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Olde Loohuis KM, de Kok BC, Bruner W, Jonker A, Salia E, Tunçalp Ö, Portela A, Mehrtash H, Grobbee DE, Srofeneyoh E, Adu-Bonsaffoh K, Brown Amoakoh H, Amoakoh-Coleman M, Browne JL. Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002449. [PMID: 37819950 PMCID: PMC10566738 DOI: 10.1371/journal.pgph.0002449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
Effective interpersonal communication is essential to provide respectful and quality maternal and newborn care (MNC). This scoping review mapped, categorized, and analysed strategies implemented to improve interpersonal communication within MNC up to 42 days after birth. Twelve bibliographic databases were searched for quantitative and qualitative studies that evaluated interventions to improve interpersonal communication between health workers and women, their partners or newborns' families. Eligible studies were published in English between January 1st 2000 and July 1st 2020. In addition, communication studies in reproduction related domains in sexual and reproductive health and rights were included. Data extracted included study design, study population, and details of the communication intervention. Communication strategies were analysed and categorized based on existing conceptualizations of communication goals and interpersonal communication processes. A total of 138 articles were included. These reported on 128 strategies to improve interpersonal communication and were conducted in Europe and North America (n = 85), Sub-Saharan Africa (n = 12), Australia and New Zealand (n = 10), Central and Southern Asia (n = 9), Latin America and the Caribbean (n = 6), Northern Africa and Western Asia (n = 4) and Eastern and South-Eastern Asia (n = 2). Strategies addressed three communication goals: facilitating exchange of information (n = 97), creating a good interpersonal relationship (n = 57), and/or enabling the inclusion of women and partners in the decision making (n = 41). Two main approaches to strengthen interpersonal communication were identified: training health workers (n = 74) and using tools (n = 63). Narrative analysis of these interventions led to an update of an existing communication framework. The categorization of different forms of interpersonal communication strategy can inform the design, implementation and evaluation of communication improvement strategies. While most interventions focused on information provision, incorporating other communication goals (building a relationship, inclusion of women and partners in decision making) could further improve the experience of care for women, their partners and the families of newborns.
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Affiliation(s)
- Klaartje M. Olde Loohuis
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bregje C. de Kok
- Department of Anthropology, University of Amsterdam, Amsterdam, The Netherlands
| | - Winter Bruner
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Annemoon Jonker
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Emmanuella Salia
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Özge Tunçalp
- Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Hedieh Mehrtash
- Department of Sexual and Reproductive Health and Research Including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - Diederick E. Grobbee
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Emmanuel Srofeneyoh
- Department of Obstetrics and Gynecology, Greater Regional Hospital, Accra, Ghana
| | - Kwame Adu-Bonsaffoh
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Hannah Brown Amoakoh
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Accra, Accra, Ghana
| | - Mary Amoakoh-Coleman
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Accra, Accra, Ghana
| | - Joyce L. Browne
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
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Karapanos I, Bolou A, Nazer M, Iliodromiti S, Greco E. Strategies to communicate pregnancy complications: a systematic review and practical points for healthcare professionals. Curr Opin Obstet Gynecol 2023; 35:411-419. [PMID: 37560805 DOI: 10.1097/gco.0000000000000899] [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: 08/11/2023]
Abstract
PURPOSE/METHODS This systematic review aims to provide an overview of strategies available for healthcare professionals (HCPs) to effectively communicate unexpected news in pregnancy, specifically for the most common pregnancy complications. Three medical databases and grey literature were searched until March 2023 using subject headings and keywords. Snowball techniques were also used. The articles were reviewed at each stage of screening independently by two separate authors. Qualitative, quantitative and mixed methods studies were included. RECENT FINDINGS Forty-three studies were included and grouped according to the gestational age of the pregnancy complication - miscarriage, increased risk screening, foetal conditions, stillbirth. The main key points for communication were outlined at each specific complication and eventually the six common themes that emerged from all the categories were included in the acronym PRICES (Preparation - Referral - Individualized care - Clarity - Empowerment - Sensitivity). SUMMARY Given the negative impact of failed communications both in pregnancy outcomes and patients' experience, we advocate that communication training for HCP providing pregnancy care should be mandatory, and skills should be updated at regular intervals. Tools like our acronym PRICES can be used during teaching HCPs how to communicate more effectively.
