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Pregnancy Loss from the Perspective of Muslim Turkish Women: A Qualitative Study
Abstract
Pregnancy is an important period in a woman’s life and the end of this exciting journey with loss causes deep sadness and grief in the mother. Culture is an important factor affecting the individual’s reaction to loss. Many cultures are known to have certain rituals or traditions that provide support and reassurance during the grieving process. The aim of this study was to explore the perceptions of women who experienced pregnancy loss about their cultural beliefs and coping methods related to the mourning period. A qualitative design was used in the study with 21 women. Data were collected by conducting in-depth, semi-structured, face-to-face interviews using a pilot-tested interview guide. Three themes emerged from the qualitative data: (i) cultural reaction to prenatal loss; (ii) religious and spiritual practices; and (iii) coping strategies with prenatal loss. The identification of cultural factors in the bereavement process can guide researchers in the development of measurement tools related to the bereavement process, but more research is needed to reveal women’s perspectives and more cultural practices.
Grief over spontaneous abortion of women is related to religion, beliefs, and socio-cultural contexts. In-depth understanding and reflection on the grief experiences of Muslim women after spontaneous abortion can provide essential information for developing holistic and personal care plans for these women. A qualitative descriptive study was conducted in a general hospital in lower southern Thailand. Twelve participants who experienced spontaneous abortion between two months and one year before participating in the study were recruited by purposive sampling. Data were collected through in-depth semi-structured interviews from December 2021 to March 2022 until data saturation. Content analysis was used to analyze the data. Grief experiences were immersed in three themes: (1) responding to the loss (three subthemes: denying the loss, bereavement for losing an expected child, self-blame for causing spontaneous abortion); (2) coping with grief (three subthemes: using religious doctrine to accept the loss, thinking positively about the loss, overcoming the grief by getting support); and (3) bonding between the mother and the unborn child (two subthemes: unbreakable bonding, dealing with nostalgia). The rich findings of this study can serve as a framework to develop nursing practice guidelines to promote grief coping strategies for Muslim women after spontaneous abortion within a suitable cultural and religious context. © 2022, Thailand Nursing and Midwifery Council. All rights reserved.
Background: Perinatal death results in physical loss of a child as well as symbolic loss (loss of self, hope and self-esteem) experienced by many parents. Loss is often expressed via a grief response that can develop into chronic sorrow. Ineffective coping strategies may increase susceptibility to complications associated with chronic sorrow. These complications can include clinical depression, dysthymic disorder, post-traumatic stress disorder, attachment disorder, drug dependence, psychosis, and suicidal ideation. Therefore, it is crucial to understand the barriers and facilitators to chronic sorrow particularly among vulnerable populations. Aim: To explore the experience of chronic sorrow among Indonesian women who have suffered perinatal loss. Methods: The present qualitative study utilized a descriptive phenomenological approach. Participants included women who experienced chronic sorrow due to perinatal loss within the past seven weeks to three years. Maximum variation sampling was used based on women’s current number of children. Data were collected using semi-structured interviews and analyzed using a modified Stevick-Colaizzi-Keen method. Results: Three key themes emerged from the data: (1) recurrent experiences of grief are common particularly when exposed to certain triggers (memories from pregnancy, mementos); (2) adequate coping strategies and emotional support are needed to help treat grief; and (3) specific characteristics of chronic sorrow are associated with perinatal loss, such as grief that feels diminished and the presence of another child serving as both a cure and a trigger of sorrow. Conclusion: Chronic sorrow as a result of perinatal loss is experienced repeatedly when mothers face certain triggers. We have identified two characteristics (diminished grief, having another child serve to both cure and trigger sorrow) that are specific to the experience of chronic sorrow compared to that of general grief. It is important to understand the experience of chronic sorrow and how coping strategies and a support system can help grieving mothers to overcome their loss.
Background
Grief following stillbirth and child death are one of the most traumatic experience for parents with psychosomatic, social and economic impacts. The grief profile, severity and its impacts in Indian context are not well documented. This study documented the grief and coping experiences of the Indian parents following stillbirth and child death.
