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Background: Across the world, a growing number of couples are directly or indirectly affected by infertility. Advances in assisted reproductive technologies are now enabling many of them to plan to have a child. As pregnancies resulting from assisted reproductive technologies are being experienced by a growing number of couples, it is important to better understand their experiences and the difficulties they encounter during the prenatal period. Objective: This literature review aims to synthesize the qualitative results of primary studies in order to better understand couples’ experiences of pregnancy resulting from assisted reproductive technologies, after having experienced infertility. Design: A meta-synthesis was conducted in accordance with the guidelines put forth by Sandelowski and Barroso in order to carry out an integrative analysis of the knowledge resulting from qualitative studies on this phenomenon. Data sources: The literature search was carried out between October and November 2020. Seven electronic databases were searched (CINAHL, Medline, PsycNet, SCOPUS, ScienceDirect, CAIRN, ERUDIT) and 14 eligible articles were selected. Review methods: The data from the “results” and “findings” sections of each of the articles were synthesized through thematic analysis to examine and summarize the topics found in the articles selected and develop the main themes. Results: The thematic analysis is structured around four themes to describe and interpret different aspects of the experience of pregnancy resulting from ART, namely: 1) travelling a long and complex journey; 2) moving on with paradoxical emotions; 3) struggling with an emerging identity; and 4) reorganizing relationships. These results shed light on the complex issues faced by couples previously affected by infertility during a pregnancy resulting from assisted reproductive technologies. Conclusion: The journey of a pregnancy resulting from assisted reproductive technologies must be recognized in order to offer support in line with the challenges faced by couples. This research will allow for a deeper understanding of women's experience, as well as that of their partner's, in a more specific way, and to better understand the impact on family and loved ones.

Introduction : Une grossesse sur cinq ne se rend pas à terme au Canada et ce type de perte est une expérience douloureuse pour les parents. Les chercheurs qui se sont intéressés au vécu de ces familles endeuillées décrivent des interventions à privilégier, mais en les généralisant à l’ensemble des populations touchées par ce phénomène. Or, l’expérience spécifique des parents immigrants est peu étudiée. Par conséquent, leurs besoins sont méconnus et les interventions de soutien et d’accompagnement à leur endroit sont peu développées et personnalisées. Objectifs : Cette étude vise à décrire l’expérience, à travers le parcours de soins, de parents immigrants ayant vécu un décès périnatal. En deuxième lieu, elle vise à décrire leurs besoins. Méthode : Une recherche de type qualitative descriptive, par l’entremise d’entretiens semi-dirigés, a permis de rencontrer 18 parents immigrants ayant vécu un décès périnatal dans les 5 dernières années et vivant dans 3 régions différentes du Québec (Canada). Résultats : L’analyse de leur expérience fait émerger 3 thèmes : une méconnaissance du réseau de la santé, l’importance des soins personnalisés et un isolement teinté par le parcours migratoire. Discussion et conclusion : L’expérience d’avoir vécu un décès périnatal comporte des spécificités propres à la communauté immigrante. Les parents issus de cette communauté vivent des défis plus marqués considérant le contexte d’immigration. Des recommandations cliniques simples pourraient permettre de reconnaître leur expérience particulière liée à leur vécu de parent immigrant. Il incombe de personnaliser les soins qui leur seront offerts.

Introduction: Miscarriage is common, occurring in nearly 20% of pregnancies. Most women experiencing symptoms such as bleeding or abdominal pain in early pregnancy consult emergency services, the front line of care. While research has shown the psychological and physical effects of miscarriage on women, less is known about how emergency services are organized to manage their care. Objective: To describe and analyze the organization of emergency services for women experiencing miscarriage. Methods: A multiple case study was conducted in four emergency rooms in Quebec, Canada, between 2014 and 2015. A reference framework setting out an organized system of action in care adapted to emergency services was used to analyze 198 medical records of women who experienced miscarriage and were treated in these emergency rooms. Results: From the analysis, observations were made regarding the accessibility, responsiveness, and productivity of emergency services, as well as deficiencies in care continuity. While medical treatments generally corresponded to standards, system responsiveness was poor, with long waits that may have added to women’s psychological distress. Gaps were observed in care continuity, effectiveness, and quality, including missing notes in charts, high readmission rates, and lack of referrals to relevant psychosocial and other support services. Discussion and conclusion: Recommendations include developing clinical guidelines, care trajectories, and checklists for nurses’ clinical assessments. As well, early pregnancy assessment clinics are an innovative care delivery model that has proven effective in reducing admissions, shortening hospitalizations, and providing comprehensive support services.

Les effets d’un décès périnatal ont été largement documentés, mais on a rarement proposé un regard englobant sur le décès périnatal comme point de jonction temporelle à partir duquel bifurquent le parcours de vie des personnes touchées. L’approche processuelle permet de complexifier l’examen de la fausse couche en introduisant une conception « épaisse » de la temporalité, et d’examiner des phénomènes qui ont été jusqu’ici perçus indépendamment les uns des autres. Des entrevues semi-structurées ont été menées auprès de 48 femmes du Québec ayant vécu une fausse couche précoce. Une analyse thématique a permis de dégager quatre sphères touchées par cette bifurcation : 1. (para)professionnelle ; 2. conjugale ; 3. parentale ; 4. existentielle. L’analyse a permis ainsi de dégager les contours de la bifurcation générée par la fausse couche, en termes d’imprévisibilité, d’irréversibilité et de contagion, et de mettre en lumière les différents enchevêtrements qui sous-tendent cette bifurcation.

