Sun Jui-Chiung, Rei Wenmay, Sheu Shuh-Jen
School of Nursing, National Yang Ming University, Taipei City, Taiwan, ROC; Department of Nursing, Chang Gung University of Science and Technology, Taoyuan County, Taiwan, ROC.
Institute of Public Health, National Yang Ming University, Taipei City, Taiwan, ROC.
Int J Nurs Stud. 2014 Aug;51(8):1153-9. doi: 10.1016/j.ijnurstu.2013.11.009. Epub 2013 Dec 1.
The findings of most quantitative studies and the clinical guidelines for encouraging or discouraging parents to see their stillborn babies remain diverse depending on country and culture of residence. There is still a lack of research comprehensively exploring the situational or cultural meanings of parents' decisions to face their stillborn infants.
Understanding the essence and structure of decision-making and seeing phenomena that parents go through during stillbirth of their child adds to the body of nursing knowledge and provides insight into how to care for this group of clients.
A descriptive phenomenological approach with multi-setting, multistage, and paired design was used.
The study was conducted in maternity units in Taoyuan, Taiwan.
A purposive sample of 12 couples (total=24 subjects) who experienced stillbirth deliveries following a diagnosis of fetal death participated in this study.
The participants' observations and in-depth interviews were recorded and analyzed according to Giorgi's methods.
Most parents expressed a sense of deep upset, of never anticipating seeing their deceased babies while some had no fear of how their babies' bodies would look. Two constituted patterns with five themes each emerged from the study: 1.(a) "Deciding to see the stillborn baby" shows the seeing event as an experience of "believing", (b) "avoiding regret", (c)"an opportunity to say farewell", (d) "a chance for imprinting the stillborn infant in one's memory", and (e) "shock of seeing". 2.(a) "Deciding not to see the stillborn baby" demonstrates the meaning of not seeing is "cutting the attachment to the stillborn baby," (b) "preventing memory imprinting," (c) "avoiding guilt and suffering", (d) "pretending event closure", and (e) "the act of following a cultural taboo".
Participants experienced acts of seeing and not seeing throughout their denial or facing of ongoing bereavement, which was influenced by their personal beliefs, readiness for the event, and social values. Health professionals need to understand the powerful interpretation of the "visual" meaning of the stillbirth experience and learn to be sensitive, empathetic and keep communication lines open in order to create and maintain a compassionate and caring environment.
大多数定量研究的结果以及鼓励或不鼓励父母看望死产婴儿的临床指南因居住国家和文化的不同而存在差异。目前仍缺乏全面探索父母决定面对死产婴儿这一行为的情境或文化意义的研究。
理解决策的本质和结构，以及了解父母在孩子死产过程中所经历的现象，这将丰富护理知识体系，并为如何护理这一群体的患者提供见解。
采用多场景、多阶段和配对设计的描述性现象学方法。
该研究在台湾桃园的产科病房进行。
选取了12对夫妇（共24名受试者）作为有目的的样本，他们在胎儿死亡诊断后经历了死产分娩，并参与了本研究。
根据 Giorgi 的方法对参与者的观察和深度访谈进行记录和分析。
大多数父母表达了深深的不安，从未想过会看到自己死去的婴儿，而有些人则不担心婴儿的身体会是什么样子。研究得出了两种各包含五个主题的模式：1.（a）“决定看望死产婴儿”将看望事件展现为一种“相信”的体验，（b）“避免遗憾”，（c）“告别的机会”，（d）“将死产婴儿铭记于心的机会”，以及（e）“看到时的震惊”。2.（a）“决定不看望死产婴儿”表明不看望的意义在于“切断与死产婴儿的情感联系”，（b）“防止记忆留存”，（c）“避免内疚和痛苦”，（d）“假装事件结束”，以及（e）“遵循文化禁忌的行为”。
参与者在否认或面对持续的丧亲之痛的过程中经历了看望和不看望的行为，这受到他们的个人信仰、对该事件的心理准备以及社会价值观的影响。卫生专业人员需要理解死产经历中“视觉”意义的有力诠释，并学会保持敏感、富有同理心且保持沟通渠道畅通，以便营造并维持一个充满同情和关爱的环境。
