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Yeşildere Sağlam H, Gürsoy E. Termination of pregnancy due to fetal anomaly: A qualitative study from Turkey on women's experiences. Midwifery 2024; 132:103957. [PMID: 38428136 DOI: 10.1016/j.midw.2024.103957] [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: 09/05/2023] [Revised: 01/24/2024] [Accepted: 02/14/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Termination of pregnancy due to fetal anomaly is an unexpected traumatic event for women. It can cause serious complications that can negatively affect both the physical and psychological health of women. AIM This study aims to examine the experiences of women who underwent medical termination for fetal anomaly in the second trimester. METHODS The study included 12 women whose pregnancies were terminated due to fetal anomaly. Data were collected through in-depth interviews until data sufficiency was reached. Thematic analysis method was used to analyze the data. This study was conducted using an inductive qualitative design. The women's statements were examined and double-coded. By examining the codes, main themes were created after sub-themes. RESULTS Women's experiences were analyzed in five themes: difficulty in decision-making (1), emotional impact (2), stigmatization (3), dilemma between hope and anxiety (4), and post-termination care and support needs (5). Participants stated that they experienced many emotions such as indecision, sadness, helplessness, guilt, and remorse during the medical termination process. Hope, anxiety, fear, social pressure and support needs were also frequently experienced in this process. CONCLUSION Termination of pregnancy in the second trimester due to fetal anomaly caused significant psychological symptoms. In order to prevent long-term health complications, it will be important for health professionals to provide interventions designed to meet the demands of women diagnosed with fetal anomaly.
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Affiliation(s)
- Havva Yeşildere Sağlam
- Faculty of Health Sciences, Department of Nursing, Kütahya Health Sciences University, Kütahya, Turkey.
| | - Elif Gürsoy
- Faculty of Health Sciences, Department of Nursing, Eskisehir Osmangazi University, Eskisehir, Turkey
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Wang Y, Huang C, Xie J, Zeng L, Wang Y, He Y, Li Y, Qin C. Psychosocial intervention programme based on the needs of women undergoing termination of pregnancy for foetal anomalies: A modified Delphi study. Nurs Open 2024; 11:e2164. [PMID: 38606808 PMCID: PMC11010260 DOI: 10.1002/nop2.2164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/10/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024] Open
Abstract
AIM To construct a psychosocial intervention programme for women diagnosed with foetal anomalies based on their needs in China. DESIGN A three round-modified Delphi survey from September to November 2020. METHODS In Round 1, based on literature review and qualitative interviews, a face-to-face meeting with eight taskforce members was conducted to generate the initial intervention indicators. In Round 2 and 3, 15 experts and three stakeholders (women undergoing termination of pregnancy for foetal anomalies) were invited by email to evaluate the importance of the indicators and built the final psychosocial intervention programme. RESULTS The response rate for both two rounds is 100%. The experts' authority coefficient was 0.86. The Kendall W value of the two rounds ranged between 0.191 and 0.339. A needs-based psychosocial intervention programme was established, including four periods (denial, confirmation, decision-making and recovery), three needs-based supports (information, social and acceptance commitment therapy) and 27 intervention indicators. The mean value of the importance of each index was 4.00-5.00. Further research is required to evaluate whether this programme is realistic and effective for the target audiences.