Objetivo : realizar la adaptación transcultural y validación de pruebas de la Perinatal Grief Scale para el portugués Brasil y Canadá francés. Metodo : estudio metodológico, con aplicación de Escala de Duelo Perinatal desde el conjunto de procedimientos de adaptación transcultural. La populación fue compuesta por todas las mujeres que tuvieron óbito fetal en el año de 2013 vecinas en el municipio de Maringá-Brasil y participantes del Centre d’Études et de Recherche en Intervention Familiale en la Université du Québec en Outaouais - Canadá. Resultados : la escala en las versiones en portugués y francés demostró para ser confiable en las dos poblaciones. Coeficiente alfa de Cronbach de la escala aplicada en Brasil fue de 0,93 y aplicada en Canadá fue 0.94. Versión portuguesa, cuatro elementos no correlacionan con la escala total. Conclusión : la Perinatal Grief Scale puede utilizarse para identificar el estado de duelo en mujeres que tenían la muerte fetal, en su versión de cada país.

Le présent article consiste en une recension narrative des connaissances produites sur l’expérience des hommes de leur propre infertilité, afin de mieux cerner cet objet de recherche et d’identifier d’éventuelles avenues à explorer. Une recherche documentaire effectuée dans les bases de données CINAHL, MEDLINE, PsycArticles, et SCOPUS a permis d’identifier, au terme d’un tri en plusieurs étapes, 15 articles pour fins d’analyse. Cinq thèmes ont émergé : la masculinité menacée, la paternité problématisée, l’agentivité déniée/revendiquée, le rapport au corps et l’expérience émotionnelle de l’infertilité. Ces résultats permettent de dégager de nouvelles avenues de recherche ou d’interventions cliniques. D’une part, une meilleure problématisation du concept d’infertilité dans laquelle il est examiné comme un processus social et temporel aux ramifications conjugales, familiales et sociales et d’autre part une approche plus holistique de l’infertilité qui prend en compte l’ensemble des composantes du vécu des hommes.

Existe consenso que apoyar la participación de los padres en el cuidado de sus niños es fundamental y que los enfermeros pueden ser facilitadores de este proceso. Hay pocas evidencias sobre como la educación de enfermeros de la familia les capacita para trabajar con padres. El estudio tuvo como objetivo explorar las percepciones de alumnos de pregrado en enfermería sobre sus experiencias con padres durante su pasantía clínica en enfermería familiar. Investigación cualitativa exploratoria y descriptiva con doce alumnos que participaron en una entrevista de una hora, en una universidad canadiense. Para el análisis se utilizó N Vivo7. Cuatro temas reflejaron las experiencias: Vivenciando eventos críticos con padres; Percibiendo padres y su involucramiento con ellos como importantes; Construyendo un relacionamiento con padres y Reflexionando sobre educación formal y pasantía clínica. Los enfermeros de la familia necesitan revisitar sus actitudes y abrir espacio para ese miembro importante de la familia en situaciones de atención a la salud.

La transición para la paternidad es un momento en la vida que requiere de la capacidad de adaptación de un individuo. La calidad del apoyo social que reciben los padres se considera como un elemento importante en la adaptación para su nuevo rol. Estudio correlacional, que abarca cerca de 160 parejas de padres primerizos de Québec, Canadá, el objetivo fue comprender las fuentes de apoyo del padre y la madre durante el período postnatal, así como, sus características. Además, este estudio pretendía examinar la naturaleza de la relación entre las percepciones del apoyo social, la eficacia y la ansiedad de la paternidad. Los análisis multivariados revelaron que, para estos padres, el apoyo social no actúa como un factor de protección de sus percepciones para la eficacia de la paternidad. Sin embargo, las prácticas de ayuda de las enfermeras contribuyeron para las percepciones de apoyo de los padres, como para las percepciones de la misma.

ABSTRACT Objective: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. Method: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. Results: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. Final Considerations: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

Abstract OBJECTIVE To verify the association between complicated grief and sociodemographic, reproductive, mental, marital satisfaction, and professional support characteristics in women after stillbirth. METHOD Cross-sectional study with 26 women who had stillbirth in 2013, living in the city of Maringá, Brazil, and eight women who attended the Centre d'Études et de Rechercheen Intervention Familiale at the University of Quebec en Outaouais, in Canada. The instrument was administered as an interview to a small number of mothers of infants up to three months (n=50), who did not participate in the validation study. RESULTS By applying the short version of the Perinatal Grief Scale, the prevalence of complicated grief in Brazilian women was found to be higher (35%) in relation to Canadian women (12%).Characteristics of the Brazilian women associated with the grief period included the presence of previous pregnancy with live birth, absence of previous perinatal loss, postpartum depression, and lack of marital satisfaction. For the Canadians it was observed that 80% of the women presenting no grief made use of the professional support group. In both populations the occurrence of complicated grief presented a higher prevalence in women with duration of pregnancy higher than 28 weeks. CONCLUSION The women that must be further investigated during the grief period are those living in Brazil, making no use of a professional support group, presenting little to no marital satisfaction, having no religion, and of a low educational level.

ABSTRACT Objective: to understand professional care for maternal grief in the puerperium of stillbirth. Methods: a clinical-qualitative study with all the women who had stillbirths living in Maringá (Brazil) and participating in the Center d’Études et de Recherche in Family Intervention at the University of Quebec in Outaouais in Gatineau (Canada). Semi-structured interviews were carried out and the relevant aspects were categorized into themes. Results: the identified categories were: Assistance received in the puerperium with a focus on grief: hospital and outpatient environment, and Professional support in coping with maternal grief after fetal loss: with contact and memories, without contact and without memories and impossibilities of contact with the baby. Final considerations: the need for a multidisciplinary support and monitoring network for women who experienced fetal loss was evident. From this study, a routine of care for grief can be implemented in Brazil based on experiences in Canada.