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Perinatal death results in long-lasting intense grief for bereaved mothers with a potential to negatively impact on their short- and long-term outcomes and quality of life if inadequately supported in coping with and managing their experience. This study aimed at exploring the lived experience of women, of care and support following perinatal death in South-Western, Nigeria. A qualitative methodology using Heideggerian phenomenology was used. Fourteen women who had experienced perinatal death in South-Western Nigeria within the last (5) five years were interviewed, and Van Manen's approach to hermeneutic phenomenology was used in data analysis. Four main themes were identified: "they did not tell me the baby died", "response of health care professionals after the baby died", "moving on from hospital", and "support from family". The physical health status of mothers determined how they were informed of perinatal death. Health care professionals were distant, rude, nonempathetic and did not offer emotional support, in some cases. Mothers were given opportunity to see and hold their babies. There was no routine follow-up support in the community, besides a postnatal check-up appointment offered to all mothers regardless of their birth outcome. Family provided emotional support for mothers on discharge. This study was the first to explore the lived experience of women of the care and support following perinatal death in South-Western, Nigeria. There is a need for healthcare systems to review bereavement care and support provisions for women who experience perinatal death. [ABSTRACT FROM AUTHOR]

Sudden unexplained death in childhood (SUDC) is the sudden and unexpected death of a child between 1 and 18 years of age, which remains unexplained after a thorough investigation. Although it is the 4th leading category of death in England and Wales for children aged 1–4 years, there is limited awareness of SUDC and limited research into this field. There are currently no known modifiable risk factors or prevention strategies. SUDC deeply impacts families and is particularly difficult due to the sudden nature, the potential trauma of finding a child, and a lack of any clear reason. For most bereaved families understanding why their child died is very important but this is not possible following SUDC. Parents may have grief complicated by post-traumatic stress disorder (PTSD) and paralysing fear for the survival of any other siblings or pregnancies. This article is written by a professional with personal experience of losing a child to SUDC and both authors have years of experience working with and listening to families. It summarises important considerations and recommendations for any professional who could potentially interact with an affected family. [ABSTRACT FROM AUTHOR]

Shared decision-making (SDM) is included in guidelines for bereavement care after a stillbirth, as it can improve women's long-term health and wellbeing. SDM within the stillbirth context is still not common, and Italy does not yet have standardised guidelines. The ShaDeS (Sha red De cision-Making in S tillbirth) study aims to investigate how Italian women with a stillbirth perceive their own centrality in decision-making processes around bereavement care and how this might impact satisfaction of care. The ShaDeS study is a cross-sectional study based on a web survey consisted of four sections: sociodemographic information and medical history, communication of bad news and bereavement care, decisions about childbirth (SDM-Q-9, SHARED, and DCS), and decisions and communication about autopsy (CPS). 187 women answered the survey. For the 41.1% of women that did not have an emergency childbirth, the SDM-Q-9 median score was 66.6 (0–100 range), and the SHARED median score was 3.5 (1–5 range). 29.4% of participants reached the proposed cutoff of 37.5 in the DCS (0–100 range) suggesting a difficulty in reaching decisions. Satisfaction scores were lower for those with such difficulties (p < 0.0001). Of the 64.5% of women that discussed autopsy, 28.3% were involved in an SDM approach, despite this being associated with higher levels of satisfaction of care (p < 0.05). An SDM approach is only moderately widespread amongst our participants, despite it being significantly related to higher levels of satisfaction. Further studies should investigate the tools that both patients and healthcare professionals need for an SDM approach. [ABSTRACT FROM AUTHOR]

The contagiousness of some illnesses (e.g., COVID-19) limits the ways in which families can interact with their dying loved ones who have been admitted to the hospital, especially in the intensive care unit. As a result, nurses have developed culturally relevant strategies for virtual bereavement care for patients and families predeath, perideath, and postdeath. Specific ways nurses can support, communicate, and facilitate meaningful rituals when patients die in isolation are provided in this article. [ABSTRACT FROM AUTHOR]