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Affiliation(s)
- Ying Wang
- Health Management Medicine Center and Department of Nursingthe Third Xiangya Hospital, Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Chi Huang
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Jiaying Xie
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Lihong Zeng
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Yaohan Wang
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Yanjuan He
- Department of Obstetrics and GynecologyChangsha Hospital for Maternal and Child Health CareChangshaChina
| | - Ying Li
- Department of Pediatrics, the Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Chunxiang Qin
- Health Management Medicine Center and Department of Nursingthe Third Xiangya Hospital, Central South UniversityChangshaChina
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Akın Işık R, İş M, Kaya Y. "You Are in the Middle of a Road, a Road With No End": Experiences of Women Who Underwent Medical Termination of Their Pregnancies: A Phenomenologıcal Study. J Hosp Palliat Nurs 2024; 26:E83-E90. [PMID: 38206298 DOI: 10.1097/njh.0000000000001006] [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: 01/12/2024]
Abstract
This article focused on the experiences of women who underwent medical termination of their pregnancies. The study adopted a qualitative phenomenological research design with a sample of 20 pregnant women. Data were collected between April and June 2022 using a personal information form and a semistructured individual interview. The qualitative data were analyzed into 4 categories: "psychosocial impacts," "impacts on functionality," "coping," and "expectations." These categories comprised 8 themes and 24 subthemes. Nurses play a crucial role in adopting family-centered approaches to offer holistic care. They should prioritize providing physical care throughout the medical termination, while also assessing the psychological impact of fetal loss. Perinatal palliative care and bereavement counseling should be integrated into care practices.
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Thomas J, Keels J, Calzone KA, Badzek L, Dewell S, Patch C, Tonkin ET, Dwyer AA. Current State of Genomics in Nursing: A Scoping Review of Healthcare Provider Oriented (Clinical and Educational) Outcomes (2012-2022). Genes (Basel) 2023; 14:2013. [PMID: 38002957 PMCID: PMC10671121 DOI: 10.3390/genes14112013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
In the 20 years since the initial sequencing of the human genome, genomics has become increasingly relevant to nursing. We sought to chart the current state of genomics in nursing by conducting a systematic scoping review of the literature in four databases (2012-2022). The included articles were categorized according to the Cochrane Collaboration outcome domains/sub-domains, and thematic analysis was employed to identify key topical areas to summarize the state of the science. Of 8532 retrieved articles, we identified 232 eligible articles. The articles primarily reported descriptive studies from the United States and other high-income countries (191/232, 82%). More than half (126/232, 54.3%) aligned with the "healthcare provider oriented outcomes" outcome domain. Three times as many articles related to the "knowledge and understanding" sub-domain compared to the "consultation process" subdomain (96 vs. 30). Five key areas of focus were identified, including "nursing practice" (50/126, 40%), "genetic counseling and screening" (29/126, 23%), "specialist nursing" (21/126, 17%), "nurse preparatory education" (17/126, 13%), and "pharmacogenomics" (9/126, 7%). Only 42/126 (33%) articles reported interventional studies. To further integrate genomics into nursing, study findings indicate there is a need to move beyond descriptive work on knowledge and understanding to focus on interventional studies and implementation of genomics into nursing practice.
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Affiliation(s)
- Joanne Thomas
- Genomics Policy Unit, Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK;
| | - Jordan Keels
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02476, USA;
| | - Kathleen A. Calzone
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- National Institutes of Health, National Cancer Institute, Center for Cancer Research, Genetics Branch, Bethesda, MD 20892, USA
| | - Laurie Badzek
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- Ross and Carol Nese College of Nursing, Penn State University, University Park, PA 16802, USA
| | - Sarah Dewell
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- School of Nursing, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - Christine Patch
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- Engagement and Society, Wellcome Connecting Science, Hinxton CB10 1RQ, UK
| | - Emma T. Tonkin
- Genomics Policy Unit, Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK;
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
| | - Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02476, USA;
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
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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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Sun S, Sun Y, Qian J, Tian Y, Wang F, Yu Q, Yu X. Parents' experiences and need for social support after pregnancy termination for fetal anomaly: a qualitative study in China. BMJ Open 2023; 13:e070288. [PMID: 37734885 PMCID: PMC10514653 DOI: 10.1136/bmjopen-2022-070288] [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: 02/14/2023] [Accepted: 08/29/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore the experiences and need for social support of Chinese parents after termination of pregnancy for fetal anomalies. DESIGN A qualitative study using semistructured, in-depth interviews combined with observations. Data were analysed by Claizzi's phenomenological procedure. SETTING A large, tertiary obstetrics and gynaecology hospital in China. PARTICIPANTS Using purposive sampling approach, we interviewed 12 couples and three additional women (whose spouses were not present). RESULTS Four themes were identified from the experiences of parents: the shock of facing reality, concerns surrounding termination of pregnancy, the embarrassment of the two-child policy and the urgent need for social support. CONCLUSION Parents experienced complicated and intense emotional reactions, had concerns surrounding the termination of pregnancy and an urgent need for social support. Paternal psychological reactions were often neglected by healthcare providers and the fathers, themselves. These findings suggest that both mothers and fathers should receive appropriate support from family, medical staff and peers to promote their physical and psychological rehabilitation.
