1
|
Lockton J, Oxlad M, Due C. Grandparents' pregnancy and neonatal loss network: Designing a website for grandparents bereaved by the perinatal loss of a grandchild. PEC INNOVATION 2023; 3:100228. [PMID: 37876634 PMCID: PMC10590732 DOI: 10.1016/j.pecinn.2023.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/03/2023] [Accepted: 10/07/2023] [Indexed: 10/26/2023]
Abstract
Objectives When a child dies during the perinatal period, grandparents lack the resources to navigate their loss. We applied principles of co-creation and consumer-informed design to seek grandparents' expertise in determining (1) whether an internet-based resource would be suitable/beneficial for grandparents, (2) if so, what design features and content should be included and, (3) any barriers to utilising an internet-based resource. Method In Stage One, 152 grandparents responded to a survey regarding health and eHealth literacy and website design and content. In Stage Two, a draft website was developed, with 21 grandparents providing feedback about the website's design, content and navigability. Results Health and eHealth literacy measures indicated that >60% of participants had adequate literacy, and over 70% considered an internet-based resource useful. Grandparents provided design and content preferences, valuing diversity and peer support, and offered recommendations to optimise the website. Directing grandparents to public internet facilities would reduce barriers to access. Conclusion A website is a suitable resource for grandparents seeking information and support following the loss of a grandchild in the perinatal period. Innovation Grandparents see benefits in internet-based resources and can contribute to co-design. Further work could explore cultural differences.
Collapse
Affiliation(s)
- Jane Lockton
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
2
|
Kim MA, Sang J, Yi J, Sung J, Howey W. Changes in Relationships in Bereaved Families: Perspectives of Mothers Who Lost a Child to Cancer. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:525-549. [PMID: 34565259 DOI: 10.1177/00302228211047105] [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] [Indexed: 11/15/2022]
Abstract
The loss of a child greatly affects the dynamics of interpersonal relationships in bereaved families. This study explored the relationships in bereaved Korean families from the perspectives of mothers after the death of a child due to cancer. We conducted in-depth interviews with 15 bereaved mothers of a deceased child with childhood cancer. Thematic analysis identified 12 subthemes related to bereaved mothers' struggles in grief within three significant themes based on family relationships: (a) relationship with husband; (b) relationship with surviving child or children; and (c) relationships with extended family members. Findings highlight bereaved mothers' need to build supportive family relationships while acknowledging bereaved family members' different grieving styles and their own challenges in grieving the loss of a child.
Collapse
Affiliation(s)
- Min Ah Kim
- Department of Social Welfare, Sungkyunkwan University, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jina Sang
- School of Social Work and Family Sciences, The University of Akron, Akron, Ohio, United States
| | - Jaehee Yi
- College of Social Work, University of Utah, Salt Lake City, Utah, United States
| | - Jimin Sung
- Department of Social Welfare, Sungkyunkwan University, Sungkyunkwan University, Seoul, Republic of Korea
| | - Whitney Howey
- College of Social Work, University of Utah, Salt Lake City, Utah, United States
| |
Collapse
|
3
|
Fadaei Z, Mirlashari J, Nikbakht Nasrabadi A, Ghorbani F. Silent Mourning: Infant Death and Caring for Iranian Parents Under the Influence of Religious and Socio-cultural Factors. JOURNAL OF RELIGION AND HEALTH 2023; 62:859-878. [PMID: 36282348 DOI: 10.1007/s10943-022-01684-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Despite all the advances in healthcare technology and all the care services in the field of neonates, many infants die in neonatal intensive care units (NICUs). This qualitative study investigated socio-cultural factors influencing the care for bereaved parents in three main NICUs of northwest Iran between March 2018 and April 2019. The purposeful sampling method with the maximum variation was used, and data collection was continued until obtaining rich data to answer the research question. Twenty-eight interviews were conducted with 26 healthcare providers. The thematic analysis method was applied to analyze the data, and two main themes, including "Religious context as a restriction on the parental involvement in the infant's end-of-life care" and the "Socio-cultural challenges of the grieving process among parents", were generated accordingly. The religious and socio-cultural contexts in the NICUs of Iran are a restriction to the presence of parents at their infants' end-of-life phase, and health care providers are less inclined to have parents in the NICU at the time of infant death.
