scholarly journals Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sergio A. Silverio ◽  
Abigail Easter ◽  
Claire Storey ◽  
Davor Jurković ◽  
Jane Sandall ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Pregnancy Loss ◽  
Perinatal Death ◽  
Future Health ◽  
Care Services ◽  
Bereaved Parents ◽  
Care And Support ◽  
Template Analysis ◽  
Bereavement Care ◽  
Late Miscarriage

Abstract Background The COVID-19 pandemic poses an unprecedented risk to the global population. Maternity care in the UK was subject to many iterations of guidance on how best to reconfigure services to keep women, their families and babies, and healthcare professionals safe. Parents who experience a pregnancy loss or perinatal death require particular care and support. PUDDLES is an international collaboration investigating the experiences of recently bereaved parents who suffered a late miscarriage, stillbirth, or neonatal death during the global COVID-19 pandemic, in seven countries. In this study, we aim to present early findings from qualitative work undertaken with recently bereaved parents in the United Kingdom about how access to healthcare and support services was negotiated during the pandemic. Methods In-depth semi-structured interviews were undertaken with parents (N = 24) who had suffered a late miscarriage (n = 5; all mothers), stillbirth (n = 16; 13 mothers, 1 father, 1 joint interview involving both parents), or neonatal death (n = 3; all mothers). Data were analysed using a template analysis with the aim of investigating bereaved parents’ access to services, care, and networks of support, during the pandemic after their bereavement. Results All parents had experience of utilising reconfigured maternity and/or neonatal, and bereavement care services during the pandemic. The themes utilised in the template analysis were: 1) The Shock & Confusion Associated with Necessary Restrictions to Daily Life; 2) Fragmented Care and Far Away Families; 3) Keeping Safe by Staying Away; and 4) Impersonal Care and Support Through a Screen. Results suggest access to maternity, neonatal, and bereavement care services were all significantly reduced, and parents’ experiences were notably affected by service reconfigurations. Conclusions Our findings, whilst preliminary, are important to document now, to help inform care and service provision as the pandemic continues and to provide learning for ongoing and future health system shocks. We draw conclusions on how to enable development of safe and appropriate services during this pandemic and any future health crises, to best support parents who experience a pregnancy loss or whose babies die.

scholarly journals Nurses' Awareness and Stress on Perinatal Bereavement Care

2020 ◽  
Author(s):  
Eunhui Kim ◽  
Hae Won Kim
Keyword(s):  
Perinatal Death ◽  
Management Program ◽  
Perinatal Bereavement ◽  
Bereaved Parents ◽  
Perceived Importance ◽  
Hospital Policies ◽  
High Level ◽  
Bereavement Care ◽  
Nurses Attitude ◽  
Level Of Importance

Abstract Background: A descriptive study was conducted to examine nurses’ awareness and stress related to perinatal bereavement care (PBC), improving nurses’ capabilities related to PBC.Methods: 136 nurses who had experienced perinatal death at least once participated. Data were analyzed using descriptive statistics in SPSS version 25.0 for Windows. Nurses’ awareness was assessed in terms of three subdomains (attitudes, importance of policies related to PBC, and importance of training related to PBC). Results: The participants high scores for the attitude-related items of “giving sufficient time to bereaved parents to mourn for their dead baby” (4.54 points) and “nurses should treat bereaved parents with respect and dignity” (4.51 points), and they perceived a high level of importance for the policy-related items of “every staff member in the hospital should understand the policies relevant for PBC” and “when nurses feel emotional exhaustion, they should seek support” (4.58 points). Nurses’ stress was high when performing PBC in combination with a heavy workload (4.25 points) and when informing parents of a poor prognosis (4.25 points). Nurses’ attitude toward PBC was associated with the perceived importance of policies (r=0.40, p<.001), the perceived importance of PBC-related training (r=0.61, p<.001), and stress related to PBC (r=0.29, p<.001). Conclusions: Establishing hospital policies related to PBC and providing PBC training for nurses could positively affect nurses’ attitudes toward PBC. A stress management program for nurses could reduce the stress caused by PBC.

scholarly journals Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 2 — Prenatal, Fetal, and Neonatal Outcomes

2020 ◽  
Vol 02 (02) ◽  
pp. 53-60
Author(s):  
Rachelle Warner ◽  
Jodie C. Avery ◽  
Susan Neuhaus ◽  
Michael J. Davies
Keyword(s):  
Middle East ◽  
Reproductive Health ◽  
Childhood Cancer ◽  
Birth Defects ◽  
Neonatal Death ◽  
Pregnancy Loss ◽  
Perinatal Death ◽  
Descriptive Analysis ◽  
Perinatal Outcomes ◽  
Self Report

