Women's experience of early pregnancy care in the emergency department: A qualitative study

Warner, Alexandra; Saxton, Anne; Indig, Devon; Fahy, Kathleen; Horvat, Leanne

doi:10.1016/j.aenj.2012.02.002

Cited by 23 publications

(45 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

141

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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

141

View full text Add to dashboard Cite

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“…Often the main reason for presenting to the ED is to confirm whether or not the pregnancy is viable . Indeed, for many women, early pregnancy bleeding is a distressing experience because of the potential for pregnancy loss . Various factors influence how women perceive their care in the ED when experiencing early pregnancy loss.…”

Section: Introductionmentioning

confidence: 99%

“…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%

“…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 . It is evident that there is some dissatisfaction with care and further work can be done to understand the patient experience.…”

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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Women’s persistent depressive and perinatal grief symptoms following a miscarriage: the role of childlessness and satisfaction with healthcare services

deMontigny

Verdon

Meunier

et al. 2017

Arch Womens Ment Health

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The objectives of this cross-sectional study were to determine whether depressive and perinatal grief symptoms vary according to time since miscarriage and to test whether childlessness and satisfaction with healthcare services influence symptom duration. A total of 245 women who had experienced a miscarriage answered a self-report questionnaire, indicating the date of their miscarriage and assessing their present level of depressive and perinatal grief symptoms. They also provided sociodemographic characteristics and indicated their level of satisfaction with healthcare services. One-way analyses of variance indicated that women who had miscarried within the past 6 months reported higher scores for depressive symptoms than did women who had miscarried between 7 and 12 months ago and more than 2 years ago. However, when controlling for childlessness and satisfaction with healthcare services, those differences became respectively marginal and non-significant, indicating that depressive symptoms are similar across time for more than 2 years after the loss. Regarding perinatal grief, results revealed that symptoms significantly decreased across time only for women with children and women who were satisfied with healthcare services. For childless women and those dissatisfied with healthcare services, perinatal grief symptoms did not vary according to time since miscarriage. Results suggest that, particularly for women who are childless and/or dissatisfied with healthcare services, depressive and perinatal grief symptoms persist long after a miscarriage. These results highlight the importance of paying particular attention to more vulnerable women and of improving healthcare services post-miscarriage.

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Women's experience of early pregnancy care in the emergency department: A qualitative study

Cited by 23 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

Women’s persistent depressive and perinatal grief symptoms following a miscarriage: the role of childlessness and satisfaction with healthcare services

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