Methods
This exploratory qualitative study in Delhi (India) included in-depth interviews with parents (50 mothers and 49 fathers), who had stillbirth or child death, their family members (n = 41) and community representatives (n = 12). Eight focus group discussions were done with community members (n = 72). Inductive data analysis included thematic content analysis. Perinatal Grief Scale was used to document the mother’s grief severity after 6–9 months of loss.
Results
The four themes emerged were grief anticipation and expression, impact of the bereavement, coping mechanism, and sociocultural norms and practices. The parents suffered from disbelief, severe pain and helplessness. Mothers expressed severe grief openly and some fainted. Fathers also had severe grief, but didn’t express openly. Some parents shared self-guilt and blamed the hospital/healthcare providers, themselves or family. Majority had no/positive change in couple relationship, but few faced marital disharmony. Majority experienced sleep, eating and psychological disturbances for several weeks. Mothers coped through engaging in household work, caring other child(ren) and spiritual activities. Fathers coped through avoiding discussion and work and professional engagement. Fathers resumed work after 5–20 days and mothers took 2–6 weeks to resume household chores. Unanticipated loss, limited family support and financial strain affected the severity and duration of grief. 57.5% of all mothers and 80% mothers with stillbirth had severe grief after 6–9 months.
Conclusions
Stillbirth and child death have lasting psychosomatic, social and economic impacts on parents, which are usually ignored. Sociocultural and religion appropriate bereavement support for the parents are needed to reduce the impacts.
Stillbirth is a persistent public health problem with enormous impacts on parents, families and communities (de Bernis et al, The Lancet, 2016, Vol 387: 703‐716). The care of health workers and community is vital to parents’ recovery after stillbirth (Flenady et al, BJOG, 2014, Vol 121: 137‐140). However, care is often suboptimal, particularly in limited‐resource settings. Close linkages between poverty, women’s education and disempowerment mean that women who have lost a baby are especially vulnerable. Mothers of stillborn babies in Africa, a region with one of the highest stillbirth rates, are often forbidden from mourning and mistreated (Kiguli et al, The Lancet, 2016, Vol 387: e16‐e16).
Objective:
To explore parents' lived experiences of care and support following stillbirth in urban and rural health facilities.
Design:
Qualitative, interpretative, guided by Heideggerian phenomenology.
Setting:
Nairobi and Western Kenya, Kampala and Central Uganda.
Sample:
A purposive sample of 75 women and 59 men who had experienced the stillbirth of their baby, (≤ 1 year), received care in the included facilities.
Methods:
In-depth interviews, analysed using Van Manen's reflexive approach.
Results:
Three main themes were identified; parents described devastating impacts and profound responses to their baby's death. Interactions with health workers were a key influence, but poor communication, environmental barriers and unsupportive facility policies/practices meant that needs were often unmet. After discharge, women and partners sought support in communities to help them cope with the death of their baby, but frequently encountered stigma engendering feelings of blame and increasing isolation.
Conclusions:
Parents in Kenya and Uganda were not always treated with compassion and lacked care or support they needed after the death of their baby. Health workers in Kenya and Uganda, in common with other settings, have a key role in supporting bereaved parents. There is an urgent need for context and culturally appropriate interventions to improve communication, health-system and community support for African parents.
ABSTRACT
Objective: To explore the experiences, coping strategies, and support systems available for perinatally bereaved mothers.
Materials and Methods: A descriptive phenomenological design was employed to explore lived experiences of perinatally bereaved mothers and saturation was reached with the 12th
participant. Participants were recruited through purposive sampling and data was collected by in-depth, individual, face-to-face interviews. Data analysis was guided by Colaizzi’s method.
Results: Four main themes emerged – deprived care, immediate reactions to the loss, painful reminders of the loss, and coping strategies. Participants felt that deprived care contributed to their loss, and continuous support required in managing it was mostly lacking. Participants employed various strategies in coping with the loss, including self-motivation and religious beliefs.