Stillbirth is a traumatic life-event for parents. Compassionate care from health workers supports grief and adjustment, alleviating psychological distress and minimising serious adverse health and social consequences. Bereavement support in facilities in LMICs, including in sub-Saharan Africa, often fails to meet parents' needs. However, very few studies have explored health worker's experiences in these settings. To explore the lived experiences of midwives, doctors and others, caring for women after stillbirth in Kenya and Uganda. Qualitative, guided by Heideggerian phenomenology. Sixty-one health workers, including nurse-midwives (N = 37), midwives (N = 12) and doctors (N = 10), working in five facilities in Kenya and Uganda, were interviewed. Data were analysed following Van Manen's reflexive approach. Three main themes summarised participants' experiences: ' In the mud and you learn to swim in it ' reflected a perceived of lack of preparation; skills were gained through experience and often without adequate support. The emotional and psychological impacts including sadness, frustration, guilt and shame were summarised in 'It's bad, it's a sad experience'. Deficiencies in organisational culture and support, which entrenched blame, fear and negative behaviours were encapsulated in Nobody asks 'how are you doing?'. Health workers in Kenya and Uganda were deeply sensitive to the impacts of stillbirth for women and families, and often profoundly and personally affected. Care and psychological support were acknowledged as often inadequate. Interventions to support improved bereavement care in sub-Saharan Africa need to target increasing health worker knowledge and awareness and also embed supportive organisational cultures and processes. [ABSTRACT FROM AUTHOR]

It is widely acknowledged that midwives are essential in providing care for mothers experiencing perinatal death. However, midwifery students lack the knowledge and skills needed to deal with perinatal death, and. There is limited research on perinatal bereavement care training for midwifery students. To investigate undergraduate midwifery students' experiential learning of perinatal bereavement care and serve as a reference for future perinatal bereavement care teaching and training. Qualitative descriptive design. University in Guangzhou, China. Undergraduate midwifery students at a university in Guangzhou, China. This research was conducted at a university in Guangzhou, China. The participants were recruited using purposeful sampling. Semi-structured, in-depth interviews were conducted with 11 midwifery students who participated in perinatal bereavement care training from May to June 2023. The Colalizzi 7-step data analysis method was used for data analysis. From the data, five themes emerged: 1) immersive experience of perinatal bereavement care, 2) formation of perspectives on perinatal bereavement care, 3) clarification of the service boundaries and internalization of the professional service spirit, 4) emotional impact and coping strategies, and 5)) factors influencing practice optimization. Experiential learning is an effective teaching strategy. However, participants continued to feel unprepared to provide perinatal bereavement care. Implementing relevant training, disseminating perinatal bereavement care knowledge and skills, and enhancing the ability of midwifery students to manage and cope with the psychological impact of perinatal death are important. • Undergraduate midwifery (MW) students' perinatal bereavement care (PBC) experience was analyzed. • The first study published regarding MW students' learning experiences in reformed education program in a Chinese university. • Study findings can facilitate MW educators with PBC teaching. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic hindered access to routine healthcare globally, prompting concerns about possible increases in pregnancy loss and perinatal death. PUDDLES is an international collaboration exploring the impact of the COVID-19 pandemic on parents who experience pregnancy loss and perinatal death in seven countries, including Aotearoa New Zealand. To explore parents' experiences of access to healthcare services and support following baby loss during the COVID-19 pandemic in Aotearoa New Zealand. We conducted in-depth, semi-structured interviews with 26 bereaved parents, including 20 birthing mothers, and six non-birthing parents (one mother and five fathers). Types of loss included 15 stillbirths, four late miscarriages, and one neonatal death. Participant ethnicities were broadly representative of Aotearoa New Zealand's multi-ethnic society. Data were analysed using Template Analysis. Analysis revealed five themes relating to pandemic impact on bereaved parent's experiences. These were: 'Distanced and Impersonal care'; 'Navigating Hospital Rules'; Exclusion of Non-birthing Parents; 'Hindered Access to Social Support'; and 'Continuity of Relational Care'. The COVID-19 pandemic exacerbated isolation of bereaved parents through perceived impersonal care by healthcare professionals and restrictions on movement hindered access to social and cultural support. Compassionate bending of the rules by healthcare professionals and community postnatal visits by continuity of care midwives following the bereavement appeared to be mitigating factors. Social isolation is an added challenge for parents experiencing baby loss during a pandemic, which may be mitigated by flexible and compassionate care from healthcare professionals, especially continuity of care midwives. [ABSTRACT FROM AUTHOR]