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Affiliation(s)
- Shiwen Sun
- Department of Obstetrics, Zhejiang University School of Medicine, Women's Hospital, Hangzhou, China
| | - Yaping Sun
- Zhejiang University School of Medicine, Hangzhou, China
| | - Jialu Qian
- Zhejiang University School of Medicine, Hangzhou, China
| | - Yanping Tian
- Department of Obstetrics, Zhejiang University School of Medicine, Women's Hospital, Hangzhou, China
| | - Fang Wang
- Nursing Department, Zhejiang University School of Medicine, Women's Hospital, Hangzhou, China
| | - Qing Yu
- Department of Obstetrics, Zhejiang University School of Medicine, Women's Hospital, Hangzhou, China
| | - Xiaoyan Yu
- Department of Obstetrics, Zhejiang University School of Medicine, Women's Hospital, Hangzhou, China
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Roncoroni J, Whitaker S, Magdamo B, Hendrix T, Zaręba K, Yohannes R. Perceptions of Patient-Centered Care and Their Association With Patient Satisfaction in Abortions for Medical Reasons. Womens Health Issues 2023:S1049-3867(23)00069-5. [PMID: 37230927 DOI: 10.1016/j.whi.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 02/10/2023] [Accepted: 03/03/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Abortions for medical reasons, which happen in the event of fetal abnormalities or maternal life endangerment, are highly politicized and understudied given their prevalence. Our objective was to understand the health care experiences of U.S. individuals who had an abortion of a wanted pregnancy for medical reasons in the second or third trimester. METHODS Participants were recruited on Facebook and completed surveys with their demographic information, their perception of their health provider's cultural sensitivity, their patient satisfaction, and their satisfaction with their decision to proceed with an abortion for medical reasons. RESULTS Participants were 132 women who were mostly between the ages of 31 and 40 (72.7%), highly educated (84.1% had at least a 4-year college degree), and non-Hispanic White (85.6%). There was no statistically significant difference in patients' rated highest average item score on their providers' Competence or Sensitivity; however, average item scores of providers' Competence and Sensitivity were both higher than Respect scores. Linear regression results show that experiencing patient-centered care significantly predicted patient satisfaction (β = .73, t(131) = 12.03, p < .001) and decision satisfaction (β = .37, t(131) = 4.63, p < .001). CONCLUSION Our findings underscore the importance of training providers to deliver patient-centered care that empowers patients to adapt to challenging situations, such as the diagnosis of medical concerns during pregnancy. Providers understanding and supporting the complex process of an abortion for medical reasons can ameliorate the emotional impact of this procedure.
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Affiliation(s)
- Julia Roncoroni
- Department of Counseling Psychology, University of Denver, Denver, Colorado.
