Bringing together the ‘Threads of Care’ in possible miscarriage for women, their partners and nurses in non-metropolitan EDs

Edwards, Susan; Birks, Melanie; Chapman, Ysanne; Yates, Karen

doi:10.1016/j.colegn.2017.09.004

Cited by 26 publications

(92 citation statements)

References 28 publications

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“…However, a systematic search in five major electronic databases (CINAHL, Medline, PsycARTICLES, PsycINFO and Social Work Abstracts) reveals that only six studies seem to have addressed the specific experiences of parents who visit the ED during a miscarriage. These qualitative studies were carried out in Australia (Edwards, Birks, Chapman, & Yates, ; McLean & Flynn, ; Warner et al, ), Canada (MacWilliams et al, ) and the USA (Baird et al, ; Koziol‐McLain et al, ). The participating women reported multiple shortcomings in the care they received.…”

Section: Introductionmentioning

confidence: 99%

Exploring the needs of parents who experience miscarriage in the emergency department: A qualitative study with parents and nurses

Emond

Montigny

Guillaumie

2019

Journal of Clinical Nursing

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Aims and objectives To understand how parents experienced miscarriage in an emergency department setting. Objectives were to identify parents’ needs, isolate factors that influenced their experience, and provide recommendations to improve care from the perspective of women, their partners, nurses and nurse managers. Background Miscarriage is the most prevalent complication encountered during pregnancy. It subjects parents to a multitude of emotions and may have significant consequences on mental health. Emergency department visits are frequently the only opportunity for parents to receive formal support during a miscarriage; it is thus crucial to understand the experiences of parents in this setting. Design The study employed a descriptive, exploratory, qualitative approach with semi‐structured interviews. Methods The study was founded on the W.K. Kellogg Foundation's Logic Model Development Guide (2004) and Meleis’ Transitions Theory (2015). A total of 26 participants were interviewed (17 parents, 7 emergency department nurses and 2 emergency department nurse managers). Consolidated criteria for reporting qualitative research was used to report results. Results Three categories of needs were identified: physical health, cognitive and emotional. For instance, parents expressed a need to receive more information during their visit to the emergency department (i.e., a cognitive need), whether about the diagnostic test results or how to ensure a better recovery. Parents also reported a desire for professionals to address their emotional concerns. Nurses were aware of the emotional impact of miscarriage but felt that they were not adequately trained in providing optimal care to parents in this situation. Conclusions Parents who visited the emergency department for miscarriage reported several unfulfilled needs that generated dissatisfaction with care. Emergency department organisational constraints hindered optimal nursing care practices. Relevance to clinical practice Nurses have an important role to play in improving parents’ experience. They can do so by understanding the needs of parents and by being involved in developing new guidelines.

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Section: Introductionmentioning

confidence: 99%

Exploring the needs of parents who experience miscarriage in the emergency department: A qualitative study with parents and nurses

Emond

Montigny

Guillaumie

2019

Journal of Clinical Nursing

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“…Early pregnancy bleeding can have a significant emotional impact on women. The importance of acknowledging women's distress and emotions is not only highlighted in the present study, but is a recurring theme in other studies exploring the management of early pregnancy loss . Many women reported positive experiences during their ED visit when staff showed active listening, thoughtfulness and empathy.…”

Section: Discussionmentioning

confidence: 63%

“…Various factors influence how women perceive their care in the ED when experiencing early pregnancy loss. Women who perceived that ED staff did not show empathy or provide emotional support reported that this negatively affected their experience . Women were also dissatisfied about long wait times particularly as some women believed that pregnancy loss required urgent medical attention .…”

Section: Introductionmentioning

confidence: 99%

“…Women were also dissatisfied about long wait times particularly as some women believed that pregnancy loss required urgent medical attention . Many women also reported that they were dissatisfied with the level of communication from practitioners about their pregnancy loss and want to be involved in shared decision making . Women also feel unsupported without follow‐up care after leaving the ED .…”

