Article

Complicated grief after perinatal loss

Department of Psychosomatic Medicine, University of Leipzig, Germany.
Dialogues in clinical neuroscience 06/2012; 14(2):187-94.
Source: PubMed

ABSTRACT

The loss of an infant through stillbirth, miscarriage, or neonatal death is recognized as a traumatic life event. Predictors of development of complicated grief after prenatal loss include lack of social support, pre-existing relationship difficulties, or absence of surviving children, as well as ambivalent attitudes or heightened perception of the reality of the pregnancy. Risk of complicated grief was found to be especially high after termination of a pregnancy due to fetal abnormality. Studies have revealed that men and women show different patterns of grief, potentially exacerbating decline in a relationship. Although it is clear that prenatal loss has a large psychological impact, it is concluded that there is a substantial lack of randomized controlled studies in this field of research.

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    • "Early and late fetal death, including miscarriage and stillbirth, occur in about 25% of all pregnancies (Hutti, Armstrong, & Myers, 2013). Miscarriage is the death of a fetus before 20 weeks gestation; stillbirth is the death of a fetus after 20 weeks gestation but before birth (Kersting & Wagner, 2012). The overall prevalence of miscarriage in pregnancy varies from 15% to 75%, depending on the age of the pregnant woman, and the greatest risk is associated with women older than 45 years (Adolfsson, 2011). "
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    ABSTRACT: Objective: To examine the experiences of, meaning for, and personal consequences for obstetric, emergency, and surgical nurses caring for women after fetal death and to determine how these nurses use Swanson's caring processes in providing such care. Design: Four focus groups. Setting: Two hospitals within the same health care system. Participants: Registered nurses (N = 24) working in the obstetric, surgery, or emergency departments. Methods: Swanson's Theory of Caring guided focus group questions that were audiotaped and transcribed verbatim. Data were analyzed using a continuously emergent process of data collection, data reduction, data display, and interpretation. Results: All participants demonstrated all of Swanson's caring processes but used them preferentially according to situational exigencies and level of rapport with each woman. Nurses had positive and negative feelings associated with caring for women after fetal loss. Conclusions: Obstetric nurses provided relatively equal focus on all processes in the Theory of Caring except Maintaining Belief. Surgical and emergency department nurses focused primarily on the caring processes of Knowing and Doing For. The negative feelings reported by nurses mirror some emotions commonly associated with compassion fatigue. More research is needed to determine whether nurses caring for mothers experiencing fetal loss are at risk for compassion fatigue. Research is also needed to identify strategies and interventions to help nurses so they may continue to give the best care possible to these very vulnerable families without detriment to themselves.
    Full-text · Article · Dec 2015 · Journal of Obstetric Gynecologic & Neonatal Nursing
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    • "A perinatalis veszteség miatti gyász a komplikált gyász egyik jelensége [1], amelynek megélése, az azzal való szembesülés terhet ró a szülőkre, környezetükre és az egészségügyi szakemberekre egyaránt, ugyanakkor kevéssé feldolgozott, tanulmányozott területről beszélünk. Talán az egyik legnehezebben feldolgozható veszteségről van szó [2]. "
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    ABSTRACT: The sorrow caused by perinatal loss is a phenomenon of pathological mourning, a burden for the parents, their environment and the medical personnel, yet, it is a less studied field. (1) To present the applied practice in healthcare institutions, to compare the valid protocol with the effective help provided and to study how these events affect the helping personnel professionally and psychologically. In-depth interviews with the involved personnel (n = 8). The authors studied the practice of the given institution; existing and wanted theoretical and practical competencies; personal attitude and the experienced difficulties. Acting well professionally is a specially demanding task, with few tools to use when communicating, when helping the parents cope with sorrow, or when coping with their own feelings, all these involving a risk for burn-out. The results can serve to create trainings aimed at helping the patients with adequate support and improving coping strategies. Orv. Hetil., 2015, 156(29), 1174-1178.
    Preview · Article · Jul 2015 · Orvosi Hetilap
    • "Le processus de deuil semble être similaire au processus de deuil après la perte de toute personne proche [8]. La majorité des auteurs rapportent une disparition du chagrin dans des délais assez variables allant de 3 à 6 mois, voire 1 à 2 ans pour d'autres [8] [9] [11] (NP4). "
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    ABSTRACT: The objective of this study was to evaluate the relationship between psychology and pregnancy loss. A literature review was conducted by consulting Medline until April 2014. Psychological factors appear to be significantly associated with the risk of recurrent miscarriage. Depression and anxiety are common symptoms after miscarriage. A return to normal scores of depression and anxiety is frequently found in one year. A systematic psychological treatment after an episode of miscarriage seems to not bring obvious benefits, one year after a miscarriage, in terms of anxiety and depression. After a stillbirth, psychological impacts on the couple, such as anxiety and depressive symptoms, are common. An empathetic and respectful attitude of all medical and paramedical team at the support is associated with better psychological experience. After a pregnancy loss, psychological consequences are common and usually reversible. An attitude of empathy is desirable in order to accompany patients and to consider a future pregnancy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
    No preview · Article · Nov 2014
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