Background: Following on from Part 1 of these companion articles, which described the maternal and paternal cohort of the Middle East Area of Operations (MEAO) Census Study, this manuscript aims to describe fetal and infant characteristics and outcomes from the self-report data, including live deliveries, stillbirths, all other pregnancy losses, and unknown outcomes. Methods: A descriptive analysis was performed on the clinical variables where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the occurrence of adverse gestational outcomes. Odds ratios were also calculated for perinatal outcomes. Infant characteristics and outcomes were evaluated using statistical analysis software IBM SPSS v26. Results: There were 15,417 pregnancies reported by respondents to the MEAO Census Study. Of these, 74% (11,367) resulted in a live delivery, 0.75% in a stillbirth, and 20% in another type of pregnancy loss (ectopic pregnancy, miscarriage, termination). The unadjusted odds of an adverse perinatal outcome were higher in the MEAO Census population than in the general Australian population, notably stillbirth (OR = 3.11, 95% CI 2.56–3.80), perinatal death (OR = 3.80, 95% CI 3.26–4.44), and neonatal death (OR = 5.43, 95% CI 4.27–6.91). There were 499 cases of birth defects reported and 85 cases of childhood cancer in the MEAO population. The unadjusted odds of childhood cancer were slightly higher (OR = 1.7, 95% CI 0.09–3.28) in the MEAO population, and the unadjusted odds of birth defects were lower (OR = 0.52, 95% CI 0.40–0.68). The male:female infant sex ratio of babies born to respondents was 102 (5939 males:5823 females). Conclusions: The MEAO Census Study presents a generally reassuring picture of reproductive health for women serving in the Australian Defence Force with regards to the risk of pregnancy loss and perinatal outcomes. The increased odds of perinatal and neonatal death and stillbirth are worthy of further study and evaluation, as is the increase in likelihood of childhood cancer in the offspring of MEAO veterans.

scholarly journals Levothyroxine and the risk of adverse pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Magnus Bein ◽  
Oriana Hoi Yun Yu ◽  
Sonia Marzia Grandi ◽  
Francesca Y. E. Frati ◽  
Ihab Kandil ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subclinical Hypothyroidism ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Observational Studies ◽  
Pregnancy Loss ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy ◽  
Levothyroxine Treatment

Abstract Background Levothyroxine replacement therapy may decrease the risk of adverse pregnancy outcomes among women with subclinical hypothyroidism (SCH). The aim of this study is to conduct a systematic review and meta-analysis to examine the risk of adverse pregnancy, perinatal, and early childhood outcomes among women with SCH treated with levothyroxine. Methods A systematic literature search was conducted using Ovid-Medline, Ovid-EMBASE, Pubmed (non-Medline), Ebsco-CINAHL Plus with full text and Cochrane Library databases. Randomized controlled studies (RCTs) and observational studies examining the association between treatment of SCH during pregnancy and our outcomes of interest were included. Studies that compared levothyroxine treatment versus no treatment were eligible for inclusion. Data from included studies were extracted and quality assessment was performed by two independent reviewers. Results Seven RCTs and six observational studies met our inclusion criteria. A total of 7342 individuals were included in these studies. RCTs demonstrated several sources of bias, with lack of blinding of the participants or research personnel; only one study was fully blinded. In the observational studies, there was moderate to serious risk of bias due to lack of adjustment for certain confounding variables, participant selection, and selective reporting of results. Pooled analyses showed decreased risk of pregnancy loss (RR: 0.79; 95% CI: 0.67 to 0.93) and neonatal death (RR: 0.35; 95% CI: 0.17 to 0.72) associated with levothyroxine treatment during pregnancy among women with SCH. There were no associations between levothyroxine treatment and outcomes during labour and delivery, or cognitive status in children at 3 or 5 years of age. Conclusion Treatment of SCH with levothyroxine during pregnancy is associated with decreased risks of pregnancy loss and neonatal death. Given the paucity of available data and heterogeneity of included studies, additional studies are needed to address the benefits of levothyroxine use among pregnant women with SCH.