| | - Salina Whitaker
- Department of Counseling Psychology, University of Denver, Denver, Colorado
| | - Brigid Magdamo
- Department of Counseling Psychology, University of Denver, Denver, Colorado
| | - Tayler Hendrix
- Department of Counseling Psychology, University of Denver, Denver, Colorado
| | - Kornelia Zaręba
- Obstetrics & Gynecology Department, College of Medicine & Health Sciences (CMHS), United Arab Emirates University (UAEU), Al Ain, United Arab Emirates
| | - Rebekah Yohannes
- Department of Counseling Psychology, University of Denver, Denver, Colorado
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Zhou M, Li X, Huang C, Xie J, Liu L, Wang Y, Xiao G, Zhang T, Qin C. Needs for supporting women undergoing termination of pregnancy for fetal anomaly: A phenomenological study based on the cognitive-emotional-behavioral framework. Midwifery 2023; 123:103726. [PMID: 37192569 DOI: 10.1016/j.midw.2023.103726] [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: 08/08/2022] [Revised: 03/29/2023] [Accepted: 05/10/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To determine and describe the needs of women undergoing termination of pregnancy for fetal anomaly (TOPFA) in China. STUDY DESIGN Qualitative study with semi-structured interviews. Consolidated Criteria for Reporting Qualitative Studies checklist was used for reporting. SETTING Three general hospitals and one special hospital in Changsha, Hunan, China. PARTICIPANTS 12 women who had undergone TOPFA and 12 healthcare providers who had experienced in caring for these women. METHODS This study was based on the cognitive-emotional-behavioral framework (CEBF) of women who had to undergo TOPFA. Twenty-four participants (12 women and 12 healthcare providers) were recruited from two hospitals in China. Semi-structured face-to-face interviews were conducted based on interview guides. ATLAS.ti software was used to encode and analyze data. Qualitative content analysis was also applied. FINDINGS Four themes emerged: information, emotional, professional psychological, and social supports. Each theme was subdivided into four phases for a detailed description of the temporal order (denial, confirmation, decision-making, and recovery phases) within the framework. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Our study analyzes the four needs of women who underwent TOPFA and the specifics of each need at different phases based on the CEBF. The importance of offering professional psychological support, detailed information, timely emotional support, and comprehensive social support for these women is illustrated. This study contributes to the understanding of women's needs, hence providing a theoretical basis for the construction of supportive programs.
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Affiliation(s)
- Mengjia Zhou
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China; XiangYa School of Nursing, Central South University, Changsha, China
| | - Xi Li
- School of Medicine, Jishou University, Jishou, China
| | - Chi Huang
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China; XiangYa School of Nursing, Central South University, Changsha, China
| | - Jiaying Xie
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China; XiangYa School of Nursing, Central South University, Changsha, China
| | - Li Liu
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China; XiangYa School of Nursing, Central South University, Changsha, China
| | - Ying Wang
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China; XiangYa School of Nursing, Central South University, Changsha, China
| | - Gui Xiao
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China; XiangYa School of Nursing, Central South University, Changsha, China
| | - Tingting Zhang
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China; XiangYa School of Nursing, Central South University, Changsha, China
| | - Chunxiang Qin
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha, China.
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Hope Aspects of the Women's Experience after Confirmation of a High-Risk Pregnancy Condition: A Systematic Scoping Review. Healthcare (Basel) 2022; 10:healthcare10122477. [PMID: 36554001 PMCID: PMC9778290 DOI: 10.3390/healthcare10122477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Pregnancy is a period of transformation, hope, expectation, and worry for women and their families. A high-risk pregnancy refers to a pregnancy in which the mother and/or fetus are at greater-than-normal risk of complications, and it evokes a range of emotional and psychological experiences that largely depend on the care and support provided by health professionals. The purpose of this review is to summarize the existing literature on the lived experience of hope in women facing a high-risk pregnancy related to their own health and/or medical conditions related to the fetus. METHODS This review followed the Joanna Briggs Institute's methodology. No limits on a date were applied to the search. Identified titles and abstracts were screened to select original reports and were cross-checked for any overlap of cases. We included studies that emphasized the experience of hope of pregnant women dealing with a pregnancy complication. MAIN RESULTS According to the results of the present scoping review, we found two main dimensions: women experiencing a high-risk pregnancy themselves and prenatal diagnosis. In both cases, the women were in a dilemma between hope and hopelessness. CONCLUSION The findings demonstrate that women facing high-risk pregnancies struggle with multiple fears and concerns about their own health and the fetus's health. Further research is needed to identify best practices for the care provided to the vulnerable populations.
