The experience of becoming a mother following successful in vitro fertilization: A grounded theory

Clinical nurses' compassion fatigue psychological experience process: a constructivist grounded theory study

BACKGROUND

Clinical nurses are susceptible to compassion fatigue when exposed to various types of traumatic events in patients for extended periods of time. However, the developmental process, staging, and psychological responses distinct to each stage of compassion fatigue in nurses are not fully clarified. This study aimed to explore the processes of compassion fatigue and the psychological experiences specific to each phase of compassion fatigue among clinical nurses.

METHODS

Charmaz's Constructivist Grounded Theory methodology was used in this qualitative research. Semi-structured interviews were conducted with 13 clinical nurses with varying degrees of compassion fatigue from December 2020 to January 2021. Interview data were analyzed using grounded theory processes.

RESULTS

The data were categorized into five separate categories and 22 sub-categories. This study found that the process of compassion fatigue is dynamic and cumulative, which was classified into five phases: compassion experience period, compassion decrement period, compassion discomfort period, compassion distress period, and compassion fatigue period.

CONCLUSION

Clinical nurses who experience compassion fatigue may go through five stages that are stage-specific and predictable. The findings can shed light on local and global applications to better understand the problem of nurses' compassion fatigue. The interventions for addressing compassion fatigue in clinical nurses should be stage-specific, targeted, and individualized.

Parents' experiences of life after medicalised conception: a thematic meta-synthesis of the qualitative literature

BACKGROUND

Medicalised Conception (MAC) assists many couples to achieve pregnancy worldwide. As the impact of MAC has been linked to increased pregnancy-specific anxiety and parenting difficulties, this review aimed to explore parental experiences of pregnancy and early parenting following MAC, identifying parents' psychological, social and health needs.

METHOD

Five databases were searched systematically from inception to March 2023. Identified articles were screened for eligibility against the inclusion criteria and the results were analysed using thematic synthesis. The Critical Appraisal Skills checklist was employed to appraise methodological quality.

RESULTS

Twenty qualitative studies, drawing on a total of 19 participant samples, were included in this review, most with samples with history of subfertility. The findings were synthesised into three main themes (consisting of seven subthemes): 1) The vulnerable parent: fear, doubt, uncertainty, 2) the stark realisation of the parental dream, 3) psychosocial needs and support. Parents lacked a sense of safety during pregnancy and reported acting protectively both antenatally and postnatally. Furthermore, their identity transition was complex and non-linear, influenced by sociocultural context.

CONCLUSIONS

Considerable unmet psychosocial needs were identified including the potential for anxiety in pregnancy, the possibility of feeling excluded and marginalised, and a reluctance to share distress and experiences with healthcare professionals. These findings suggest a need for consistent, holistic care, integrating psychological services.

The precursors's adaptation to pregnancy, prenatal attachment and maternal self-confidence

We investigated the precursors for prenatal attachment (PA), adaptation to pregnancy and maternal self-confidence, and the relationship of these variables with each other. This cross-sectional study was conducted between July and December 2020. Data were obtained using an online survey from social media groups. The mean Prenatal Self Evaluation Questionnaire scores of women had a negative and moderate correlation with mean Pharis Self-Confidence Scale (r=-0.287, p=.000) and negative and weak correlation with mean Prenatal Attachment Inventory scores (r=-0.317, p=.000). Women who conceived following assisted reproductive techniques had a higher level of readiness to give birth (17.62 ± 5.22) than women who conceived spontaneously (29.57 ± 6.15) (β=-0.285, t=-3.547, p=.002). We concluded that when women's adaptation to pregnancy increased in the prenatal period, their PA level and self-confidence towards baby care increased. The results of this study may guide healthcare professionals in terms of improving care for women who have attachment and adaptation problems during pregnancy. Women who conceived following assisted reproductive techniques can be reassured that infertility does not have a negative impact on their readiness for birth. Healthcare professionals could ensure adaptation in women who have problems with adaptation during pregnancy by initiating interventions that support PA and increase the maternal self-confidence levels of women.Impact StatementWhat is already known on this subject? There were few studies examining the relationship between women's conception style with prenatal attachment (PA), adaptation to pregnancy, and maternal self-efficacy.What do the results of this study add? In this study, it was determined that women who conceived following assisted reproductive techniques have higher levels of being ready to give birth than women who conceived spontaneously without medical assistance. Additionally, it was found that as women evaluate themselves positively in the prenatal period, their PA and maternal self-confidence level regarding baby care increased.What are the implications of these findings for clinical practice and/or further research? Since this study examines the precursors of maternal self-confidence, PA and adaptation to pregnancy in Turkish pregnant women, it was shown that studies in different cultures are needed in terms of generalisability of the results. In addition, there is a need to identify risky women who have low self-confidence in baby care during pregnancy and have attachment and adjustment problems, and to culture-specific intervention programs need to be developed and tested.