a School of Social Work , Lakehead University , Thunder Bay , ON , Canada.
Soc Work Health Care. 2019 Apr;58(4):392-411. doi: 10.1080/00981389.2019.1580237. Epub 2019 Feb 18.
Often referred to as miscarriage, Early Pregnancy Loss (EPL) is the spontaneous death of a fetus experienced within the first 20 weeks of gestation and is the most common complication in pregnancy. Symptoms of an impending EPL are routinely managed in the Emergency Department (ED). EPL can have a substantial impact on women, potentially leading to psychological and emotional health issues and risks to future pregnancies. Despite the high prevalence of EPL, many women suffer in silence due to the common societal belief that EPL are insignificant. Many women experience EPL as an ambiguous loss and are at risk for disenfranchised grief. Compassionate, patient-centred care has been identified by women as an essential and often missing aspect of ED care and can have a profound impact on the overall well-being of women after EPL. Social workers play a critical role in the ED given that they prioritize the psychosocial well-being of patients in a system that is structured to primarily address trauma care. In an effort to reduce the psychological impact and complicated grief reactions of women experiencing EPL, specific recommendations for social work intervention to address the individual needs of women experiencing EPL in the ED are presented. These include acknowledging the loss, providing psychoeducation, honouring the loss, assessing resources, referral and additional information, and building capacity in the ED.
常被称为流产，早期妊娠丢失（EPL）是指妊娠 20 周内胎儿的自然死亡，是妊娠中最常见的并发症。EPL 的即将发生的症状通常在急诊部（ED）进行管理。EPL 可能对女性产生重大影响，可能导致心理和情绪健康问题以及对未来怀孕的风险。尽管 EPL 的患病率很高，但由于社会普遍认为 EPL 不重要，许多女性都默默忍受。许多女性将 EPL 视为一种模糊的损失，并且存在被剥夺悲伤的风险。女性认为富有同情心、以患者为中心的护理是 ED 护理的一个重要方面，通常缺失，这对 EPL 后女性的整体健康有深远影响。鉴于社会工作者优先考虑患者的社会心理福祉，他们在以主要解决创伤护理为结构的系统中发挥着至关重要的作用。为了减少经历 EPL 的女性的心理影响和复杂的悲伤反应，提出了针对 ED 中经历 EPL 的女性的具体社会工作干预建议，以满足她们的个体需求。这些建议包括承认损失、提供心理教育、尊重损失、评估资源、转介和提供更多信息，并在 ED 中建立能力。