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Affiliation(s)
- Ioannis Karapanos
- Women's Health Research Unit, Wolfson Institute of Population Health Sciences, Queen Mary University of London, Barts and The London School of Medicine and Dentistry
| | - Angeliki Bolou
- Women's Health Research Unit, Wolfson Institute of Population Health Sciences, Queen Mary University of London, Barts and The London School of Medicine and Dentistry
- School of Health Sciences, Institute for Lifecourse Development: Centre for Chronic Illness and Ageing, Faculty of Education, Health & Human Sciences, University of Greenwich
| | - Maya Nazer
- Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
| | - Stamatina Iliodromiti
- Women's Health Research Unit, Wolfson Institute of Population Health Sciences, Queen Mary University of London, Barts and The London School of Medicine and Dentistry
| | - Elena Greco
- Women's Health Research Unit, Wolfson Institute of Population Health Sciences, Queen Mary University of London, Barts and The London School of Medicine and Dentistry
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Galeotti M, Heaney S, Robinson M, Aventin Á. Evaluation of a pregnancy loss education intervention for undergraduate nursing students in Northern Ireland: A pre- and post-test study. BMC Nurs 2023; 22:268. [PMID: 37580730 PMCID: PMC10424365 DOI: 10.1186/s12912-023-01408-4] [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: 05/29/2023] [Accepted: 07/19/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Research highlights the importance of compassionate communication, adequate delivery of information, and professional support to help alleviate parental distress following pregnancy loss. However, many healthcare professionals do not feel sufficiently trained to deal with pregnancy loss in practice. We aimed to address this deficiency with an evidence-informed educational intervention to increase knowledge, skills, self-awareness, and confidence regarding pregnancy loss among UK nursing students. METHODS Educational resources, which included an 82-minute podcast and 40-minute online lecture were developed. The podcast focused on the lived experiences of three women who had experienced miscarriage, stillbirth, and termination of pregnancy for medical reasons. The pre-recorded lecture included definitions of types of pregnancy loss, discussion of the importance of communication, and information on the clinical management of pregnancy loss. Students were presented with both the lecture and podcast as a self-directed element of existing curricula. A pre-test/post-test cross-sectional survey design was used to investigate the impact of the educational intervention. The Perinatal Bereavement Care Confidence Scale (PBCCS) was completed by 244 first year BSc Nursing students before and up to a week after receiving the intervention. Quantitative data were analysed using a Paired Samples Wilcoxon test. Responses to open-ended questions, which allowed students to give feedback on the intervention content and delivery were analysed using Qualitative Content Analysis. RESULTS 96% (n = 235) of the sample reported having no prior experience or training in the management and support of those experiencing pregnancy loss. At pre-test, 88% (n = 215) of students rated themselves as not confident in dealing with pregnancy loss in a professional capacity. Post-test, we found statistically significant effects for perceived competency on all learning outcomes (p < .001). Qualitative analysis of n = 745 individual text responses to open-ended questions indicated four categories related to the perceived value of using real-life stories for learning, demystifying a taboo subject, and providing tools for practice. Respondents suggested the inclusion of more information on memory-making, support networks, and mental health following pregnancy loss. CONCLUSIONS The educational intervention increased student nurses' perceived knowledge, confidence, and skills in caring for families experiencing pregnancy loss. This offers potential for increased quality of care for those experiencing pregnancy loss in healthcare settings, increased patient satisfaction, and improved mental health-related outcomes.
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Affiliation(s)
- Martina Galeotti
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Suzanne Heaney
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Martin Robinson
- Stress, Trauma and Related Conditions Research Centre, School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Áine Aventin
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
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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] [MESH Headings] [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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Nord GA, Doty AMB, Monick AJ, McCarthy DM, Casten RJ, Aldeen AZ, Nawrocki PS, Rising KL. Emergency Medicine Clinician Experiences Addressing Uncertainty in First-Trimester Bleeding. J Patient Exp 2022; 9:23743735221140698. [DOI: 10.1177/23743735221140698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this work is to understand Emergency Department (ED) clinicians’ experiences in communicating uncertainty about first-trimester bleeding (FTB) and their need for training on this topic. This cross-sectional study surveyed a national sample of attending physicians and advanced practice providers (APPs). The survey included quantitative and qualitative questions about communicating with patients presenting with FTB. These questions assessed clinicians’ frequency encountering challenges, comfort, training, prior experience, and interest in training on the topic. Of 402 respondents, 54% reported that they encountered challenges at least sometimes when discussing FTB with patients where the pregnancy outcome is uncertain. While the majority (84%) were at least somewhat prepared for these conversations from their training, which commonly addressed the diagnostic approach to this scenario, 39% strongly or moderately agreed that they could benefit from training on the topic. Because the majority of ED clinicians identified at least sometimes encountering challenges communicating with pregnant patients about FTB, our study indicates a need exists for more training in this skill.