Collapse
Affiliation(s)
- Zeinab Fadaei
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Jila Mirlashari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- College of Nursing, Seattle University, Seattle, Washington State, USA
| | - Alireza Nikbakht Nasrabadi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tohid Sq., Tehran, Iran.
| | - Fatemeh Ghorbani
- Pediatric Nursing Department, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
4
|
Chichester M, Tepner L, Côté-Arsenault D. Nursing Care of Childbearing Families After Previous Perinatal Loss. Nurs Womens Health 2022; 26:379-388. [PMID: 36065093 DOI: 10.1016/j.nwh.2022.07.011] [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: 05/17/2021] [Revised: 06/12/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
Nurses who care for childbearing families facilitate the family's adaptation to the arrival of a newborn through assessment of physical, emotional, and psychological needs. After experiencing a perinatal loss, such as miscarriage, stillbirth, or neonatal death, a woman's perception of pregnancy and of her sense of control in becoming a mother can include fear and anxiety, and she may have significantly different needs than a pregnant woman who has not experienced perinatal loss. In this article, we provide evidence-based information and recommendations for maternal-child nurses caring for childbearing families who are preparing to welcome a new baby (sometimes called a "rainbow baby") after a previous perinatal loss.
Collapse
|
5
|
Tatterton MJ, Lyon JA. 'I no longer feel alone': meeting the needs of bereaved grandparents through a children's hospice support group. Int J Palliat Nurs 2022; 28:193-201. [PMID: 35648684 DOI: 10.12968/ijpn.2022.28.5.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Children's hospices provide a range of family-centred care services, including bereavement support. Not all hospices provide specific services for grandparents. AIM To explore how a hospice-based bereavement support group supported grandparents in their grief following the death of a grandchild. METHODS Grandparents attending a group were invited to complete an anonymous questionnaire. Questionnaires from eight groups, run between 2015 and 2019 were collated and interpreted to identify themes. FINDINGS A total of 121 grandparents attended the groups; 113 returned the questionnaires (93% response). A total of three superordinate themes were identified: environment and space, being with people who understand, and the opportunity to hear the stories of others. Grandparents valued hearing the stories of others, providing an opportunity to reflect on the experience of others. CONCLUSION Grandparents felt supported and validated by the group. Facilitated sessions increased coping and resilience of participants, enabling grandparents to support their partner, adult children and surviving grandchildren more effectively.
Collapse
Affiliation(s)
- Michael J Tatterton
- Associate Professor and Professional Lead for Children and Young People's Nursing, School of Nursing and Healthcare Leadership, University of Bradford; Visiting Consultant Nurse Children's Palliative Care, Martin House Children's Hospice, UK
| | - Judith A Lyon
- Staff Nurse and Grandparent Lead, Martin House Children's Hospice, UK
| |
Collapse
|
6
|
Schoonover KL, Prokop L, Lapid MI. Valuable Informal Bereavement Support Strategies for Bereaved Parents of Stillborn, Young Children, and Adult Children: A Scoping Review. J Palliat Care 2022; 37:381-400. [PMID: 35354346 DOI: 10.1177/08258597211062762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Informal support of a bereaved parent is common after the loss of a child (stillborn, young or adult child); however, it is not clear which aspects of informal support were perceived to be helpful by the bereaved parent. The aim of this scoping review is to clarify from the standpoint of bereaved parents what are considered helpful and unhelpful characteristics of informal support given by the support network of bereaved parents. Methods: A comprehensive search of databases from 2000 to April 20, 2020 was conducted for clinical studies published in English on informal bereavement support of adult bereaved parents of stillborn to adult children; 52 articles met criteria for the scoping review. The databases included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Ovid PsycINFO, and Scopus. Results: Specific supportive strategies reported by parents as helpful more frequently included talking with other supportive persons felt to be supportive, meeting another person with a similar type of loss, and a loss-specific peer support group. Other support included peer support groups in general, tangible aid, talking with the spouse about the child who died and/or accepting each other's different grieving styles, and remembrance gestures. Specific supportive strategies reported by parents as unhelpful more frequently included feeling of stigma or blame due to type of death or feeling that the type of death was not considered equal to other deaths and platitudes & insensitive comments. Other unhelpful support included talking with others felt to be unsupportive about discussing the loss, others stating a time limit to grief, others actively avoiding or stopping all communication with the bereaved parent, and one spouse not accepting the grieving style of the other or the spouse not willing to discuss the loss. Conclusion: Support focused on supportive verbal and nonverbal communication towards the bereaved parent and tangible aid were noted to be helpful informal support. Feeling stigma for or judged by others due to the type of death or the death not being considered equal (such as in deaths due to suicide and stillborn deaths) to other types of deaths as well as informational support (utilization of clichés/platitudes, advice giving, statements about the process and end point of grieving) were noted to be unhelpful informal support.