Diagnosis of dengue fever in a patient with early pregnancy loss

2021 ◽  
Vol 14 (8) ◽  
pp. e243968
Author(s):  
Naomi N Adjei ◽  
Anna Y Lynn ◽  
Ernest Topran ◽  
Oluwatosin O Adeyemo
Keyword(s):  
Neonatal Death ◽  
Vaginal Bleeding ◽  
Pregnancy Loss ◽  
Clinical Evidence ◽  
Adverse Outcomes ◽  
Intravenous Fluids ◽  
Early Pregnancy Loss ◽  
Orbital Pain ◽  
History Of

Dengue is a mosquito-borne virus that causes an influenza-like illness ranging in severity from asymptomatic to fatal. Dengue in pregnancy has been associated with adverse outcomes including miscarriage, preterm birth and fetal and neonatal death. We present the case of a multiparous woman who presented at 9 weeks’ gestation with vaginal bleeding and abdominal cramping after a 1 month stay in Mexico. She was initially diagnosed with miscarriage with plan for outpatient follow-up. She was readmitted 3 days later with fever, retro-orbital pain, arthralgia, rash, pancytopenia and transaminitis and managed with intravenous fluids and acetaminophen. Of note, dengue serology was initially negative but retesting 2 days later was positive. It is imperative that clinicians have heightened suspicion for dengue in pregnant women with history of travel to or residence in a dengue-endemic area and consistent clinical evidence.

Measuring reopening readiness: a universal COVID-19 index for US states

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eunju Suh ◽  
Mahdi Alhaery
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Future Health ◽  
Content Type ◽  
Counter Measures ◽  
Care Services ◽  
Future Health Care ◽  
Pandemic Severity ◽  
Occupancy Rates ◽  
Bed Occupancy Rates

PurposeWhile United States is among countries with the world’s highest coronavirus infections, its approaches and policies to reopen the economy vary by state. A lack of objective criteria and monitoring toward satisfying the criteria can lead to another COVID-19 outbreak and business closures. Considering the pressing need to return to normalcy without a rebound of COVID-19 infections and deaths, an index that provides a data-driven and objective insight is urgently needed. Hence, a method was devised to assess the severity of the COVID-19 pandemic and determine the degree of progress any state has made in containing the spread of COVID-19.Design/methodology/approachUsing measures such as the weekly averages of daily new deaths, ICU bed occupancy rates, positive cases and test positivity rates, two indexes were developed: COVID-19 reopening readiness and severity.FindingsA clear difference in the pandemic severity trends can be observed between states, which is possibly due to the disparity in the state’s response to coronavirus. A sharp upward trend in index values requires caution prior to moving to the next phase of reopening.Originality/valueThe composite indexes advanced in this study will provide a universal, standardized and unbiased view of each state’s readiness to reopen and allow comparisons between states. This in turn can help governments and health-care agencies take counter measures if needed as to the anticipated demand for future health-care services and minimize adverse consequences of opening.

scholarly journals Legal Framework for the Training of Health Care Specialists in the Health Care System of Lithuania to Work with the Disabled

2020 ◽  
Vol 10 (2) ◽  
pp. 150-161
Author(s):  
Milda Ratkevičienė
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
People With Disabilities ◽  
Legal Framework ◽  
Equal Rights ◽  
Future Health ◽  
Global Trends ◽  
Care Services ◽  
The World ◽  
The Disabled

AbstractIntroduction:Health care is one of the most important fields not only in individual countries, but globally as well, yet it remains one of the most sensitive topics, too. Global organisations have calculated that one out of seven residents around the world has some sort of disability. It is very likely that due to various processes, the number of people with disabilities will increase. Therefore, the world in general and each country in particular, Lithuania included, faces a great challenge: to ensure suitable and high-quality accessibility to health care services for the disabled. Each country must have clear political guidelines and strategies how to ensure training of health care specialists qualified and able to carry out their tasks when working with the disabled. Therefore, this article analyses global trends of training specialists to work with the disabled and legal basis of such specialist training in Lithuania.Methods:This article features analysis of scientific literary sources and legal documents.Results:International and national Lithuanian documents have clearly established that people with disabilities have equal rights to health care services like the rest of the population without any reservations, so this norm must be established adhering to the principles of accessibility, suitability and universality, and which basically should be ensured by health care specialists. However, document analysis has revealed that documents governing the training of health care specialists in Lithuania and processes related to it pay little attention to the training of future health care specialists to work with the disabled, while descriptions of some specific areas of studies, e.g. dentistry, pharmacy, etc. designed to train health care specialists do no address the work with the disabled at all.Discussion and conclusions:Analysis has revealed that institutions of higher education in Lithuania that train health care specialists are not legally entitled to, other requirements aside, to focus the study process on the work with the disabled. Therefore, it begs the question whether such specialists are actually ready to implement the requirements guiding the provision of health care services and ensure top-quality and proper provision of services to all members of the society, irrespective of their special needs, disabilities, etc. Therefore, this article can serve as a basis for further research related to the training of health care specialists to work with the disabled in order to identify what practice is applied in this area in other countries, as well as to ensure it internationally, what are the options and means required to implement it and how to improve the training of health care specialists as much as possible to work with the disabled ensuring the quality of health care in particular and their life in general.