Conclusions: Clinicians need to be more vigilant and ensure that mothers and neonates receive adequate care. Increasing awareness of the support needs of perinatally bereaved mothers could rally emotional support for them during grieving moments.
Aims:
To synthesise research findings regarding the coping experiences of parents following perinatal loss.
Design:
Noblit and Hare's interpretive meta-ethnography was followed.
Data sources:
A comprehensive systematic search of the published literature (2013-2018) was undertaken in five databases, complemented by supplementary searches.
Review methods:
Fourteen studies met the research objective and inclusion criteria.
Results:
Five themes describe the coping strategies used by parents who experience perinatal loss. The themes were synthesised into the metaphor Staying afloat in the storm.
Conclusion:
Parents use coping strategies to manage perinatal loss andthe use of these strategies is conditioned by cultural, social and individual factors. This study has implications for evidence-based practice by showing care needs and the importance of implementing emotional and patient-centred care interventions.
This paper argues that there is a cultural taboo against the public recognition and expression of perinatal grief that hinders parents’ ability to mourn and their psychological adjustment following a loss. It is proposed that this cultural taboo is recreated within the therapy relationship, as feelings of grief over a perinatal loss are minimized or avoided by the therapist and parent or patient. Importantly, it is suggested that if these cultural dynamics are recognized within the therapy relationship, then psychotherapy has the immense opportunity to break the taboo by validating the parent’s loss as real and helping the parent to mourn within an empathic and affect-regulating relationship. Specifically, it is suggested that therapists break the cultural taboo against perinatal grief and help parents to mourn through: acknowledging and not pathologizing perinatal grief reactions, considering intrapsychic and cultural factors that impact a parent’s response to loss, exploring cultural reenactments within the therapy relationship, empathizing with the parent’s experience of loss and of having to grieve within a society that does not recognize perinatal loss, coregulating the parent’s feelings of grief and loss, and helping patients to create personally meaningful mourning rituals. Lastly, the impact of within and between cultural differences and therapist attitudes on the therapy process is discussed.
In the course of our supervisory work over the years we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The first article provides an introduction to this series. The second article focused on context, research questions and designs. The third article focused on sampling, data collection and analysis. This fourth article addresses FAQs about trustworthiness and publishing. Quality criteria for all qualitative research are credibility, transferability, dependability, and confirmability. Reflexivity is an integral part of ensuring the transparency and quality of qualitative research. Writing a qualitative research article reflects the iterative nature of the qualitative research process: data analysis continues while writing. A qualitative research article is mostly narrative and tends to be longer than a quantitative paper, and sometimes requires a different structure. Editors essentially use the criteria: is it new, is it true, is it relevant? An effective cover letter enhances confidence in the newness, trueness and relevance, and explains why your study required a qualitative design. It provides information about the way you applied quality criteria or a checklist, and you can attach the checklist to the manuscript.
Despite the high rate of infant mortality in Ghana, few studies have explored the maternal experience of infant loss and the perinatal grieving process. As part of a larger study that interviewed 153 mothers with a sick infant, this 1-year follow-up study reinterviewed eight mothers from the original cohort whose infant died since the study began. Mothers were queried about mental health, coping, and cultural issues related to the loss. Mothers were often discouraged from speaking or thinking about the death due to fear of psychological harm and impact on fertility. Primary coping mechanisms involved seeking support within the community and accepting the loss as God’s will. Mothers desired more communication from health-care providers at the time of death. Despite the cultural norm of silent acceptance in the face of perinatal loss, intense maternal grief and desire to mourn may allow more opportunities for health-care workers to support bereaved mothers.
Introduction:
Perinatal loss is one of the most stressful life events that parents and caregivers experience. Providing an empathetic, caring environment to support mothers who experience perinatal loss is necessary. The aim of this study was to assess mothers' perception of the quality of services received from health centers after perinatal loss.