Collapse
Affiliation(s)
| | | | - Maria I Lapid
- Mayo Clinic, Rochester, MN, USA.,Mayo Clinic Hospice, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
7
|
Arnone M, Dumond LG, Yazdani N, El-Baroudi R, Pouliot A, Modanloo S. Evaluation of a grandparent bereavement support group in a Pediatric Palliative Care Hospice. PROGRESS IN PALLIATIVE CARE 2021. [DOI: 10.1080/09699260.2021.1988311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Madelena Arnone
- Roger Neilson House, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada
| | - Lynn Grandmaison Dumond
- Roger Neilson House, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada
| | - Nahal Yazdani
- Roger Neilson House, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada
| | - Rayan El-Baroudi
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Annie Pouliot
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Shokoufeh Modanloo
- Roger Neilson House, Ottawa, Ontario, Canada
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
8
|
Lai WS, Li WW, Chiu WH. Grieving in silence: Experiences of bereaved Taiwanese family members whose loved ones died from cancer. Eur J Oncol Nurs 2021; 52:101967. [PMID: 33957464 DOI: 10.1016/j.ejon.2021.101967] [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: 12/18/2020] [Revised: 03/31/2021] [Accepted: 04/14/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To explore the experience of grief in bereaved Taiwanese family members whose loved ones died from cancer. METHOD A qualitative study was used in this interview-based investigation. A purposive sampling technique and maximum variability were used to obtain a comprehensive overview. A total of 16 Taiwanese adults whose beloved family member had died of cancer were recruited from a palliative care unit of a medical center in southern Taiwan. Interviews were transcribed verbatim and analyzed using thematic analysis. The data analysis and interpretation were critically evaluated and discussed until final agreement was achieved. Recruitment was terminated when the data were found to be saturated. RESULTS Four "TEAR" themes reflecting the experience of grief in bereaved Taiwanese family were extracted from the transcript analyses: taboo topics, emotion hiding, asynchronous grief, and relational tension. The participants endured the mutual influence of the family atmosphere, which was akin to silently walking the grief journey and inconsistent with TEAR model of task-oriented mourning. Silent grieving dominated their lives, which is different from Western culture with a more explicit expression of grief. CONCLUSIONS Silent grief provides a new avenue for exploring grief among bereaved families, potentially impacting their ability to fully grieve through the expressed feelings proposed by William Worden's TEAR model of task-oriented mourning. Thus, this silent grieving should be acknowledged. The findings provide support for developing family-centered, culturally tailored bereavement care. Healthcare professionals play an important role in detecting changes in family dynamics that may interfere with support from family members.
Collapse
Affiliation(s)
- Wei-Shu Lai
- Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan.
