confidence to provide perinatal bereavement support
Transcript confidence to provide perinatal bereavement support
AN EXPLORATION OF THE
PSYCHOSOCIAL FACTORS THAT
IMPACT ON MIDWIVES’ CONFIDENCE
TO PROVIDE BEREAVEMENT
SUPPORT TO PARENTS WHO HAVE
EXPERIENCED A PERINATAL LOSS
Felicity Agwu Kalu
Introduction and Background to the
Perinatal loss is the loss of a baby at any stage of
pregnancy (miscarriage, ectopic pregnancy and
stillbirth) and the death of a liveborn baby in the first
twenty eight days after birth (Armstrong 2002, Ewing
2005, John & Cooke 2006 Radestad et al. 2007).
Perinatal loss is one of the most painful, traumatic
and devastating experiences for many parents
(Kohner & Henley 2001, Abboud & Liamputtong
2005, Bennet et al. 2005, McCreight 2005, Simmons
et al. 2006, Kean 2008).
Introduction and Background to the
The outcomes for many parents depends on the
midwives’ ability to provide effective bereavement
support (Cote Arsenault & Donato 2007, Henley &
Caring for, and supporting bereaved parents is
demanding, difficult, stressful, and emotionally
demanding, thus making the provision of effective
bereavement support challenging (Kohner & Henley
2001, Mitchell 2005, Chan et al. 2007, 2008, 2009).
Theoretical Context of Perinatal
Freud (1915, 1917, 1933)
Klein (1940, 1955)
Bowlby (1969, 1973, 1980, 1988)
Ainsworth (1967, 1985).
Socio-cultural perspectives on grief
- Disenfranchised grief (Doka 2002)
- Gender differences in grieving (Murkoff et al. 2002, O’Leary &
Thorwick 2006, Serrano & Lima 2006).
Effects of perinatal bereavement on
-High levels of psychological distress around the time of loss and
in subsequent pregnancies (Cote- Arsenault & Dombeck 2001,
Corbett-Owen & Krueger 2001, Walker & Davidson 2001,
Armstrong 2002, Cote- Arsenault & Donato 2007).
Some midwives have the ability to provide perinatal
bereavement support while many others are unable to do so
(Roehrs et al. 2008).
Aim of the study
To explore the psychosocial factors
that impact on midwives’ confidence
to provide bereavement support to
who have experienced a perinatal
What is the level of the confidence of midwives to provide
perinatal bereavement support to grieving parents?
What are the psychosocial factors that predict confidence in
midwives to provide bereavement support to bereaved
What organisational support do midwives need to promote
their confidence to provide perinatal bereavement support to
parents in maternity hospitals and in the communities?
Mixed Method approach
Explanatory sequential design
(Creswell et al. 2003)
Rationale for Mixed Method approach
To gain a more comprehensive knowledge (breadth and depth)
about the psychosocial factors that influence midwives’
confidence in providing perinatal bereavement support.
- To provide more robust evidence to understand the complexity of
this new and relatively unexplored area of research.
To draw on the complementary strengths of both quantitative
and qualitative methods (Hunter & Brewer 2003, Bryman 2004
Teddlie & Tashakkori 2010).
Phase 1 Study design: The
Method: Cross sectional survey
Setting: Three maternity teaching hospitals in Ireland.
Population and Sample: An estimated sample size of 273 midwives
and nurses will be required to achieve a 95% confidence level. With
the addition of a 10% attrition rate to account for missing data the
target sample required for this study will be 300 midwives and nurses.
Plan and procedure
Testing and piloting of the questionnaire
Main survey implementation
Data Analysis to include, descriptive statistics, a series of univariate
and multivariate analysis
Phase 2 Study design: The
Purposive sampling of 6 to 8 midwives and nurses
Data collection method: focus group discussions
Data analysis: Content analysis (Krippendorf, 2004)
Interpretation of the Connected
Summary and interpretation of the
Summary and interpretation of the qualitative
Discussion of the extent and in what ways
the qualitative research findings help to
explain the quantitative results.
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