Methods:
This study was conducted in 2014-2015 using qualitative content analysis. Participants in the study were 40 women with a history of miscarriage, stillbirth, or neonatal death who live in Tehran and Shahrekord, Iran. Data were collected from the participants through semi-structured, in-depth interviews, and they were analyzed using qualitative content analysis.
Results:
One theme and six main categories were developed, and they indicated the mothers' experiences and understandings of the quality of service received after perinatal loss. The major theme was 'dissatisfaction with the quality of care received.' The main categories included: 1) effective communication, 2) expecting responsiveness, 3) expecting to respect the patient's dignity, 4) expecting better care, 5) tension of medical expenses, and 6) insufficient facilities.
Conclusion:
The findings of this study highlighted the weaknesses, inadequacies, strengths, and opportunities in providing health services. They can help reproductive health policy-makers reduce the pain and suffering of the affected families with appropriate measures.
The aim of this qualitative study was to determine what the emotional reactions, experiences, and coping and support systems of families would be after the death of their children from cancer. The sample comprised 19 family members from five families. At the time of the interviews, it had been 8–14 months since the death of their children. The data were collected through in-depth interviews and analyzed through the content analysis method. Data were classified into three stages: shock and disbelief regarding the loss, sensitivity and inquiry into the past, and adapting to the loss. The first reactions of family members to either expected or unexpected losses were similar. All in the family displayed denial and disbelief, as well as self-directed aggressive behavior. All family members described the 3–4 months following the death of the child as very painful and distressing. Anger, blaming others and/or themselves, depression, and anxiety were common feelings among all family members, appearing to be more prevalent in mothers. These emotions were accompanied by an inquiry into the past. At the time of the interviews, three fathers and all adolescent siblings had returned to their daily routines and developed new objectives. They were therefore considered to have adapted to the loss. It was seen, however, that all mothers remained in the “sensitivity” and “inquiry into the past” stages. It was found that families did not have effective social and professional support before or after their loss.
Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
Background
Women of reproductive age are vulnerable to psychosocial problems, but these have remained largely unexplored in Muslim women in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women.
Methods
A qualitative study was conducted in a specialist centre among Muslim mothers who had experienced perinatal loss. Purposive sampling to achieve maximum variation among Muslims in relation to age, parity and previous perinatal death was used. Data was collected by focus group discussion and in-depth unstructured interview until the saturation point met. Sixteen mothers who had recent perinatal loss of wanted pregnancy, had received antenatal follow up from public or private health clinics, and had delivery in our centre participated for the study. All of them had experienced psychological difficulties including feelings of confusion, emptiness and anxiety over facing another pregnancy.
Results
Two out of sixteen showed anger and one felt guilt. They reported experiencing a lack of communication and privacy in the hospital during the period of grief. Family members and friends play an important role in providing support. The majority agreed that the decision makers were husbands and families instead of themselves. The respondents felt that repetitive reminder of whatever happened was a test from God improved their sense of self-worth. They appreciated this reminder especially when it came from husband, family or friends closed to them.
Conclusion
Muslim mothers who had experienced perinatal loss showed some level of adverse psychosocial impact which affected their feelings. Husbands and family members were the main decision makers for Muslim women. Health care providers should provide psychosocial support during antenatal, delivery and postnatal care. On-going support involving husband should be available where needed.
The Dual Process Model of Coping with Bereavement (DPM; Stroebe & Schut, 1999) is described in this article. The rationale is given as to why this model was deemed necessary and how it was designed to overcome limitations of earlier models of adaptive coping with loss. Although building on earlier theoretical formulations, it contrasts with other models along a number of dimensions which are outlined. In addition to describing the basic parameters of the DPM, theoretical and empirical developments that have taken place since the original publication of the model are summarized. Guidelines for future research are given focusing on principles that should be followed to put the model to stringent empirical test.
Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design.
To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups).
We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed.
Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting.