| | - Wen-Wen Li
- School of Nursing, San Francisco State University, USA
| | - Wei-Hsin Chiu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| |
Collapse
|
9
|
Lockton J, Oxlad M, Due C. Knowing how to help: Grandmothers' experiences of providing and receiving support following their child's pregnancy loss. Women Birth 2020; 34:585-592. [PMID: 33153951 DOI: 10.1016/j.wombi.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/16/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022]
Abstract
PROBLEM Pregnancy loss is a distressing experience for parents, however no research has addressed grandmothers' experiences of grief and support following a child's pregnancy loss. BACKGROUND No research has specifically addressed grandmothers' experiences of support and bereavement care following pregnancy loss. AIM This study seeks to understand three key areas: (1) the support grandmothers provide to their child; (2) the support they received themselves following pregnancy loss, and; (3) supports desired by grandmothers. The study aims to contribute insights into actions midwives could take to support grandmothers following pregnancy loss. METHODS Semi-structured interviews were conducted with 14 grandmothers to understand their support experiences. Interviews were analysed using Braun and Clarke's approach to thematic analysis. FINDINGS Themes related directly to the three research questions: one: providing support, comprising two themes - being strong, protecting their family and the challenges of knowing how to help. Two, receiving support, also comprised two themes - lack of professional support offered to grandmothers and informal support and self-support strategies. Three, desired support, comprised three themes - I had no idea: increasing knowledge of pregnancy loss, peer support helps: they know how it feels, and honouring our grandchildren, making meaning. DISCUSSION Grandmothers may give extensive support to their child following pregnancy loss but lack confidence and face challenges in doing so. Few formal supports are available to grandmothers themselves, with grandmothers relying on their social networks for their own support. CONCLUSIONS Grandmothers need early access to information and guidance from midwives and hospital bereavement services, as well as ongoing peer support with flexible delivery options.
Collapse
Affiliation(s)
- Jane Lockton
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
10
|
Fernández-Sola C, Camacho-Ávila M, Hernández-Padilla JM, Fernández-Medina IM, Jiménez-López FR, Hernández-Sánchez E, Conesa-Ferrer MB, Granero-Molina J. Impact of Perinatal Death on the Social and Family Context of the Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3421. [PMID: 32422977 PMCID: PMC7277582 DOI: 10.3390/ijerph17103421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Perinatal death (PD) is a painful experience, with physical, psychological and social consequences in families. Each year, there are 2.7 million perinatal deaths in the world and about 2000 in Spain. The aim of this study was to explore, describe and understand the impact of perinatal death on parents' social and family life. METHODS A qualitative study based on Gadamer's hermeneutic phenomenology was used. In-depth interviews were conducted with 13 mothers and eight fathers who had suffered a perinatal death. Inductive analysis was used to find themes based on the data. RESULTS Seven sub-themes emerged, and they were grouped into two main themes: 1) perinatal death affects family dynamics, and 2) the social environment of the parents is severely affected after perinatal death. CONCLUSIONS PD impacts the family dynamics of the parents and their family, social and work environments. Parents perceive that society trivializes their loss and disallows or delegitimizes their grief. IMPLICATIONS Social care, health and education providers should pay attention to all family members who have suffered a PD. The recognition of the loss within the social and family environment would help the families to cope with their grief.
Collapse
Affiliation(s)
- Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
- Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco 01090, Chile
| | - Marcos Camacho-Ávila
- Hospital La Inmaculada, 04600 Huércal-Overa, Spain;
- Hospital de Torrevieja, 03186 Torrevieja, Spain;
| | - José Manuel Hernández-Padilla
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
- School of Health and Education, Middlesex University, London NW4 4BH, UK
| | - Isabel María Fernández-Medina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
| | - Francisca Rosa Jiménez-López
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
| | - Encarnación Hernández-Sánchez
- Hospital de Torrevieja, 03186 Torrevieja, Spain;
- Faculty of Health Sciences, Universidad Católica de San Antonio de Murcia, 30107 Guadalupe de Maciascoque, Spain
| | | | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 La Cañada de San Urbano, Spain; (I.M.F.-M.); (F.R.J.-L.); (J.G.-M.)
- Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco 01090, Chile
| |
Collapse
|
11
|
Sun S, Yang M, Zhang J, Zhou X, Jia G, Yu X. Family support for pregnant women with foetal abnormality requiring pregnancy termination in China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1020-1029. [PMID: 31919920 DOI: 10.1111/hsc.12935] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
Family support is an important protective factor for pregnant women with a foetal abnormality and can prevent adverse psychological outcomes in this population. This study aimed to explore the importance and influencing factors of family support for pregnant women with foetal abnormalities requiring pregnancy termination and then determine the correlation between family support and women's post-traumatic stress symptoms. A mixed methods study was conducted from March 2016 to September 2017. In all, 214 participants were surveyed using self-reported questionnaires including the demographic, family and obstetric information questionnaire, the Family Adaptation Partnership Growth Affection and Resolve Index and the Impact of Event Scale-Revised to collect quantitative data. Semi-structured in-depth interviews with 28 participants were conducted to collect qualitative data. Of the pregnant women with foetal abnormalities, 35% had obstacles in family function such that family support was low. The Impact of Event Scale-Revised score was negatively associated with total score on the Family Adaptation Partnership Growth Affection and Resolve Index as well as the score for each item on this index. In terms of family support, the demographic, family and obstetric variables hierarchically entered into the regression models significantly explained 20.0%, 26.5% and 2.6% of variation, respectively. In addition, three key themes were identified based on qualitative analyses: intensified instrumental support, inadequate emotional support and insufficient informational support. The findings showed that family support plays a protective role in preventing post-traumatic stress symptoms following termination of pregnancy. At present, family support still needs to be improved, especially in emotional support and informational support. The factors influencing family support may be important to consider for improving family support.
