McNamara Karen, Meaney S, O'Connell O, McCarthy M, Greene R A, O'Donoghue K
Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Wilton, Cork, Ireland.
National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland.
Arch Gynecol Obstet. 2017 Apr;295(4):845-852. doi: 10.1007/s00404-017-4309-9. Epub 2017 Feb 17.
Exposure to adverse perinatal events can impact on the way healthcare professionals (HCPs) provide patient care. The aim of this study was to document the experiences of HCPs following exposure to intrapartum death (IPD), to identify opinions surrounding education and suitable support strategies, and to ascertain if involvement with an IPD had any impact on clinical practice.
A questionnaire study, with open and closed questions, was developed and set in a tertiary maternity hospital. Consultant obstetricians, trainee obstetricians and midwives were invited to participate. Respondents were questioned about the impact that an intrapartum death had on them, the support they received in the immediate aftermath and their opinions regarding ongoing education and training in the areas of intrapartum death and self-care.
Eighty percent of HCPs in our study had a direct involvement with an IPD. Most (82%) HCPs received no training in dealing with IPD while 94% had no education on self-care strategies. Despite it being desired by most (80%), debriefing was offered to just 11% of HCPs who were involved in an IPD. Three main qualitative themes emerged from the data; the personal impact of IPDs on HCPs, implications for professional practice and future patient care, and the importance on non-judgemental support.
Maternity hospitals need to improve their support structures for HCPs following an IPD. It is hoped that this study will inform future educational practice and identify potential support strategies.
围产期不良事件的暴露会影响医护人员提供患者护理的方式。本研究的目的是记录医护人员在经历产时死亡（IPD）后的经历，确定围绕教育和适当支持策略的意见，并确定参与IPD是否对临床实践有任何影响。
在一家三级妇产医院开展了一项包含开放式和封闭式问题的问卷调查研究。邀请了产科顾问医生、实习产科医生和助产士参与。受访者被问及产时死亡对他们的影响、事件刚发生后他们得到的支持，以及他们对产时死亡和自我护理领域持续教育与培训的看法。
我们研究中80%的医护人员直接参与了产时死亡事件。大多数（82%）医护人员未接受过处理产时死亡事件的培训，94%的人未接受过自我护理策略方面的教育。尽管大多数人（80%）希望进行汇报，但参与产时死亡事件的医护人员中只有11%得到了汇报。数据中出现了三个主要的定性主题；产时死亡事件对医护人员的个人影响、对专业实践和未来患者护理的影响，以及无评判性支持的重要性。
妇产医院需要改善产时死亡事件后对医护人员的支持结构。希望本研究能为未来的教育实践提供参考，并确定潜在的支持策略。
