Cacciatore Joanne, Bushfield Suzanne
Social Work Department, Arizona State University, Phoenix, AZ 85069-7100, USA.
J Soc Work End Life Palliat Care. 2007;3(3):59-79. doi: 10.1300/J457v03n03_06.
More children die as a result of stillbirth than all other causes of infant deaths combined (Ananth, Shiliang, Kinzler, and Kramer, 2005; Goldenberg, Kirby, and Culhane, 2004; Froen, 2005; National Institute of Health, 2004); yet, mothers experiencing stillbirth are often left without support afterwards (Kubler-Ross, 2004; Fahey-McCarthy, 2003; Fletcher 2002; Saddler, 1987; DeFrain, 1986; Kirkley-Best & Kellner, 1982). Despite social work's growing involvement in care at the end of life, parents of stillborn children have not experienced consistent, relevant, and competent professional care in coping with the tragedy of death. Forty-seven women between the ages of 19 and 51 were recruited through nonprofit agencies that provide bereavement care to grieving families. Results of this qualitative study suggest that stillbirth is emotionally complex with long-lasting symptoms of grief and significant struggles to find meaning. The findings also support the need for perceived psychosocial and spiritual support from professional caregivers, family, and friends. The women's own experiences argue for comprehensive approaches to support the grief and loss of stillbirth, and for the importance of social work involvement in both immediate and longer term interventions.
死产导致的儿童死亡人数比其他所有婴儿死亡原因的总和还要多（阿南特、石亮、金兹勒和克莱默，2005年；戈尔登伯格、柯比和卡尔汉，2004年；弗勒恩，2005年；国立卫生研究院，2004年）；然而，经历过死产的母亲事后往往得不到支持（库布勒-罗斯，2004年；费伊-麦卡锡，2003年；弗莱彻，2002年；萨德勒，1987年；德弗雷恩，1986年；柯克利-贝斯特和凯尔纳，1982年）。尽管社会工作在临终关怀方面的参与度不断提高，但死产儿的父母在应对死亡悲剧时并未得到持续、相关且称职的专业护理。通过为悲伤家庭提供丧亲护理的非营利机构招募了47名年龄在19岁至51岁之间的女性。这项定性研究的结果表明，死产在情感上很复杂，会产生长期的悲伤症状，并且在寻找意义方面存在重大困难。研究结果还支持了从专业护理人员、家人和朋友那里获得心理社会和精神支持的必要性。这些女性自身的经历表明，需要采取综合方法来支持死产后的悲伤和失落，以及社会工作参与即时和长期干预的重要性。