• Increased understanding of how actor-based simulation can enable students to make sense of the complexities of caring for bereaved parents for the first time. • Addressing the potential of using actor-based simulation in reducing students' anxieties and concerns in communicating and responding to the needs of bereaved parents prior to clinical placement. • Enhanced understanding of how transformational learning theory can illustrate changes in students' perspectives and learning about compassionate holistic care. Student midwives frequently encounter bereaved parents in clinical practice; however, the experience of caring for bereaved parents can be a significant source of traumatic stress. Although the use of simulation to teach bereavement care is considered a powerful experiential form of learning, evidence for its effectiveness as a transformative learning strategy is limited. To explore student midwives' lived experience of caring for bereaved parents experiencing perinatal loss using high-fidelity simulation. Students midwives participated in an actor-based bereavement simulated scenario. Data was collected using semi-structured interviews. Interpretative Phenomenological Analysis was conducted to gain a deep understanding of the meaning of the experience. Mezirow's Transformative Learning Theory was applied as an analytical framework to illustrate how the student midwives made sense of and learned from the experience of caring for bereaved parents experiencing perinatal loss. One BSc (Hons), 156-week undergraduate midwifery programme within a university in the Northwest of England. A purposeful sample of nine first-and second-year student midwives volunteered to participate in the study. One of the superordinate themes that emerged from the analysis (1) ' trying to console and making things easier' and the related subthemes (1a) 'what words can I say', (1b)' my instinct was to console the mum', (1c)'left to sort of pick up the pieces' captured the deep sense of powerlessness and the professional dilemmas experienced as students struggled to emotionally console and communicate the right words to say to the grieving parents. The study highlights the vital role of simulation as a defined model of bereavement education that equips students with the necessary knowledge, skills, and confidence to provide compassionate care to bereaved parents experiencing perinatal loss. The emotional toll of caring for bereaved parents is significant, and higher education institutions should adopt experiential forms of learning using actor-based simulation scenarios to emotionally prepare students to care holistically for parents affected by perinatal loss. [ABSTRACT FROM AUTHOR]

Rapid changes to how maternity health care is delivered has occurred in many countries across the globe in response to the COVID-19 pandemic. Maternity care provisions have been challenged attempting to balance the needs and safety of pregnant women and their care providers. Women experiencing a pregnancy after loss (PAL) during these times face particularly difficult circumstances. In this paper we highlight the situation in three high income countries (Australia, Ireland and USA) and point to the need to remember the unique and challenging circumstances of these PAL families. We suggest new practices may be deviating from established evidence-based guidelines and outline the potential ramifications of these changes. Recommendations for health care providers are suggested to bridge the gap between the necessary safety requirements due to the pandemic, the role of the health care provider, and the needs of families experiencing a pregnancy after loss. Changes to practices i.e. limiting the number of antenatal appointments and access to a support person may have detrimental effects on both mother, baby, and their family. However, new guidelines in maternity care practices developed to account for the pandemic have not necessarily considered women experiencing pregnancy after loss. Bereaved mothers and their families experiencing a pregnancy after loss should continue to be supported during the COVID-19 pandemic to limit unintended consequences. [ABSTRACT FROM AUTHOR]

Background: Palliative care is an integral element of care provision in neonatal intensive care units (NICUs). Healthcare providers working in NICUs are likely to provide palliative care at some point in their career.Purpose: This article examines what neonatal palliative care entails, how parents perceive healthcare providers' actions, what they potentially need at the end of their infant's life, and what bereavement interventions are most supportive for parents.Search Strategy: We conducted a search of full-text articles published in English in PubMed and CINAHL using the following key words: "NICU bereavement care," "end-of-life care," "infant loss," and "palliative care."Findings: Healthcare providers should consider alleviation of the infant's pain and suffering when discussing whether to provide or continue aggressive medical interventions. The timing of these discussions is important. Parents appear to be most comforted by compassionate, caring healthcare providers who show competence and knowledge in the provision of medical/nursing and palliative care.Implications For Practice: Healthcare providers working in NICUs require specific training in bereavement/palliative care for infants. Families facing the death of their infant must receive support from qualified providers both during and after that death. Furthermore, the infant's quality of life must be considered when discussing withholding or withdrawing care.Implications For Research: There is a need for further research investigating the specific types of training required by healthcare providers in NICU settings who are providing bereavement/palliative care to neonates, in order to best support the families' needs in these situations. [ABSTRACT FROM AUTHOR]

