Research highlights the importance of compassionate communication, adequate delivery of information, and professional support to help alleviate parental distress following pregnancy loss. However, many healthcare professionals do not feel sufficiently trained to deal with pregnancy loss in practice. We aimed to address this deficiency with an evidence-informed educational intervention to increase knowledge and confidence communicating about pregnancy loss among UK nursing students.
Background Research highlights the importance of compassionate communication, adequate delivery of information, and professional support to help alleviate parental distress following pregnancy loss. However, many healthcare professionals do not feel sufficiently trained to deal with pregnancy loss in practice. We aimed to address this deficiency with an evidence-informed educational intervention to increase knowledge, skills, self-awareness, and confidence regarding pregnancy loss among UK nursing students. Methods Educational resources, which included an 82-minute podcast and 40-minute online lecture were developed. The podcast focused on the lived experiences of three women who had experienced miscarriage, stillbirth, and termination of pregnancy for medical reasons. The pre-recorded lecture included definitions of types of pregnancy loss, discussion of the importance of communication, and information on the clinical management of pregnancy loss. Students were presented with both the lecture and podcast as a self-directed element of existing curricula. A pre-test/post-test cross-sectional survey design was used to investigate the impact of the educational intervention. The Perinatal Bereavement Care Confidence Scale (PBCCS) was completed by 244 first year BSc Nursing students before and up to a week after receiving the intervention. Quantitative data were analysed using a Paired Samples Wilcoxon test. Responses to open-ended questions, which allowed students to give feedback on the intervention content and delivery were analysed using Qualitative Content Analysis. Results 96% (n = 235) of the sample reported having no prior experience or training in the management and support of those experiencing pregnancy loss. At pre-test, 88% (n = 215) of students rated themselves as not confident in dealing with pregnancy loss in a professional capacity. Post-test, we found statistically significant effects for perceived competency on all learning outcomes (p < .001). Qualitative analysis of n = 745 individual text responses to open-ended questions indicated four categories related to the perceived value of using real-life stories for learning, demystifying a taboo subject, and providing tools for practice. Respondents suggested the inclusion of more information on memory-making, support networks, and mental health following pregnancy loss. Conclusions The educational intervention increased student nurses’ perceived knowledge, confidence, and skills in caring for families experiencing pregnancy loss. This offers potential for increased quality of care for those experiencing pregnancy loss in healthcare settings, increased patient satisfaction, and improved mental health-related outcomes.
Background Losing a baby during pregnancy can be a devastating experience for expectant parents. Many report dedicated, compassionate healthcare provision as a facilitator of positive mental health outcomes, however, healthcare services have been severely impacted during the COVID-19 pandemic. Aim To explore women’s experiences of healthcare service provision for miscarriage and termination of pregnancy for medical reasons (TFMR) on the island of Ireland during the COVID-19 pandemic. Methods Findings combine data from elements of two separate studies. Study 1 used a mixed methods approach with women who experienced miscarriage and attended a hospital in Northern Ireland. Study 2 was qualitative and examined experiences of TFMR in Northern Ireland and Ireland. Data analysed for this paper includes open-ended responses from 145 women to one survey question from Study 1, and semi-structured interview data with 12 women from Study 2. Data were analysed separately using Thematic Analysis and combined for presentation in this paper. Results Combined analysis of results indicated three themes, (1) Lonely and anxiety-provoking experiences; (2) Waiting for inadequate healthcare; and (3) The comfort of compassionate healthcare professionals. Conclusions Women’s experiences of healthcare provision were negatively impacted by COVID-19, with the exclusion of their partner in hospital, and delayed services highlighted as particularly distressing. Limited in-person interactions with health professionals appeared to compound difficulties. The lived experience of service users will be helpful in developing policies, guidelines, and training that balance both the need to minimise the risk of infection spread, with the emotional, psychological, and physical needs and wishes of parents. Further research is needed to explore the long-term impact of pregnancy loss during a pandemic on both parents and health professionals delivering care.
BackgroundMiscarriage remains a considerable concern for women with as many as 15-25% of pregnancies not ending in a live birth. This experience has been robustly associated with negative impacts on health and well-being, however much of the extant evidence focuses on psychological pathologies. Adopting a more holistic approach, this study sought to examine the distress of women experiencing miscarriage following management at home, or in hospital.MethodologyThe current study used Network Analysis to examine associations between indicators of distress as measured by the Revised Impact of Miscarriage Scale (RIMS), e.g. feelings of loss, isolation, and devastation. The most influential or central distress indicators were assessed for the total sample of women who experience a miscarriage in the previous 5 years living in the UK (N = 839), and for subsamples of women who experienced miscarriage at home (n = 493), or in hospital (n = 273) comparing the networks of associated distress indicators for these groups.ResultsThese results suggested “feelings of a person lost”, a “destroyed zest for life” and “feelings of isolation” as the most central distress indicators in the impact of miscarriage network. These were therefore considered to influence the wider network of distress, including those of different domains within the RIMS. Comparisons between those who experienced miscarriage at home and in hospital revealed similar distress network structures, however those who experienced miscarriage at home displayed greater associations between distress indicators in the network.ConclusionThose most influential distress indicators are highlighted as important targets for screening psychological distress following miscarriage, and as potentially viable intervention targets to promote greater well-being among women experiencing miscarriage. These findings provide a novel understanding of psychological distress following miscarriage as a system of connected symptoms, further research is called for to examine the broader potential influences of the impact of miscarriage network.
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