Collapse
Affiliation(s)
- Shiwen Sun
- Department of nursing, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Mengye Yang
- Department of Nursing, Suzhou Municipal Hospital, Suzhou, China
| | - Jieqiong Zhang
- Department of nursing, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Xiaoli Zhou
- Department of Nursing, Suzhou Municipal Hospital, Suzhou, China
| | - Ge Jia
- Department of Nursing, Medical college of Shihezi University. No, Shihezi, China
| | - Xiaoyan Yu
- Department of nursing, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
12
|
Atienza-Carrasco J, Linares-Abad M, Padilla-Ruiz M, Morales-Gil IM. Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study. J Clin Nurs 2020; 29:1220-1237. [PMID: 31887230 DOI: 10.1111/jocn.15162] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/21/2019] [Accepted: 12/20/2019] [Indexed: 12/01/2022]
Abstract
AIM To determine and describe the experiences of pregnant women who receive a diagnosis of chromosomopathy and/or foetal malformation during a prenatal check-up and who decide to legally terminate the pregnancy. BACKGROUND When a pregnancy is terminated, the woman must cope with frustrated motherhood. The psychological consequences of this will largely depend on the care and support provided by health professionals. When a congenital anomaly is diagnosed, a patient-centred communication helps understanding, influences adaptation to the new situation and ensures the person concerned has sufficient (autonomy or independence or ability) to make appropriate decisions. METHODS A qualitative study, based on a phenomenological approach, was carried out through nonparticipant observation and semi-structured interviews with 27 obstetric patients. NVivo 11 software was used, and content analysis was performed. The manuscript was developed using the COREQ guidelines to inform qualitative studies. RESULTS The clinical relationship may be affected by communication problems such as patients' perceptions of scarce emotional involvement by obstetricians, by poor psychosocial support during the termination of the pregnancy and by insufficient follow-up after discharge. CONCLUSION Nurses are in a privileged position to promote the empowerment of affected women. It is necessary to improve aspects related to the privacy of patients and the awareness and training of the interdisciplinary team in interpersonal communication. Post-loss follow-up is recommended to assess individual needs, thus facilitating an optimal approach to ease the grieving process. RELEVANCE TO CLINICAL PRACTICE During the prenatal diagnosis, the existence of a fetal anomaly is emphasized, but support and follow up of the mother may be neglected; therefore, exhaustive knowledge about the obstetric history, the state of health and the expectations of patients is as important as a multidisciplinary team trained in counseling strategies and with a comprehensive care plan that covers all areas, especially those that control maternal emotions.
Collapse
Affiliation(s)
| | | | - María Padilla-Ruiz
- Research Unit, Costa del Sol Health Care Agency, Marbella, Spain.,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | | |
Collapse
|
13
|
Lockton J, Due C, Oxlad M. Love, Listen and Learn: Grandmothers' Experiences of Grief Following Their Child's Pregnancy Loss. Women Birth 2019; 33:401-407. [PMID: 31387781 DOI: 10.1016/j.wombi.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In Australia, 15-20% of pregnancies result in miscarriage, and 0.69% in stillbirth. Pregnancy loss is a distressing experience for parents, with many turning to their own parents for support. Pregnancy loss has been identified as an ambiguous loss, leading to disenfranchised grief. However little research has been conducted regarding grandparents' experiences following pregnancy loss. Much of what is known comes indirectly from family studies of grief and loss. This study aimed to explore grandparents' experiences of loss and grief, following a child's pregnancy loss. DESIGN A grounded theory approach using a qualitative inductive thematic analysis research design was employed. Individual participant interviews provided the data for analysis which was conducted using a six-step approach. METHODS Interviews were conducted with 14 grandmothers. Interviews were semi-structured, with open-ended questions. Thematic Analysis was applied using Braun and Clarkes' (2013) approach to analysis. RESULTS Five themes were identified: Pregnancy loss is a grief like no other, Excited anticipation - then nothing, Ambiguity following pregnancy loss exacerbates grief, Grief is isolating, Multiple losses, changed family relationships, and Ceremonies and mementoes: Tangible, with lasting benefits for grandparents. CONCLUSIONS Early access to information and guidance, ongoing peer support with flexible delivery options, and involvement in memory making activities could reduce ambiguity and disenfranchisement. Increasing community education and participation in raising awareness was identified as a way for grandparents to honour their loss and support others. Further research could explore grandfathers' experiences, the longer-term outcomes for grandparents and families, and the impact of support strategies.
