Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Anupama Shahid
- Barts Health NHS Trust, Royal London Hospital, London, UK
| | - Ioannis Gallos
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Andrew Horne
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Siobhan Quenby
- Biomedical Research Unit in Reproductive Health, University of Warwick, Coventry, UK
| | - Arri Coomarasamy
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Emond T, Guillaumie L, de Montigny F. Using a logic model to develop an intervention for improving miscarriage care in the emergency department. EVALUATION AND PROGRAM PLANNING 2021; 85:101910. [PMID: 33561757 DOI: 10.1016/j.evalprogplan.2021.101910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/04/2020] [Accepted: 01/17/2021] [Indexed: 06/12/2023]
Abstract
Miscarriage is the most common pregnancy-related complication and is frequently treated at the emergency department (ED). Parents have expressed dissatisfaction with the care they received at the ED and few interventions have been developed for improving miscarriage care. When planning an intervention, it is crucial to develop a program theory specifying what must be done for an intervention to achieve its objectives. The purpose of this paper is to describe the logic model process for developing an intervention intended to improve parents' miscarriage experience at the ED. The six steps of W. K. Kellogg Foundation (2004) theory logic model were used to 1) describe the problem; 2) conduct a needs assessment; and to identify 3) expected results, 4) influential factors, 5) intervention strategies, and 6) assumptions related to change strategies. A community-based participatory approach was used. It included two planning groups: parents who had visited the ED for a miscarriage (N = 9) and health professionals (N = 8). The theory logic model provided a rigorous framework for intervention development based on theories, scientific evidence, and the experiences of parents and health professionals. Detailed description of the intervention should facilitate its implementation, evaluation, and replication for other health problems.
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Affiliation(s)
- Tina Emond
- Faculty of Nursing, Université Laval, 1050, avenue de la Médecine, Local 3645, Québec, Québec, G1V 0A6, Canada.
| | - Laurence Guillaumie
- Faculty of Nursing, Université Laval, 1050, avenue de la Médecine, Pavillon Ferdinand-Vandry, Local 3443, Québec, Québec, G1V 0A6, Canada.
| | - Francine de Montigny
- Faculty of Nursing, University du Québec en Outaouais, C.P. 1250, succ. Hull, Gatineau, Quebec, J8X 3X7, Canada.
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18
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deMontigny F, Verdon C, Meunier S, Gervais C, Coté I. Protective and risk factors for women's mental health after a spontaneous abortion. Rev Lat Am Enfermagem 2020; 28:e3350. [PMID: 32901768 PMCID: PMC7478879 DOI: 10.1590/1518-8345.3382.3350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 05/01/2020] [Indexed: 11/30/2022] Open
Abstract
Objective: to examine personal and contextual protective and risk factors associated
with women’s mental health after a spontaneous abortion. Method: a cross-sectional study was carried out where 231 women who had experienced
spontaneous abortions in the past 4 years answered a self-reporting online
questionnaire to assess their mental health (symptoms of depression,
anxiety, perinatal grief) and to collect personal as well as contextual
characteristics. Results: women who had experienced spontaneous abortions within the past 6 months had
higher scores for depressive symptoms than those who had experienced
spontaneous abortions between 7 and 12 months ago, while anxiety level and
perinatal grief did not vary according to the time since the loss. Moreover,
low socioeconomic status, immigrant status, and childlessness were
associated with worse mental health after a spontaneous abortion. In
contrast, the quality of the conjugal relationship and the level of
satisfaction with health care were positively associated with women’s mental
health. Conclusion: women in vulnerable situations, such as immigrants, women with a low
socioeconomic status, or childless women are particularly vulnerable to
mental health problems after a spontaneous abortion. However, beyond those
personal and contextual factors, the quality of the conjugal relationship
and the level of satisfaction with health care could be important protective
factors.
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Affiliation(s)
- Francine deMontigny
- Université du Québec en Outaouais, Gatineau, Qc, Canada.,Scholarship holder at the Canadian Research Chair in Psychosocial Family Health, Canada
| | | | | | - Christine Gervais
- Université du Québec en Outaouais, Gatineau, Qc, Canada.,Scholarship holder at the Fonds Québécois de Recherche en Santé, Canada
| | - Isabel Coté
- Université du Québec en Outaouais, Gatineau, Qc, Canada
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Carroll K, Noble-Carr D, Sweeney L, Waldby C. The "Lactation After Infant Death (AID) Framework": A Guide for Online Health Information Provision About Lactation After Stillbirth and Infant Death. J Hum Lact 2020; 36:480-491. [PMID: 32427507 PMCID: PMC7411512 DOI: 10.1177/0890334420926946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Katherine Carroll
- School of Sociology, College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | - Debbie Noble-Carr
- School of Sociology, College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | - Lara Sweeney
- School of Sociology, College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | - Catherine Waldby
- Research School of Social Sciences, Australian National University, Canberra, Australia
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20
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Valdez A. Who Cares for the Emergency Nurse? J Emerg Nurs 2019; 45:602-604. [PMID: 31706441 DOI: 10.1016/j.jen.2019.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 11/19/2022]
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Professional Flourishing: The Job Demands–Resources Model and Emergency Nursing. J Emerg Nurs 2019; 45:607-610. [DOI: 10.1016/j.jen.2019.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 02/06/2023]
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