Women with fetal death: nurses’ care limitations (original) (raw)
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Attention to women in situation of intrauterine fetal death: experiences of health professionals
Revista gaucha de enfermagem, 2021
OBJECTIVES Understand the experiences of health professionals in obstetric care in relation to the situation of intrauterine fetal death. METHOD Study of a qualitative approach, in which 11 health professionals participated. Data were collected through semi-open interviews and submitted to thematic content analysis. RESULTS The professionals' difficulty in dealing with the topic and its invisibility during the training proved to be challenging. The lack of ambience and the forms of organization of attention reflected in the care for women and families who are undergoing intrauterine fetal death. The lack of strategies and spaces for sharing among professionals was directly related to the suffering and feeling of helplessness in the cases. FINAL CONSIDERATIONS There is a need to develop strategies for changes in the model and organization of the service in the face of situations of fetal death, promoting spaces that are welcoming producers.
Caring for women through early pregnancy loss: Exploring nurses’ experiences of care
Collegian, 2020
Background: Early pregnancy loss is a common experience globally yet little is known about nurses' experiences of providing early pregnancy loss care to women. Aims: Study aims were to explore the experiences of nurses providing this care, what assists and challenges them and their perceptions of how they could be better supported. Methods: A qualitative descriptive design was employed. Findings: Twenty-five registered nurses completed in-depth interviews. Thematic analysis revealed four themes and nine subthemes: (1) Caring for all needs (Prioritising physical needs, Acknowledging emotional needs, Offering explanations and information, Respecting individuality); (2) Caring through the journey; (3) Working with challenges (Managing the environment, Tendering time); and (4) Reflecting on the role (Recognising their good work, Valuing experience and knowledge, Facing the impact of care). Discussion: Valuable insight revealed the complexity of the nurses' work and the emphasis they place on emotional care. Comparisons can be made to Hochschild's concepts of emotional labour and emotion work. It is suggested that the nurses' gift emotion work to care for the women. However, in an outcomesbased hospital environment, nurses can also be at risk of burnout. Conclusion: Nurses must be supported by health organisations to continue their emotion work. Further research into interventions to support nurses providing early pregnancy loss care, including trialling Balint groups, are recommended.
Midwives' experience of delivery care in late foetal death: A qualitative study
Aim: To explore the experiences of midwives regarding the attention given during labour in late foetal death. Design: Qualitative research using a hermeneutic-interpretative phenomenological approach was carried out. Data were collected through focus groups, audio-recorded, transcribed verbatim, and analyzed using the van Manen approach. Setting and Participants: Three focus group with a purposive sample of 18 midwives from 10 public hospitals and 1 primary health centre in Madrid, Spain were conducted. Findings: Two main themes were identified: Professionals for Life Not Death; and Organizing the Work Without Guidelines. Midwives felt there is a lack of social awareness related to the possibility of antepartum death that keeps the mourning hidden and affects the midwives´practice during the late foetal death process. Midwives recognize difficulties in coping with a process that ends in death: organizations are not prepared for these events (not suitable rooms), there is lack of training to cope with them, and lack of continuity in the attention received by the parents when they are discharged. Conclusion: Midwives need to be trained in mourning and communication skills to guarantee good practice when attending late foetal death. Intervention guidelines and support mechanisms are required, not only for the parents, but also for the healthcare professionals.
Nursing Care for Mothers with Incomplete Abortions: Case Study
Journal of Vocational Nursing, 2022
Incomplete abortion is bleeding in pregnancy before 20 weeks, where some of the products of conception have come out of the uterine cavity through the cervical canal left in the decidua or placenta. Methods: This research uses a case study design. Data collection from assessment to nursing evaluation was carried out in the jasmine room of Dr Soegiri Lamongan Hospital in February 2019. Participant care at the hospital for three days-data collection techniques using interviews, observation, and documentation. Data analysis uses narrative analysis based on the analysis of relevant facts and theories. Results: The assessment of the two participants was the first and second pregnancies, with gestational ages of 12 and 16 weeks, experiencing vaginal bleeding and abdominal pain. There is abdominal tenderness, a pain scale of 5, and uterine contractions on examination. The nursing diagnosis was acute pain associated with uterine contractions and fluid volume deficit related to bleeding (abortion). The evaluation was carried out for 72 hours of reduced pain. The discussion is expected that nurses provide health education about pain and incomplete abortion. Conclusions: The pain and anxiety were reduced after implementing nursing for 72 hours. The reference from this study is for nurses to provide health education related to pain in incomplete abortion.