Collapse
Affiliation(s)
- Jane Lockton
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
14
|
Watson J, Simmonds A, La Fontaine M, Fockler ME. Pregnancy and infant loss: a survey of families' experiences in Ontario Canada. BMC Pregnancy Childbirth 2019; 19:129. [PMID: 30991981 PMCID: PMC6469137 DOI: 10.1186/s12884-019-2270-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 03/27/2019] [Indexed: 11/29/2022] Open
Abstract
Background Pregnancy and infant loss has a pervasive impact on families, health systems, and communities. During and after loss, compassionate, individualized, and skilled support from professionals and organizations is important, but often lacking. Historically, little has been known about how families in Ontario access existing care and supports around the time of their loss and their experiences of receiving such care. Methods An online cross-sectional survey, including both closed-ended multiple choice questions and one open-ended question, was completed by 596 people in Ontario, Canada relating to their experiences of care and support following pregnancy loss and infant death. Quantitative data were analyzed descriptively using frequency distributions. Responses to the one open-ended question were thematically analyzed using a qualitative inductive approach. Results The majority of families told us that around the time of their loss, they felt they were not adequately informed, supported and cared for by healthcare professionals, and that their healthcare provider lacked the skills needed to care for them. Almost half of respondents reported experiencing stigma from providers, exacerbating their experience of loss. Positive encounters with care providers were marked by timely, individualized, and compassionate care. Families indicated that improvements in care could be made by providing information and explanations, discharge and follow-up instructions, and through discussions about available supports. Conclusions Healthcare professionals can make a positive difference in how loss is experienced and in overall well-being by recognizing the impact of the loss, minimizing uncertainty and isolation, and by thoughtfully working within physical environments often not designed for the experience of loss. Ongoing supports are needed and should be tailored to parents’ changing needs. Prioritizing access to specialized education for professionals providing services and care to this population may help to reduce the stigma experienced by bereaved families.
Collapse
Affiliation(s)
- Jo Watson
- Pregnancy and Infant Loss (PAIL) Network, Women and Babies Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada. .,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
| | - Anne Simmonds
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Michelle La Fontaine
- Pregnancy and Infant Loss (PAIL) Network, Women and Babies Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada
| | - Megan E Fockler
- Pregnancy and Infant Loss (PAIL) Network, Women and Babies Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
15
|
Tatterton MJ, Walshe C. Understanding the bereavement experience of grandparents following the death of a grandchild from a life‐limiting condition: A meta‐ethnography. J Adv Nurs 2019; 75:1406-1417. [DOI: 10.1111/jan.13927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/12/2018] [Accepted: 11/21/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Michael J. Tatterton
- Martin House Children's Hospice Wetherby West Yorkshire UK
- International Observatory on End of Life Care Lancaster University Lancaster UK
| | - Catherine Walshe
- International Observatory on End of Life Care Lancaster University Lancaster UK
| |
Collapse
|
16
|
Ladhani NNN, Fockler ME, Stephens L, Barrett JF, Heazell AE. No 369 - Prise en charge de la grossesse aprés une mortinaissance. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 40:1684-1700. [DOI: 10.1016/j.jogc.2018.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
17
|
No. 369-Management of Pregnancy Subsequent to Stillbirth. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 40:1669-1683. [DOI: 10.1016/j.jogc.2018.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
18
|
Youngblut JM, Brooten D. Comparison of mothers and grandmothers physical and mental health and functioning within 6 months after child NICU/PICU death. Ital J Pediatr 2018; 44:89. [PMID: 30097046 PMCID: PMC6086060 DOI: 10.1186/s13052-018-0531-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 08/06/2018] [Indexed: 11/12/2022] Open
Abstract