scholarly journals PARENTS 2 study protocol: pilot of Parents’ Active Role and ENgagement in the review of Their Stillbirth/perinatal death

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e020164 ◽  
Author(s):  
Danya Bakhbakhi ◽  
Dimitrios Siassakos ◽  
Claire Storey ◽  
Alexander Heazell ◽  
Mary Lynch ◽  
...  
Keyword(s):  
Parental Involvement ◽  
Focus Groups ◽  
Perinatal Mortality ◽  
Neonatal Death ◽  
Review Process ◽  
Perinatal Death ◽  
Active Role ◽  
Online Questionnaire ◽  
Mortality Review ◽  
The Impact

BackgroundThe perinatal mortality review meeting that takes place within the hospital following a stillbirth or neonatal death enables clinicians to learn vital lessons to improve care for women and their families for the future. Recent evidence suggests that parents are unaware that a formal review following the death of their baby takes place. Many would welcome the opportunity to feedback into the meeting itself. Parental involvement in the perinatal mortality review meeting has the potential to improve patient satisfaction, drive improvements in patient safety and promote an open culture within healthcare. Yet evidence on the feasibility of involving bereaved parents in the review process is lacking. This paper describes the protocol for the Parents' Active Role and Engangement iN the review of their Stillbirth/perinatal death study (PARENTS 2) , whereby healthcare professionals’ and stakeholders’ perceptions of parental involvement will be investigated, and parental involvement in the perinatal mortality review will be piloted and evaluated at two hospitals.Methods and analysisWe will investigate perceptions of parental involvement in the perinatal mortality review process by conducting four focus groups. A three-round modified Delphi technique will be employed to gain a consensus on principles of parental involvement in the perinatal mortality review process. We will use three sequential rounds, including a national consensus meeting workshop with experts in stillbirth, neonatal death and bereavement care, and a two-stage anonymous online questionnaire. We will pilot a new perinatal mortality review process with parental involvement over a 6-month study period. The impact of the new process will be evaluated by assessing parents’ experiences of their care and parents’ and staff perceptions of their involvement in the process by conducting further focus groups and using a Parent Generated Index questionnaire.Ethics and disseminationThis study has ethical approval from the UK Health Research Authority. We will disseminate the findings through national and international conferences and international peer-reviewed journals.

scholarly journals A Systematic Literature Review of the Current State of Knowledge Related to Interventions for Bereaved Parents

2019 ◽  
Vol 36 (12) ◽  
pp. 1124-1133 ◽  
Author(s):  
Nancy Dias ◽  
Verna L. Hendricks-Ferguson ◽  
Holly Wei ◽  
Elizabeth Boring ◽  
Kerry Sewell ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Emotional Health ◽  
Group Discussions ◽  
Assessment Development ◽  
Bereaved Parents ◽  
Mesh Terms ◽  
Support Resource ◽  
State Of The Science ◽  
Bereavement Care

Aims: The purpose of this systematic literature review is to describe the interventions for bereaved parents, evaluate intervention effectiveness through study methodology rigor, replicability, and theoretical foundations. Methods: We searched MEDLINE via PubMed (1966-2018), CINAHL (1937-present), PsycINFO (1887-present), and Embase (1947-present) using various search words and MeSH terms related to the study purpose. A blinded screening of title/abstract was performed, with conflicting inclusion decisions resolved through group discussions. Matrices for remaining articles were created and discussed among the team. The levels of evidence of the 9 records were rated from very low to high based on the Grading of Recommendations Assessment, Development, and Evaluation guidelines. Results: Our initial pool included 1025 articles. After the screening of titles/abstracts, 63 articles were retained for full-text reviews. Evaluated based on the inclusion/exclusion criteria, 9 records met the review criteria. Of the 9 records, 1 was graded as very low, 3 low, and 5 low to moderate. The interventions for bereaved parents varied from using single-model interventions such as expressive arts therapy and telephone support to multimodal interventions that combined resources (ie, peer support, resource packets, and health-care support). Only 1 study explicitly illustrated how its bereavement intervention was designed based on the proposed theoretical model. Conclusions: This review highlights the need for individualized, well-tested, and effective bereavement care interventions to support bereaved parents. In summary, the state of the science on interventions for bereaved parents is poor and much work needs to be done to effectively address the needs of bereaved parents, including both their physical and emotional health needs.

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