The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
Despite the high prevalence of miscarriage and stillbirth, prenatally bereaved couples tend to experience a sense of isolation or loneliness after their loss. The purpose of this study was to describe the prenatal loss experiences of partners from a sociocultural perspective. Data were gathered via semi-structured interviews with 10 couples (n = 20). The findings of the study reflected the inner experiences of partners, how sociocultural context has impacted their grief experiences, and how women’s and men’s grief reactions differ within this sociocultural context.
Miscarriage is generally defined as the loss of a pregnancy before viability. An estimated 23 million miscarriages occur every year worldwide, translating to 44 pregnancy losses each minute. The pooled risk of miscarriage is 15·3% (95% CI 12·5-18·7%) of all recognised pregnancies. The population prevalence of women who have had one miscarriage is 10·8% (10·3-11·4%), two miscarriages is 1·9% (1·8-2·1%), and three or more miscarriages is 0·7% (0·5-0·8%). Risk factors for miscarriage include very young or older female age (younger than 20 years and older than 35 years), older male age (older than 40 years), very low or very high body-mass index, Black ethnicity, previous miscarriages, smoking, alcohol, stress, working night shifts, air pollution, and exposure to pesticides. The consequences of miscarriage are both physical, such as bleeding or infection, and psychological. Psychological consequences include increases in the risk of anxiety, depression, post-traumatic stress disorder, and suicide. Miscarriage, and especially recurrent miscarriage, is also a sentinel risk marker for obstetric complications, including preterm birth, fetal growth restriction, placental abruption, and stillbirth in future pregnancies, and a predictor of longer-term health problems, such as cardiovascular disease and venous thromboembolism. The costs of miscarriage affect individuals, health-care systems, and society. The short-term national economic cost of miscarriage is estimated to be £471 million per year in the UK. As recurrent miscarriage is a sentinel marker for various obstetric risks in future pregnancies, women should receive care in preconception and obstetric clinics specialising in patients at high risk. As psychological morbidity is common after pregnancy loss, effective screening instruments and treatment options for mental health consequences of miscarriage need to be available. We recommend that miscarriage data are gathered and reported to facilitate comparison of rates among countries, to accelerate research, and to improve patient care and policy development.
Nearly one in five clinically confirmed pregnancies ends in a loss before 20 weeks (Bardos et al., 2015). Despite the prevalence of miscarriage, many women and partners experience a lack of acknowledgment and support while also encountering complicated concerns related to the intersection of perinatal loss, culture, religious and spiritual issues, medical treatment, their reproductive stories, and grief (Randolph et al., 2015). Counselors working with these clients must address complex cultural considerations. As such, we review key cultural and religious/spiritual issues related to early pregnancy loss and offer recommendations for practice based on the current literature in the context of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009) counseling competencies.
This introduction to the special issue on Anthropology and grief explores the contributions of an ethnographic approach to the interdisciplinary study of grief. After a brief overview of previous anthropological research, we identify key themes emerging from this global collection of case studies: the benefits of long-term fieldwork in nuancing the complexity of grief and complicating cultural narratives that surround it; the ways in which emotional aspects of grief are shaped by cultural norms and by the manner of death; and the relationships between the living and dead, including ontologies of the dead and culturally sanctioned forms of remembering and forgetting.
Problem:
The negative implications of perinatal death on mothers' mental health are documented, however little is known about their experience of hope.
Background:
Within the broader literature, hope has contributed to better mental health and bereavement adjustment and often bereaved mothers report the importance of hope for the grieving process.
Aim:
This study aims to explore bereaved mothers' experience of hope following perinatal death.
Methods:
Individual interviews were conducted with 33 mothers having experienced the death of an infant in the perinatal period. Data from the interviews were analysed using thematic analysis.
Findings:
The mothers' experience of hope following perinatal loss is organized into three themes: Hope disrupted by perinatal loss; Transformed hope: a new pregnancy challenged by the sense of foreboding of another loss; and Ways to restore and foster hope in life.
Discussion:
Although hope has been a motivating force for mothers to reconnect with their life plan and move on after a loss, it is also negatively affected by the experience of perinatal bereavement, social support, and health professionals' clinical practice.