Third-trimester stillbirth affects approximately 2.6 million women worldwide each year. Although most stillbirths (98%) occur in low- and middle-income countries, most of the research on the impact of stillbirth and bereavement care has come from high-income countries. The impact of stillbirth ranges from stigma to disenfranchised grief, broken relationships, clinical depression, chronic pain, substance use, increased use of health services, employment difficulties, and debt. Appropriate bereavement care following a stillbirth is essential to minimise the negative socio-economic impact on parents and their families. This article presents the best practice points in stillbirth bereavement care, including taking an individualised and flexible approach. The latest published research, guidelines, and best practice points from high-income countries will be used and will highlight the gaps in the research which urgently need to be addressed. Research and investment in appropriate, respectful aftercare is needed to minimise the negative impact for parents. [ABSTRACT FROM AUTHOR]

Copyright of Frontières is the property of Universite du Quebec a Montreal, Revue Frontieres and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Author-supplied Abstracts.)

Grief care provided by visiting nurses has an important role with the family through continued involvement before and after the patient's death. Given that there were few support and educational systems for nurses offering grief care in Japan, this study aimed to develop a grief care education program for visiting nurses. The educational focus was to improve visiting nurses' knowledge and motivation and actions for providing grief care and to promote networking between participants. The study design was a longitudinal 1-group pretest-posttest study. Participants were a convenience sample of 114 nurses who had applied for the program in response to a recruiting announcement mailed to home visit nursing care stations in the suburbs of Tokyo. The education program was conducted in a single session consisting of a lecture, a case study, narrative, and reflection. The program was evaluated at 4 different times before and after the program using anonymous self-report questionnaires. Data were statistically analyzed using repetitive 1-way analysis of variance and Bonferroni multiple comparison. The score for ''understanding of grief care'' and ''provide grief care through multiprofessional collaboration'' scored significantly higher after the program. ''The quality of my nursing practice improved'' showed a significant rise. ''Promotion of networking'' scored high just after the program, but later, the scores were significantly lower. Therefore, participants deepened their understanding of grief care and learned to support bereaved families in collaboration with other professions. Creating an education program can provide mutual support against stress and contribute to learning, if it is done with awareness of where nurses have a designated meeting place for supporting each other. [ABSTRACT FROM AUTHOR]

In recent years there has been an increasing emphasis upon public health perspectives that place palliative care in the context of end-of-life services across whole populations. There is little corresponding public health interest in bereavement. Yet if we have to develop relevant, coherent, and comprehensive end-of-life care policies and practices, public health approaches to palliative care need to be accompanied by public health approaches to bereavement care. We argue here that palliative care services should match their commitment to providing a good death with a commitment to supporting good grief, and that this means investing their efforts principally in developing community capacity for bereavement care rather than seeking to deliver specialized bereavement services to relatives and friends of those who have received palliative care services. [ABSTRACT FROM AUTHOR]

Copyright of SCENARIO: Official Italian Journal of ANIARTI is the property of ANIARTI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the field of renal nursing, long-term relationships are often formed with patients. Chronic kidney disease is a life-threatening, irreversible condition that requires intensive, ongoing nursing intervention in order to sustain the life of sufferers. However, many renal patients die each year. In order to acknowledge the significance of the lives of renal patients to bereaved relatives and support those nurses providing renal care within Barts and The London NHS Trust, a service of remembrance is provided by the supportive and palliative care renal team. Elements from various religious traditions are included in the service, as well as non-religious readings, aimed at creating an inclusive atmosphere, sensitive to an ethnically and culturally diverse patient group. Feedback from families and staff members has been overwhelmingly positive. The service is offered annually, as a celebration of life. This article examines nurses' responses to death when they work in areas of high patient mortality and the role of a service of remembrance in meeting the needs of bereaved families, friends and staff. [ABSTRACT FROM AUTHOR]