Application of Caring Theory to Nursing Care of Women Experiencing Stillbirth
MCN: The American Journal of Maternal/Child Nursing, 2019
I n 2013, approximately 24,000 stillbirths occurred in the United States (MacDorman & Gregory, 2015), which equates to over 70 stillbirths a day. The American College of Obstetricians and Gynecologists (2009) defi nes stillbirth as any fetal death occurring during pregnancy at 20 weeks of gestation or later. Stillbirth is a signifi cant life-altering event that may have intense and enduring adverse psychological and emotional sequelae; not only for mothers and families, but also for their care providers (Bruce, 1962; Cacciatore, 2013). Most research about stillbirth addresses it in conjunction with other types of perinatal loss including miscarriage and neonatal loss; however, the stillbirth experience may involve nuances that distinguish it from other types of loss. These nuances may be specifi c to handling a deceased newborn, caring for a grieving mother while also providing obstetrical care, and simultaneously caring for a mother laboring with a stillbirth and for another laboring with a live birth.
Reducing the Effects of Maternal Death: Midwives' Strategies
https://www.ijhsr.org/IJHSR\_Vol.9\_Issue.2\_Feb2019/IJHSR\_Abstract.019.html, 2019
The ability to cope and adapt in a stressful work environment is a sign of good mental health. Some work environments are challenging and the individual employee is expected to take responsibility for his/her safety, whether physical or psychological. Coping and adaptation are functional roles for all humans, and are important for survival and well-being of every individual. Naturally, midwives working in challenging environment would employ some strategies to help them cope with the effects of maternal deaths. However, literature has little on the coping strategies adopted by midwives in the Ashanti Region of Ghana to deal with the effects of maternal deaths. Therefore, this article highlights the coping strategies adopted by midwives to mitigate the effects of maternal deaths and how they adapt to their work environment. A qualitative research approach, with an exploratory descriptive design was employed in the study. Purposive sampling was utilized in selecting 18 ward supervisors and 39 ward-based midwives as they met the inclusion criteria. Data were collected through semi-structured individual interviews and focus group discussions. The Thematic Content Analysis was used to manage data through transcribing, organizing, development of categories and the coding of data. Final data management was assisted by qualitative computer data analysis package (Atlas ti version 7.1.7). Two main themes and six sub-themes emerged from the study. The major themes are: informal strategies and systemic support system using maternal death review/audit. It is recommended that, hospitals should provide counselling services through employee assistance programme to facilitate coping with maternal deaths.
The concept of ‘nursing’ in the abortion services
Journal of Advanced Nursing, 2010
Title. The concept of 'nursing' in the abortion services. Aim. This paper is a report of a study of the perceptions of nurses who work in abortion services. Background. International debate surrounds abortion. In England and Wales the Abortion Act which was introduced in 1967 recently came under public review in relation to its legal limit of 24 weeks gestation. The review did not extend to those working within abortion services, and these nurses' views remained unknown. Investigating the perceptions of nurses who work in abortion services adds a dimension to the debate from a professional perspective which has hitherto been absent. Methods. Qualitative semi-structured interviews were conducted in 2007 with nine nurses working in three different abortion clinics in the United Kingdom. NVivo was used to manage the interview data and thematic analysis identified patterns of nursing concepts and attitudes. Findings. Two global themes of 'Attitudes Towards' and 'Coping With' abortion were identified. Six organizational themes detailed these: 'society', 'nurses' and 'reasoning' in 'Attitudes Towards' and 'role', 'clients' and 'late gestation abortion' in 'Coping With'. Eleven basic themes further described the organizational themes. Kim's theory of Human Living was used to clarify and provide a rationale for the nursing approach to care in this setting. Conclusion. The ability of participants to care for their clients as individuals illustrates the nature of empowerment of the nurses to attain the goals of the client. Making this support explicit through defined roles for nurses would potentially enable nurses in abortion services to perform their role more effectively at all gestation times.
Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2019
Objective Several factors might affect the health and the quality of life of women who had a severe maternal morbidity (SMM) or a maternal near-miss (MNM) episode. The objective of the present study was to explore the perspectives of the professionals on the repercussions of SMM or of MNM after interviewing women who survived such episodes. Method Selected cases that captured the attention of professionals were reported. The professionals built individually 10 narratives, which were analyzed with the technique of content analysis. Results According to the perspectives of the professionals, women surviving a severe maternal condition and their families experienced clinical and psychosocial consequences. Some cases portrayed the intense psychological distress in mourning for the loss of the fetus or of their reproductive capacity and changes in family dynamics generating emotional overload, depression, and gender violence. Conclusion The analysis of narratives may offer an idea on the...
Nurses' Experiences of Grieving When There Is a Perinatal Death
SAGE Open, 2013
The experience of grieving a loss is a significant human experience (Pilkington, 2006). According to the Report on Bereavement and Grief Research by the Center for the Advancement of Health, "Many health care providers experience grief-sometimes profound grief-when a patient dies" (Genevro, Marshall, Miller, & Center for the Advancement of Health, 2004, p. 550). While the literature confirms that nurses grieve the loss of their patients (