Conclusion:
Bereaved mothers have reported a disruption in their experience of hope. While some experience a loss of hope or a sense of hopelessness, others experience a transformation and restoration of hope, which is reinvested in the grieving process. Mothers' experience of hope highlights the need for the support of a healthcare professional and may contribute to enhanced clinical practice through the promotion of bereavement care, considering the aspects that instil, maintain, and interfere with hope.
The belief in the evil eye is associated with feelings of envy that brings harm to children. In Punjabi Muslim culture the evil eye is a threat to a child’s health before and after birth. This article investigates the “evil eye” belief and protective measures adopted by Punjabis to refract it. The study was conducted in a Pakistani Punjabi village. Findings reveal a dominant magico-religious approach, along with gradually diminishing folk remedies.
In this article, I try to think through the question, “What distinguishes phenomenology in its original sense?” My intent is to focus on the project and methodology of phenomenology in a manner that is not overly technical and that may help others to further elaborate on or question the singular features that make phenomenology into a unique qualitative form of inquiry. I pay special attention to the notion of “lived” in the phenomenological term “lived experience” to demonstrate its critical role and significance for understanding phenomenological reflection, meaning, analysis, and insights. I also attend to the kind of experiential material that is needed to focus on a genuine phenomenological question that should guide any specific research project. Heidegger, van den Berg, and Marion provide some poignant exemplars of the use of narrative “examples” in phenomenological explorations of the phenomena of “boredom,” “conversation,” and “the meaningful look in eye-contact.” Only what is given or what gives itself in lived experience (or conscious awareness) are proper phenomenological “data” or “givens,” but these givens are not to be confused with data material that can be coded, sorted, abstracted, and accordingly analyzed in some “systematic” manner. The latter approach to experiential research may be appropriate and worthwhile for various types of qualitative inquiry but not for phenomenology in its original sense. Finally, I use the mythical figure of Kairos to show that the famous phenomenological couplet of the epoché-reduction aims for phenomenological insights that require experiential analysis and attentive (but serendipitous) methodical inquiry practices.
Objective:
to explore women's experiences of labour and birth in the context of a termination of pregnancy for fetal abnormality in the second trimester of pregnancy.
Design:
meta-synthesis of 10 qualitative studies which included the experiences of 581 women. Data analysis was informed by van Manen's four lifeworld existentials (lived body, lived space, lived time and lived human relationships) and focused only on women's experiences of their labour and birth when terminating a pregnancy in the second trimester for fetal abnormality.
Key findings:
eight themes were generated by the analysis. In my head: a storm of emotion reflected the lived or felt space. In this space women make meaning of the experience. Too late to turn back time and Living and escaping the moment considered lived time; it is lived time that enables a woman to reinterpret who they once were and who they are becoming. The existential concept of lived body represented the women's physical or bodily presence and was reflected in the themes; The language of labour: un-describable torture, The meaning of pain; punishment and protection and Being a mother in the space where birth meets death. Relational or the lived human relationship is reflected in See me… talk to me…hear me… be with me and Sorry baby. These themes describe the women's lived sense of others in the interpersonal space that they share with them.
Key conclusions:
the findings of this meta-synthesis provide insight into how emotionally and physically traumatic a woman's labour and birth experiences can be in this context. Women wanted to spend time with their baby constructing lasting memories that they could hold onto and share. They needed acknowledgment that their baby existed and their loss was tangible and real. What happened within the space of the relationship women shared with care providers was seen as vital, especially when respectful and dignified interaction was experienced. The women's need for human contact and support through their experience was also seen as critical.
Implications for practice:
the need for greater understanding and acknowledgement of the woman's experience by all caregivers is required. Woman-centred and situation sensitive care provision should be prioritised. Further research that acknowledges and prioritises the feminine voice and the lived experience of women is required.