Section: Introductionmentioning

confidence: 99%

“…It is evident that there is some dissatisfaction with care and further work can be done to understand the patient experience. Existing qualitative studies involved interviews with women weeks to years after their ED visit and focus on women who have experienced early pregnancy loss . However, not all women who attend the ED with early pregnancy bleeding experience pregnancy loss .…”

Section: Introductionmentioning

confidence: 99%

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Expectations and experiences of women presenting to emergency departments with early pregnancy bleeding

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Blecher

Craig

et al. 2019

Emerg Medicine Australasia

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Objective To explore women's expectations and experiences when presenting to the ED with early pregnancy bleeding. Methods We conducted a qualitative study where women presenting to the ED with early pregnancy bleeding participated in two semi‐structured interviews. An initial interview explored expectations of care and was conducted prior to ED treatment. A follow‐up interview about experiences with care was conducted after discharge from the ED. Women were recruited from three EDs in suburban Melbourne: one tertiary referral centre and two urban district hospitals. Results Thirty women with early pregnancy bleeding completed the initial interview and 22 completed the follow‐up interview. Eleven participants were primigravid women and 21 participants had never experienced early pregnancy bleeding prior to their ED presentation. Four themes relating to the patient experience were identified: (i) Acknowledgement of patients' concerns by hospital staff, including informing patients of progress and explanation of investigation results; (ii) Early pregnancy bleeding as a distressing experience, with most participants expecting that this would be acknowledged by ED staff, and privacy provided to allow for grieving; (iii) Prolonged waiting time for an urgent medical condition; and (iv) Ongoing care and support, such as providing recommendations of available services to support patients on discharge from the ED. Conclusion Early pregnancy bleeding is a distressing and anxiety‐provoking experience for women attending the ED. Appropriate emotional support is critical to the holistic care for those seeking emergency care.

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Pregnant women's experiences of non‐invasive prenatal testing (NIPT) in Japan: A qualitative study

Yamamoto

Chang

Fukushima

2021

Journal of Genetic Counseling

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In Japan, prenatal testing does not include a publicly insured routine health check‐up for pregnant women. Hence, taking advantage of such prenatal testing procedures is still not an option for a majority of Japanese women. However, social support systems for children and adults with disabilities have been developed with the assumption that people with disabilities will continue receiving support from their family members, especially their mothers. In this study, we described pregnant women's experiences regarding noninvasive prenatal testing (NIPT) within the context of their physical experiences during the NIPT process, Japanese society, and their medical circumstances. Women with no family history of genetic diseases or fetal disabilities and who had also received negative results after the NIPT explanation were recruited. Altogether, 15 women participated in the biographical narrative interview. The data were subjected to reflexive thematic analysis and signified advanced age for pregnancy as a trigger for both the women's consideration regarding receiving NIPT and interventions from their families and social group members. Participants considered themselves as the main caretaker for the older adults and individuals with disabilities and thus were afraid of the multiple responsibilities inherent in this reality. They were also concerned about the impact on any other siblings if the baby had disabilities. In addition, participants encounter physical and mental changes during the timeframe of the NIPT processes. Hence, as their fetuses mature, the psychological bonds the women develop with them are constantly evolving, and participants with histories of miscarriages or possible miscarriages expressed concerned not only about the results of NIPT but also about the specific possibility of losing their child in any way. In conclusion, the continuous support of these women throughout the NIPT process and social efforts for the improvement of the welfare system for people with disabilities are required to utilize NIPT effectively.

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Bringing together the ‘Threads of Care’ in possible miscarriage for women, their partners and nurses in non-metropolitan EDs

Cited by 26 publications

References 28 publications

Exploring the needs of parents who experience miscarriage in the emergency department: A qualitative study with parents and nurses

Exploring the needs of parents who experience miscarriage in the emergency department: A qualitative study with parents and nurses

Expectations and experiences of women presenting to emergency departments with early pregnancy bleeding

Pregnant women's experiences of non‐invasive prenatal testing (NIPT) in Japan: A qualitative study

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