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González-Ramos Z, Zuriguel-Pérez E, Collado-Palomares A, Casadó-Marín L. 'My biggest fear is that people will forget about him': Mothers' emotional transitions after terminating their pregnancy for medical reasons. J Clin Nurs 2022. [PMID: 36047291 DOI: 10.1111/jocn.16504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore women's emotional responses throughout the process of terminating a pregnancy for medical reasons. BACKGROUND Making the choice to terminate a desired pregnancy for medical reasons has a negative impact on women's health, as it is a distressing process that involves making hard decisions and readjusting one's expectations of an idealised pregnancy. METHODS A qualitative phenomenological study was conducted following the COREQ checklist. Fifteen semi-structured interviews and two focus groups were conducted with women who had terminated their pregnancies for medical reasons, previous to and during the COVID-19 lockdown. Subsequently, we analysed the content. RESULTS One main category, emotional journey during the process of terminating the pregnancy, and six subcategories were identified: (I) representation and desire to become a mother, (II) main concerns, (III) impact of the news, (IV) decision-making, (V) emotional responses before termination for medical reasons and (VI) emotional responses after termination for medical reasons. All contributed to understanding the specificities of the different phases that make up the emotional journey of terminating a pregnancy for medical reasons. CONCLUSIONS The findings of this study suggest that there are a number of predominant emotions that professionals need to be aware of in order to help women work through them and lessen the impact of pregnancy termination on their mental health. COVID-19 had different connotations depending on the women's experiences. RELEVANCE TO CLINICAL PRACTICE Our results highlight how important the role of healthcare staff is in caring for these women and their partners, which involves recognising their emotions throughout the process. Our results also underline how useful it is to conduct qualitative studies in this context, since they constitute a set of activities and interventions that result in the administration of nursing care in itself. PATIENT OR PUBLIC CONTRIBUTION The ultimate goal of the action research study is to design a positive mental health intervention. Participants will contribute to the design and final approval of the intervention.
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Affiliation(s)
- Zuleika González-Ramos
- Universitat Rovira i Virgili, Departament d'Infermeria, Avinguda Catalunya, Tarragona, Spain.,Hospital Vall d'Hebron, Passeig de la Vall d'Hebron, Barcelona, Spain
| | | | | | - Lina Casadó-Marín
- Universitat Rovira i Virgili, Departament d'Infermeria, Avinguda Catalunya, Tarragona, Spain
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Heaney S, Tomlinson M, Aventin Á. Termination of pregnancy for fetal anomaly: a systematic review of the healthcare experiences and needs of parents. BMC Pregnancy Childbirth 2022; 22:441. [PMID: 35619067 PMCID: PMC9137204 DOI: 10.1186/s12884-022-04770-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/16/2022] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Improved technology and advances in clinical testing have resulted in increased detection rates of congenital anomalies during pregnancy, resulting in more parents being confronted with the possibility of terminating a pregnancy for this reason. There is a large body of research on the psychological experience and impact of terminating a pregnancy for fetal anomaly. However, there remains a lack of evidence on the holistic healthcare experience of parents in this situation. To develop a comprehensive understanding of the healthcare experiences and needs of parents, this systematic review sought to summarise and appraise the literature on parents' experiences following a termination of pregnancy for fetal anomaly. REVIEW QUESTION What are the healthcare experiences and needs of parents who undergo a termination of pregnancy following an antenatal diagnosis of a fetal anomaly? METHODS A systematic review was undertaken with searches completed across six multi-disciplinary electronic databases (Medline, Embase, PsycINFO, CINAHL, Web of Science, and Cochrane). Eligible articles were qualitative, quantitative or mixed methods studies, published between January 2010 and August 2021, reporting the results of primary data on the healthcare experiences or healthcare needs in relation to termination of pregnancy for fetal anomaly for either, or both parents. Findings were synthesised using Thematic Analysis. RESULTS A total of 30 articles were selected for inclusion in this review of which 24 were qualitative, five quantitative and one mixed-methods. Five overarching themes emerged from the synthesis of findings: (1) Contextual impact on access to and perception of care, (2) Organisation of care, (3) Information to inform decision making, (4) Compassionate care, and (5) Partner experience. CONCLUSION Compassionate healthcare professionals who provide non-judgemental and sensitive care can impact positively on parents' satisfaction with the care they receive. A well organised and co-ordinated healthcare system is needed to provide an effective and high-quality service. TRIAL REGISTRATION PROSPERO registration number: CRD42020175970 .