Student midwives often encounter perinatal loss including stillbirth and neonatal death as part of their clinical training. There has been limited research on how student midwives cope with perinatal death. To explore the experiences of undergraduate midwifery students facing perinatal death during their internships. Qualitative research design based on interpretive phenomenological approach and COREQ-guided reporting. Tertiary maternal and child care center or general hospital. Undergraduate midwifery students from a medical university in Guangzhou, China. Study participants were recruited through purposive sampling. Semi-structured in-depth interviews were conducted between October 2020 and March 2021 with 12 midwifery students. Transcripts of the interviews were analyzed using Diekelmann's interpretive method. Four themes were identified from the data: unavoidable anxiety and avoidance response; overwhelming fear and taboos related to death; self-blame and emotional inhibition; and ethical conflict and reflection on practice. Undergraduate midwifery students believed they were ill-prepared to care for women who experienced perinatal loss, consciously endured their own negative emotions such as anxiety and fear, and hoped for improved bereavement and stillbirth care in future clinical practice. Students valued support from the bereavement midwife and identified effective strategies that would help them cope with their feelings. It is recommended that adequate education and emotional support be provided to midwifery students, who should be encouraged to provide appropriate care to grieving families. • Midwifery students often encounter perinatal death as part of their clinical training. • Midwifery students were inadequately prepared to deal with perinatal loss. • Understanding midwifery students' negative emotions is essential to improve their mental health and professional development. • Midwifery programs should consider integrating perinatal bereavement care education with clinical learning. [ABSTRACT FROM AUTHOR]

Summary: The provision of bereavement care is an important part of neonatal intensive care. This systematic review of the effectiveness of interventions to support families and facilitate emotional adjustment following the death of a baby suggests that, while these are largely appreciated by parents who have participated in research, there has been little rigorous evaluation of their effectiveness. This review reflects on possible reasons for this; for example: NICU-led bereavement care is changing, the effectiveness of bereavement care is difficult to measure, concepts of effectiveness are not static, and ethical concerns complicate experimental research. Bereavement interventions are compassion-led and generally considered to be beneficial. New research questions and new methodological challenges are discussed with reference to two examples of evolving practice: bereavement photography and the use of ritual. Future research using innovative and sensitive RCTs and consensus amongst relevant stakeholders is suggested. [Copyright &y& Elsevier]

To provide a comprehensive cross-sectional overview of published studies on perinatal bereavement care education programmes developed and tested with nurses and midwives. A scoping review following the Arksey and Malley's framework. Eight electronic databases were searched in December 2020 without restriction on language and publication date: PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science, Scopus and ProQuest. All identified studies were reviewed by two reviewers based on the article title and abstract screening. Full-text articles were assessed according to the inclusion criteria. Original studies that reported on perinatal bereavement care education for nursing and midwifery students or clinical nurses and midwives were included. Eighteen studies out of 817 articles were included. Perinatal bereavement care knowledge and skills, improvement in clinical skills in abortion care and psychological support for nurses and midwives are three core elements of the education content. Workshops and debriefing are the most frequently used formats. The duration mostly ranges from a half day to 3 days. Knowledge, confidence, satisfaction and relevant psychological variables such as posttraumatic stress symptoms are frequently used to evaluate the education programme's effectiveness. Most studies chose to use self-designed questionnaires as measurement tools. Nurses and midwives reported both positive experiences and improvement suggestions for perinatal bereavement care education programmes. This scoping review highlights the benefits of implementing education programmes for preparing nurses and midwives for perinatal bereavement care in the context of universities and hospitals. Longitudinal randomized controlled trials or quasi-experiments could further investigate the effectiveness of a more enhanced perinatal bereavement care education programme with a longer intervention time using valid and reliable evaluation tools. [ABSTRACT FROM AUTHOR]