Background Losing a child is devastating for parents and grandparents. Family and friends generally focus on comforting and supporting the bereaved parents, unintentionally ignoring the bereaved grandparents. Grandmothers and grandfathers often struggle with wanting to help their adult children (deceased child’s parents) without usurping the parents’ responsibilities and decisions regarding the deceased child. Research on mothers’ and grandmothers’ health at about the same time after the same child’s death in the neonatal or pediatric intensive care unit is lacking. The aim of this study was to compare mothers and grandmothers on physical health, mental health, and functioning in the first 1–6 months after the same child’s death in a neonatal or pediatric intensive care unit. Methods This cross-sectional secondary analysis compared 32 mothers with 32 grandmothers of the same 32 deceased children (newborn-6 years). Grandmothers were recruited through these 32 mothers. Most grandmothers and mothers were Hispanic (25%, 34%) or Black (44%, 41%), respectively. Mothers and grandmothers separately completed questions about their Physical Health, Mental Health [depression (Beck Depression Inventory), Post-Traumatic Stress Disorder (PTSD, Impact of Events-R), grief (Hogan Grief Reaction Checklist)], and Functioning (social support [MSPSS] and Employment) since the child’s/grandchild’s death. Paired t-tests and Chi Square tests were used to compare grandmothers with mothers of the same deceased infant/child on their private and separate responses to study measures. Results Mothers had significantly more acute illnesses than grandmothers. More mothers (63%) than grandmothers (37%) were categorized as clinically depressed. More mothers (69%) than grandmothers (44%) had clinical PTSD. Mothers reported significantly higher levels of despair and detachment than grandmothers. Only 4 mothers and 2 grandmothers were in therapy at the time of interview. Grandmothers and mothers rated their ability to concentrate on their work and their level of social support similarly. Conclusions Mothers had more acute illnesses, more severe depression, and a higher level of grief than grandmothers. However, few received therapy despite their high levels of depressive and PTSD symptoms.
Collapse
Affiliation(s)
- JoAnne M Youngblut
- Nicole Wertheim College of Nursing & Health Sciences, Florida International University, AHC 3, Rm 241, 11200 SW 8th St., Miami, FL, 33199, USA.
| | - Dorothy Brooten
- Nicole Wertheim College of Nursing & Health Sciences, Florida International University, AHC 3, Rm 241, 11200 SW 8th St., Miami, FL, 33199, USA
| |
Collapse
|
19
|
Meredith P, Wilson T, Branjerdporn G, Strong J, Desha L. "Not just a normal mum": a qualitative investigation of a support service for women who are pregnant subsequent to perinatal loss. BMC Pregnancy Childbirth 2017; 17:6. [PMID: 28056861 PMCID: PMC5217635 DOI: 10.1186/s12884-016-1200-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 12/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Following previous perinatal loss, women in a subsequent pregnancy may experience heightened emotions, such as anxiety and fear, with a range of longer-term implications. To support these women, the Mater Mothers' Bereavement Support Service in Brisbane, Australia, developed a Pregnancy After Loss Clinic (PALC) as a specialised hospital-based service. The present study investigated the experiences of mothers with previous perinatal loss in relation to: (a) their subsequent pregnancy-to-birth journey, and (b) the PALC service. Such research seeks to inform the ongoing development of effective perinatal services. METHOD A qualitative interview-based research design was employed with a purposive sample of 10 mothers who had previously experienced perinatal loss and who attended the Mater Mothers' PALC during their subsequent pregnancy in 2015. All mothers had subsequently delivered a live baby and were in a relationship with the father of the new baby. Women were aged between 22 and 39 years, primiparous or multiparous, and from a range of cultural backgrounds. Semi-structured interviews, conducted either at the hospital or by telephone by an experienced, independent researcher, lasted between 20 min and one hour. All interviews were audio-recorded and transcribed verbatim, with participant names changed. Interviews were analysed using content analysis by two researchers who were not involved in the service delivery or data gathering process. RESULTS Seven themes were identified from the interview material: The overall experience, The unique experience of first pregnancy after loss, Support from PALC, Experiences of other services, Recommendations for PALC services, Need for alternative services, and Advice: Mother to mother. CONCLUSIONS Participants spoke positively of the PALC services for themselves and their families. Anxieties over their subsequent pregnancy, and the desire for other health professionals to be more understanding were frequently raised. Recommendations were made to extend the PALC service and to develop similar services to support access for other families experiencing perinatal loss.