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Affiliation(s)
- Suzanne Heaney
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, MBC Building, BT9 7BL, Belfast, Northern Ireland.
| | - Mark Tomlinson
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
| | - Áine Aventin
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, MBC Building, BT9 7BL, Belfast, Northern Ireland
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Álvaro-Sánchez S, Abreu-Rodríguez I, Abulí A, Serra-Juhe C, Garrido-Navas MDC. Current Status of Genetic Counselling for Rare Diseases in Spain. Diagnostics (Basel) 2021; 11:2320. [PMID: 34943558 PMCID: PMC8700506 DOI: 10.3390/diagnostics11122320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 12/29/2022] Open
Abstract
Genetic Counselling is essential for providing personalised information and support to patients with Rare Diseases (RD). Unlike most other developed countries, Spain does not recognize geneticists or genetic counsellors as healthcare professionals Thus, patients with RD face not only challenges associated with their own disease but also deal with lack of knowledge, uncertainty, and other psychosocial issues arising as a consequence of diagnostic delay. In this review, we highlight the importance of genetic counsellors in the field of RD as well as evaluate the current situation in which rare disease patients receive genetic services in Spain. We describe the main units and strategies at the national level assisting patients with RD and we conclude with a series of future perspectives and unmet needs that Spain should overcome to improve the management of patients with RD.
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Affiliation(s)
| | - Irene Abreu-Rodríguez
- Genetics Service, Hospital del Mar Research Institute, IMIM, 08003 Barcelona, Spain;
| | - Anna Abulí
- Department of Clinical and Molecular Genetics, Hospital Vall d’Hebron, 08035 Barcelona, Spain;
- Medicine Genetics Group, Vall d’Hebron Research Institute (VHIR), 08035 Barcelona, Spain
| | - Clara Serra-Juhe
- U705 CIBERER, Genetics Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain;
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), 28029 Madrid, Spain
| | - Maria del Carmen Garrido-Navas
- CONGEN, Genetic Counselling Services, C/Albahaca 4, 18006 Granada, Spain;
- Genetics Department, Faculty of Sciences, Universidad de Granada, 18071 Granada, Spain
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Costescu D, Mui C. When there is only one patient: Induction of labour for termination of pregnancy. Best Pract Res Clin Obstet Gynaecol 2021; 79:81-94. [PMID: 35000810 DOI: 10.1016/j.bpobgyn.2021.11.001] [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: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 12/21/2022]
Abstract
Induction of labour when no live birth is anticipated presents a number of unique considerations for members of the healthcare team. The main indication for Induction of Labour for Termination of Pregnancy (iTOP) is intrauterine fetal death (IUFD) beyond a gestational age where surgical management is available, but may also be indicated in the setting of induction abortion (with or without feticide), and termination of pregnancy (with or without infant palliation) for pregnancies where a lethal fetal anomaly is diagnosed. In tertiary care centres, iTOP may represent a significant proportion of labouring patients. Despite this, there are few guidelines dedicated specifically to iTOP in either obstetrical or family planning specialties. In this article, we will consider four main themes from an evidence-informed perspective: method selection; pre-induction preparation; clinical considerations during and after iTOP; and complications management.