The 2011 and 2016 Stillbirth Lancet series made a call to action to identify mechanisms to reduce stillbirth stigma. This research answers that call, investigating the extent and dimensions of stillbirth stigma experienced by an international sample of mothers bereaved by stillbirth. To determine the prevalence and type as well as explore explanatory variables associated with higher levels of stillbirth stigma with bereaved mothers in high-income countries (Australia, United Kingdom, The United States of America and New Zealand). An international survey of 889 bereaved mothers was conducted utilising the recently developed Stillbirth Stigma Scale to explore the extent and types of stigma experienced, as well as the association between stigma and self-esteem (Rosenberg Self- Esteem Scales), perinatal grief (Perinatal Grief Scale), and perceived social support (Perceived Social Support Scale). Demographic information (e.g. age, education, stillbirth history, sexual orientation and mental health) were collected to determine the association between individual demographic factors and stillbirth stigma. Results of the Stillbirth Stigma Scale indicated that a majority (54%) of bereaved mothers experienced stigma. Self-stigma was the predominant type of stigma experienced (80%), followed by perceived devaluation (64.9%). Bereaved mothers also experienced discrimination (29.1%) and issues with disclosing their stillbirth to their community (36.7%). Stillbirth stigma scores were higher in bereaved mothers who had experienced the loss of their first child. High scores were associated with the mother's mental health status (diagnoses prior to stillbirth, and/or after stillbirth (p<.05)).The other scales used indicated that higher stillbirth stigma scores were also associated with lower self-esteem (r (877) =-.304, p<.001), lower perceived social support (r (871) =-.448, p<.001) and higher levels of grief (r (829) =.609, p<.001). The current research was the first to identify that 54% of bereaved mothers experienced stigma, with self-stigma being the most prominent. Bereaved mothers endured discriminating experiences and had trouble disclosing their stillbirth to others within their community. The first-time mother with a self- reported history of mental illnesses appears to be the most at-risk of higher levels of stigma. Future longitudinal research needs to be conducted to determine the direction of the explanatory variables i.e. mental health, self-esteem and social support and develop interventions, which support the bereaved mother and reduce stillbirth stigma. This study is the first to demonstrate the prevalence, extent, type and explanatory variables of stigma reported by bereaved mothers and the association between this and poorer outcomes including increased grief and decreased self-esteem. This study begins a dialogue about prevalence and explanatory variables of stillbirth stigma and its impact, to inform future prevention and support potential stigma reduction programs for community and bereaved mothers. [ABSTRACT FROM AUTHOR]

Pregnancy loss and the death of their baby can be overwhelming for families, especially when the loss is unexpected. The standard of bereavement care families receive around the time of pregnancy or early infant loss can have a significant impact on their psychological recovery. At times external inquiries are carried out to identify issues in the maternity care provided and make recommendations to improve its' standard. This study aims to describe the impact of bereavement care provided to families around the time of pregnancy and/or early infant loss as stated in ten published inquiry reports related to Irish maternity services. Using thematic analysis, issues with care encountered by bereaved parents as outlined in the reports were identified. These focussed around five main themes (communication, healthcare staff skills, maternity unit environment, post-mortem/coronial process, local incident reviews). Bereavement care, as described by families in the ten reports, was not consistently individualised or respectful, resulting in additional feelings of anger and upset. Problems with clear communication of complex issues, in a manner that is understandable to bereaved families, were identified in several reports. Recommendations from the inquiry reports included that experienced and skilled staff should always be available to provide immediate support to bereaved families as appropriate, and assist families in understanding and processing information around the time of their loss. Consistent, individualised bereavement care facilitates a seamless transition for bereaved families from diagnosis through the hospital stay to discharge and follow-up, allowing them to focus on their baby, their bereavement and their family's wellbeing. The process of consent for a perinatal post-mortem and associated concerns have evolved over the timeframe of the ten inquiries. We reflect further on this and the impacts of the other issues highlighted, as well as discussing possible improvements to address them as described in the scientific literature. [ABSTRACT FROM AUTHOR]

Abstract: Paediatricians play a part in the care of bereaved children by talking with them when one of their patients dies. However, children are most likely to be bereaved of an important adult. Some children need the support of a bereavement care programme. We, two paediatricians, describe how we fulfil a specific role in such a programme by listening to bereaved children and responding to their need to understand more about the death of their family member or close friend. [Copyright &y& Elsevier]