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Affiliation(s)
- Garrison A Nord
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Amanda MB Doty
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Andrew J Monick
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Danielle M McCarthy
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robin J Casten
- Department of Psychiatry, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Philip S Nawrocki
- US Acute Care Solutions, Canton, OH, USA
- Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Kristin L Rising
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- College of Nursing, Thomas Jefferson University, Philadelphia, PA, USA
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Aggarwal N, Moatti Z. "Getting it right when it goes wrong - Effective bereavement care requires training of the whole maternity team". Best Pract Res Clin Obstet Gynaecol 2021; 80:92-104. [PMID: 34866003 DOI: 10.1016/j.bpobgyn.2021.10.008] [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] [Received: 06/29/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022]
Abstract
Stillbirth or neonatal death is one of the most traumatic and distressing life experiences with negative psychosocial effects. Perinatal grief is natural and understandable, and, if not recognized and well supported, may lead to long-term harmful effects. Harm may also be caused to the other surviving siblings, families, and next generation. This can be helped by effective bereavement care. Bereavement care is an area of enormous needs, relatively untraveled road. Though the loss cannot be undone, but a negative impact can be minimized by compassionate supportive care. This chapter will focus on the need of a trained team for effective bereavement care. Principles of evidence-based best practices from the literature will be reviewed and translated into key practice implications. An emphasis is laid on a structured training involving the whole team. We hope this will help in day-to-day situation handling so as to prevent the harm associated with unaddressed grief. Areas of gap with the further need of research are highlighted.
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Affiliation(s)
- Neelam Aggarwal
- Department of Obstetrics. & Gynecology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
| | - Zoe Moatti
- Department of Obstetrics and Gynaecology, Royal London Hospital, Whitechapel Rd, London, E1 1FR, United Kingdom
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Ito Y, Tsubaki M, Kobayashi M. Families' experiences of grief and bereavement in the emergency department: A scoping review. Jpn J Nurs Sci 2021; 19:e12451. [PMID: 34490984 DOI: 10.1111/jjns.12451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/19/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
AIM Death is a frequent event in the emergency department, and many family members experience grief and bereavement. However, little is known about what families experience. The aim of this study was to explore previous findings about families' experiences of grief and bereavement in the emergency department to clarify and understand their experience. METHODS A scoping review was chosen as the design for this research. Studies were searched from four electronic databases. The obtained studies were screened independently by two reviewers and selected by mutual agreement of the entire team based upon the eligibility criteria. All relevant data were extracted, and thematic analysis was conducted to assess families' grief and bereavement experiences in the emergency department. RESULTS The database searches initially resulted in 982 studies; these were finally narrowed to 20 studies for data extraction. Publication years ranged from 1987 to 2020. The studies were conducted across nine countries; most were from the United States and had a qualitative research design. Analysis elicited the following themes: "lack of information," "breaking bad news," "being present during resuscitation," "chaotic environment," "psychosocial reaction in bereavement," and "support and care needs from healthcare professionals." CONCLUSION These themes reveal challenges in providing support and care from emergency nurses to bereaved families, including inadequate provision of information, poor design of the emergency department due to the lack of privacy, and families' unmet support and care needs. Emergency nurses need to better understand families' experience of grief and bereavement.
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Affiliation(s)
- Yoshiyasu Ito
- College of Nursing Art and Science, University of Hyogo, Akashi, Japan
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Evans CS. Early Pregnancy Loss in the Emergency Department: Lessons Learned as a Spouse, New Father, and Emergency Medicine Resident. Ann Emerg Med 2020; 77:233-236. [PMID: 33077250 DOI: 10.1016/j.annemergmed.2020.08.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Christopher S Evans
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
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