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Affiliation(s)
- Dustin Costescu
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, L8N 3Z5, Canada.
| | - Carween Mui
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, L8N 3Z5, Canada
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González-Ramos Z, Zuriguel-Pérez E, Albacar-Riobóo N, Casadó-Marín L. The emotional responses of women when terminating a pregnancy for medical reasons: A scoping review. Midwifery 2021; 103:103095. [PMID: 34320417 DOI: 10.1016/j.midw.2021.103095] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 06/29/2021] [Accepted: 07/03/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND In most countries of the world the only basis for considering a termination of pregnancy is for medical reasons. Depending on the circumstances and determinants of each case, the emotional responses to this event vary greatly. The aim of this study is to map the emotional responses of women when their pregnancy is terminated for medical reasons. METHODS A scoping review was carried out. This covered all types of qualitative and quantitative studies published in English or Spanish since 2014 which included first-person accounts of women's emotional responses when they had a termination. A bibliographic search was made of four databases (CINAHL, Cochrane Library, PsycINFO and Pubmed) along with an additional manual search and backward and forward citation chaining of the studies included. The data were reported in narrative form and the results grouped according to the descriptive characteristics of the study and the emotions involved. FINDINGS The review process resulted in the inclusion of thirty-four studies. nineteen of these followed a qualitative approach and fifteen used quantitative methodology, with six of them being intervention studies. The emotions found ranged from anxiety and depression to guilt and thankfulness, so various authors stressed the need to improve training for health professionals to provide information, advice and support to the women during the entire process of the termination of pregnancy for medical reasons. CONCLUSIONS The available studies cannot be compared given the variety of designs. The predominant emotions underlying the termination for medical reasons were stress, anxiety and depression. Future research should be carried out using samples of participants covering all causes of termination for medical reasons in a particular context so that an intervention can be designed to help lessen the impact of the process on women's mental health.
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Affiliation(s)
- Zuleika González-Ramos
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain; Hospital Vall d'Hebron. Passeig de la Vall d'Hebron, 119-129, Postal Code 08035 Barcelona, Spain
| | - Esperanza Zuriguel-Pérez
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain; Hospital Vall d'Hebron. Passeig de la Vall d'Hebron, 119-129, Postal Code 08035 Barcelona, Spain
| | - Núria Albacar-Riobóo
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain
| | - Lina Casadó-Marín
- Department of Nursing, University Rovira i Virgili. Avinguda Catalunya, 35, Postal Code 43002, Tarragona, Spain
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15
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Obst KL, Due C, Oxlad M, Middleton P. Men's experiences and need for targeted support after termination of pregnancy for foetal anomaly: A qualitative study. J Clin Nurs 2021; 30:2718-2731. [PMID: 33899276 DOI: 10.1111/jocn.15786] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore men's experiences of termination of pregnancy for life-limiting foetal anomaly, including how healthcare providers, systems and policies can best support men and their families. BACKGROUND While there is a sizable body of research and recommendations relating to women's experiences of grief and support needs following a termination of pregnancy for foetal anomaly, very few studies specifically examine men's experiences. METHODS Semi-structured interviews were completed with ten Australian men who had experienced termination of pregnancy for life-limiting foetal anomalies with a female partner between six months and 11 years ago. Interviews were completed over the telephone, and data were analysed using thematic analysis. COREQ guidelines were followed. RESULTS Thematic analysis resulted in the identification of three over-arching themes, each with two sub-themes. First, participants described the decision to terminate their pregnancy as The most difficult choice, with two sub-themes detailing 'Challenges of decision-making' and 'Stigma surrounding TOPFA'. Second, participants described that they were Neither patient, nor visitor in the hospital setting, with sub-themes 'Where do men fit?' and 'Dual need to support and be supported'. Finally, Meet me where I am described men's need for specific supports, including the sub-themes 'Contact men directly' and 'Tailor support and services'. CONCLUSIONS Findings indicated that termination of pregnancy for life-limiting foetal anomaly (TOPFA) is an extremely difficult experience for men, characterised by challenges in decision-making and perceived stigma. Men felt overlooked by current services and indicated that they need specific support to assist with their grief. Expansion of existing infrastructure and future research should acknowledge the central role of fathers and support them in addressing their grief following TOPFA. RELEVANCE TO CLINICAL PRACTICE Nursing/midwifery professionals are well situated to provide men with tailored information and to promote genuine inclusion, acknowledgement of their grief, and facilitate referrals to community supports.
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Affiliation(s)
- Kate Louise Obst
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Clemence Due
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Melissa Oxlad
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Philippa Middleton
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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