Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review.

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Lisa R Roberts, Jan M Nick, Nancy L Sarpy, Judith Peters, Shanalee Tamares
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引用次数: 0

Abstract

Objective: The objective of the scoping review was to explore the evidence and describe what is known about perinatal bereavement care guidelines provided within health care facilities prior to discharge. Additionally, the review sought to identify what is known about parents' mental health outcomes, and map these outcomes to the characteristics of the bereavement care guidelines.

Introduction: Perinatal loss poses a serious risk of emotional trauma and mental health sequelae. Conflicting evidence for international bereavement care guidelines and inconsistent implementation, a lack of experimental studies, and older syntheses with a limited focus or population made synthesis complex. Therefore, a scoping review was undertaken to determine the breadth and depth of the existing literature on this topic.

Inclusion criteria: Sources pertaining to bereavement care guidelines used in health care facilities immediately after perinatal loss (miscarriage, stillbirth, or neonatal death) and parents' mental health outcomes were included. Sources pertaining to family members other than parents, perinatal loss occurring outside of a health care facility, and physical care guidelines were excluded.

Methods: The review was conducted using JBI methodology for scoping reviews. The team considered quantitative and qualitative studies, practice guidelines, case reports, expert opinions, systematic reviews, professional organization websites, and gray literature. CINAHL (EBSCOhost), PsycINFO (EBSCOhost), SocINDEX (EBSCOhost), Cochrane Library, JBI Evidence-based Practice Database (Ovid), Embase, PubMed, ProQuest Dissertations and Theses A&I (ProQuest), Web of Science Core Collection, and Epistemonikos were the major databases searched. OpenGrey, Google Scholar, and organizational websites were also searched. The earliest empirical study publication found (1976) served as the starting date limit. After pilot-testing the screening process, data were extracted, collated, and presented in narrative format as well as in tables and figures. The search was first conducted in September and October 2021, and an updated search was performed on February 9, 2023.

Results: The results provide a broad view of bereavement care guidelines to support grieving parents' mental health. The included sources (n=195) were comprised of 28 syntheses, 96 primary studies, and 71 literature review/text and opinion. From the studies that specified the number of participants, 47,598 participants were included. Key characteristics of bereavement care guidelines were categorized as i) making meaning/memories, ii) good communication, iii) shared decision-making, iv) effective emotional and social support, and v) organizational response. Parents' reported mental health outcomes included both negative outcomes, such as depression, anxiety, anger, and helplessness, and positive outcomes, including coping, healing, recovery, and well-being.

Conclusions: Conceptually, the characteristics of published guidelines are fairly consistent across settings, with cultural variations in specific components of the guidelines. Despite the exponential increase in research on bereavement care after perinatal loss, there is a gap in research pertaining to certain characteristics of bereavement care guidelines that are accepted as best practice to support parents' mental health outcomes. This review provides support for future research given the trauma and mental health risks following perinatal loss. Policies ensuring consistent and appropriate implementation of bereavement care guidelines are essential to improve parents' mental health outcomes.

Supplemental digital content: A Spanish-language version of the abstract of this review is available: http://links.lww.com/SRX/A66 .

围产期丧子后医疗机构使用的丧亲护理指南:范围综述。
目的此次范围界定综述的目的是探索证据并描述医疗机构在出院前提供的围产期丧亲护理指南的相关情况。此外,该综述还试图确定有关父母心理健康结果的已知信息,并将这些结果与丧亲护理指南的特点相联系:导言:围产期丧亲带来了严重的精神创伤和心理健康后遗症风险。国际丧亲护理指南的证据相互矛盾,执行情况也不一致,缺乏实验性研究,而且较早的综述关注的重点或人群有限,这些都使得综述工作变得复杂。因此,我们进行了一次范围界定综述,以确定有关该主题的现有文献的广度和深度:包括与围产期丧亲(流产、死产或新生儿死亡)后医疗机构立即使用的丧亲护理指南以及父母的心理健康结果有关的资料。与父母以外的家庭成员、在医疗机构以外发生的围产期丧亲以及身体护理指南有关的资料则不包括在内:综述采用 JBI 方法进行范围界定综述。研究小组考虑了定量和定性研究、实践指南、病例报告、专家意见、系统综述、专业组织网站和灰色文献。检索的主要数据库包括 CINAHL (EBSCOhost)、PsycINFO (EBSCOhost)、SocINDEX (EBSCOhost)、Cochrane Library、JBI 循证实践数据库 (Ovid)、Embase、PubMed (NLM)、ProQuest Dissertations and Theses A&I (ProQuest)、Web of Science Core Collection 和 Epistemonikos。此外,还搜索了 OpenGrey、Google Scholar 和机构网站。搜索到的最早实证研究出版物(1976 年)作为起始日期限制。在对筛选过程进行试点测试后,对数据进行了提取、整理,并以叙述以及表格和图表的形式呈现。搜索工作于 2021 年 9 月和 10 月首次进行,并于 2023 年 2 月 9 日进行了更新:结果:研究结果提供了有关丧亲护理指南的广泛视角,以支持悲伤父母的心理健康。纳入的资料来源(n = 195)包括 28 项综述、96 项主要研究和 71 项文献综述/文本和观点。在注明参与者人数的研究中,共纳入了 33,834 名参与者。丧亲护理指南的主要特征分为 i) 意义/记忆;ii) 良好沟通;iii) 共同决策;iv) 有效的情感和社会支持;v) 组织响应。家长们报告的心理健康结果既包括消极结果,如抑郁、焦虑、愤怒和无助,也包括积极结果,包括应对、愈合、恢复和幸福:从概念上讲,已发布的指南在不同环境下具有相当一致的特点,但在指南的具体内容上存在文化差异。尽管有关围产期丧亲护理的研究呈指数级增长,但有关丧亲护理指南的某些特征的研究仍存在空白,而这些特征已被公认为支持父母心理健康结果的最佳实践。鉴于围产期丧亲所带来的创伤和心理健康风险,本综述为今后的研究提供了支持。确保一致和适当实施丧亲护理指南的政策对于改善父母的心理健康结果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JBI evidence synthesis
JBI evidence synthesis Nursing-Nursing (all)
CiteScore
4.50
自引率
3.70%
发文量
218
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