Scholars who research phenomena of concern to the discipline of nursing are challenged with making wise choices about different qualitative research approaches. Ultimately, they want to choose an approach that is best suited to answer their research questions. Such choices are predicated on having made distinctions between qualitative methodology, methods, and analytic frames. In this article, we distinguish two qualitative research approaches widely used for descriptive studies: descriptive phenomenological and qualitative description. Providing a clear basis that highlights the distinguishing features and similarities between descriptive phenomenological and qualitative description research will help students and researchers make more informed choices in deciding upon the most appropriate methodology in qualitative research. We orient the reader to distinguishing features and similarities associated with each approach and the kinds of research questions descriptive phenomenological and qualitative description research address.
Stillbirth is a traumatic prenatal loss with personal, familial, and social implications. We explored the meaning of stillbirth for ultraorthodox Israeli women for whom grieving for prenatal loss derived from the power of faith. We conducted semistructured interviews with ten ultraorthodox women, ages 26 to 55, in a qualitative study that was focused on thematic content analysis and influenced by the phenomenological-hermeneutic tradition. The loss of the fetus was experienced as a test to the women's belief in God, and was perceived as a way to experience God's love. The women's faith became stronger and provided relief, calm, and confidence in God as benefactor. The meanings they attributed to their losses enabled them to move on. Findings are discussed in the context of research and theoretical literature on coping, bereavement, and mourning processes, and meaning for pregnancy-related losses. Awareness of ethnic meanings of stillbirth promotes implementation of culture-sensitive psychosocial interventions.
The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanese women after stillbirth. Data were generated through individual in-depth interviews with 21 women selected using purposeful sampling. Three stages in an emotional journey of recovery were suffering from silent grief, searching for a way out, and achieving peace of mind and mental stability. Throughout their journey, the women's overarching concern was where the deceased child had gone and whether it was well. Together these stages composed A pathway to peace of mind, a mental journey on which women struggled to spiritually connect with the lost baby and finally sought a personal pathway to emotional peace. Findings can inform healthcare providers in providing culturally sensitive care for Taiwanese women to facilitate healing after a stillbirth. © 2014 Wiley Periodicals, Inc.
AimTo report an analysis of the concept of perinatal bereavement. Background
The concept of perinatal bereavement emerged in the scientific literature during the 1970s. Perinatal bereavement is a practice-based concept, although it is not well-defined in the scientific literature and is often intermingled with the concepts of mourning and grief. DesignConcept Analysis. Data sourcesUsing the term perinatal bereavement' and limits of only English and human, Pub Med and CINAHL were searched to yield 278 available references dating from 1974-2011. Articles specific to the experience of perinatal bereavement were reviewed. The final data set was 143 articles. Review methodsThe methods of principle-based concept analysis were used. Results reveal conceptual components (antecedents, attributes and outcomes) which are delineated to create a theoretical definition of perinatal bereavement. ResultsThe concept is epistemologically immature, with few explicit definitions to describe the phenomenon. Inconsistency in conceptual meaning threatens the construct validity of measurement tools for perinatal bereavement and contributes to incongruent theoretical definitions. This has implications for both nursing science (how the concept is studied and theoretically integrated) and clinical practice (timing and delivery of support interventions). Conclusions
Perinatal bereavement is a multifaceted global phenomenon that follows perinatal loss. Lack of conceptual clarity and lack of a clearly articulated conceptual definition impede the synthesis and translation of research findings into practice. A theoretical definition of perinatal bereavement is offered as a platform for researchers to advance the concept through research and theory development.
The study is a qualitative analysis of 19 interviews with Israeli women who have lost a first pregnancy to miscarriage. Neither the public nor health care professionals are fully aware of the implications and significance of miscarriage to the woman who has lost the pregnancy. The goal of this study was to understand and give voice to the women's experience. Five themes were revealed--the greater the joy, the more painful the crash; the nature and intensity of the loss; sources of support; life after the miscarriage; and recommendations to professionals. The experience of miscarriage was found to be grounded in the meaning of being a woman, as the loss of the pregnancy undermines the women's basic belief in their fertility and as a result threatens their meaning and role as women.
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