Transcript CONFIDENCE OF NURSES/MIDWIVES IN PROVIDING HIGH …

AN EXPLORATORY STUDY OF THE
FACTORS THAT AFFECT MIDWIVES’
CONFIDENCE TO PROVIDE
BEREAVEMENT SUPPORT TO
PARENTS WHO HAVE EXPERIENCED
A PERINATAL LOSS
Felicity Agwu Kalu
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Introduction and Background to the
problem
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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).
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Perinatal loss is one of the most painful, traumatic
and devastating experiences for many parents
(Simmons et al. 2006, Henley & Scott 2008, Kean
2008).
Introduction and Background to the
problem
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The outcomes for many parents depends on the
midwives’ ability to provide effective bereavement
support (Cote Arsenault & Donato 2007, Henley &
Scott 2007).
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Caring for, and supporting bereaved parents is
demanding, difficult, stressful, and emotionally
demanding, thus making the provision of effective
bereavement support challenging (Mitchell 2005,
Chan et al. 2007, 2008, 2009).
Theoretical Context of Perinatal
Bereavement Support
Grief
theories
Theoretical
context
Sociocultural
perspectives
on grief
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Empirical
studies
Theoretical Context
Grief theories
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Freud (1915, 1917, 1933)
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Klein (1940, 1955)
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Bowlby (1969, 1973, 1980, 1988)
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Ainsworth (1967, 1985).
Socio-cultural perspectives on grief
- Disenfranchised grief (Doka 2002)
- Gender differences in grieving (O’Leary & Thorwick 2006,
Serrano & Lima 2006).
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Empirical studies
Effects of perinatal bereavement on
grieving parents
-High levels of psychological distress around the time of loss and
in subsequent pregnancies (Cote- Arsenault & Donato 2007,
Henley & Scott 2008).
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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
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To explore the factors that affect
midwives’ confidence to provide
bereavement support to parents who
have experienced a perinatal loss.
Research Questions
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1.
What is the level of the confidence of midwives to provide
perinatal bereavement support to grieving parents?
2.
What are the factors that predict confidence in midwives to
provide bereavement support to bereaved parents?
3.
What organisational support do midwives need to promote
their confidence to provide perinatal bereavement support to
parents in maternity hospitals and in the community?
Research Design
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Mixed Method approach
Explanatory sequential design
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Quantitative
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Quan data
Quan data
collection
analysis
(Creswell et al. 2003)
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Qualitative
Qual data
collection
Qual data
analysis
Combined
data
Interpretation
Rationale for Mixed Method approach
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To gain a more comprehensive knowledge (breadth and depth)
about the 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.
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To draw on the complementary strengths of both quantitative
and qualitative methods (Hunter & Brewer 2003, Bryman 2008
Teddlie & Tashakkori 2010).
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Phase 1 Study design: The
quantitative phase
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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
Questionnaire development
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
qualitative phase
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Participants
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Purposive sampling of 6 to 8 midwives and nurses
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Data collection method: focus group discussions
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Data analysis: Content analysis (Krippendorf, 2004)
Interpretation of the Connected
Results
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Summary and interpretation of the
quantitative results
Summary and interpretation of the qualitative
results
Discussion of the extent and in what ways
the qualitative research findings help to
explain the quantitative results.
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Thank you.