Collapse
Affiliation(s)
- Pamela Meredith
- Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
| | - Trish Wilson
- Bereavement Support Service, Mater Mothers Hospital, South Brisbane, QLD, Australia
| | - Grace Branjerdporn
- Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Jenny Strong
- Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Laura Desha
- Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| |
Collapse
|
20
|
Youngblut JM, Brooten D, Blais K, Kilgore C, Yoo C. Health and Functioning in Grandparents After a Young Grandchild's Death. J Community Health 2015; 40:956-66. [PMID: 25820932 PMCID: PMC4556739 DOI: 10.1007/s10900-015-0018-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This cross-sectional study examined the physical and mental health, grief and role functioning of 136 grandparents in the first year after death of their young grandchild (newborn through 6 years). Grandparents were 36-77 years old; 73% female; 24% Hispanic, 38% Black/African American, and 38% White. Mean age of the 115 deceased grandchildren was 12.8 months (SD = 20.71) with 37% <1 month old; 65% were male, 77% died in the hospital. Grandparents were recruited through state death records and interviewed by telephone. Grandparents experienced: clinical depression (31%), PTSD (35%); illnesses (28%), hospitalizations, new chronic health conditions (mental disorders, hypertension, angina, cancer), and medication changes. Grandparents who provided care for the deceased grandchild had more intense symptoms of grief, depression and PTSD and more trouble focusing at their jobs. Severity of depressive and/or PTSD symptoms were more likely to be at clinically important levels for grandparents who had provided childcare for the deceased grandchild than for non-caregiving grandparents. Black grandparents had more severe symptoms of PTSD and thought more about their deceased grandchild on the job than White grandparents. The interaction effect of race/ethnicity and provision of child care was significant for PTSD and Blame and Anger. Hispanic grandparents who provided some child care for their deceased grandchild had less severe PTSD symptoms than caregiving Black and White grandparents. Caregiving Hispanic grandparents also experienced less Blame and Anger than White caregiving grandparents.
Collapse
Affiliation(s)
- JoAnne M Youngblut
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, AHC 3, Rm 241, 11200 SW 8th St., Miami, FL, 33199, USA,
| | | | | | | | | |
Collapse
|
21
|
Bennett N, Chichester M. Ripples in the pond: caring for extended family members after a perinatal loss. BMC Pregnancy Childbirth 2015. [PMCID: PMC4402588 DOI: 10.1186/1471-2393-15-s1-a17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
|
22
|
Abstract
Over the past 50 years, academic interest in the experiences of parents who lose a baby to stillbirth or neonatal death has grown. Stillbirth is defined in the UK as the death of a baby after 24 weeks' gestation and neonatal death is death within the first 4 weeks of life. Less is known about the experience of grandparents after such an event. As grandparents might expect to play an important role in their putative grandchild's life, including the provision of childcare to support parental employment, it seems likely that the baby's death will impact upon them. We argue that existing academic knowledge of grandparents' experiences of reproductive loss is 'by the way' knowledge, garnered incidentally from other research projects, for example, losing a grandchild per se or where researchers have interviewed grandparents as part of wider family research. The experience of grandparents who lose a grandchild at or around the time of birth should not go unnoticed. Research into their experiences can inform about the place in the family, if any, that is afforded to the unborn child before birth and whether, like fathers and the siblings of babies who have died, grandparents are also 'forgotten mourners'.
Collapse
Affiliation(s)
- Samantha Murphy
- Lecturer in Health Studies, Faculty of Health and Social Care, Department of Health and Social Care, The Open University , Walton Hall, Milton Keynes, Buckinghamshire , UK
| | | |
Collapse
|