Department of Women and Children's Health, School of Population Health sciences, Bristol Medical School, The Chilterns, Southmead Hospital, University of Bristol, Bristol, UK.
Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, London, UK.
Int J Gynaecol Obstet. 2020 May;149(2):137-147. doi: 10.1002/ijgo.13110. Epub 2020 Feb 26.
To develop global consensus on a set of evidence-based core principles for bereavement care after stillbirth.
A modified policy-Delphi methodology was used to consult international stakeholders and healthcare workers with experience in stillbirth between September 2017 and October 2018. Five sequential rounds involved two expert stakeholder meetings and three internet-based surveys, including a global internet-based survey targeted at healthcare workers in a wide range of settings.
Initially, 23 expert stakeholders considered 43 evidence-based themes derived from systematic reviews, identifying 10 core principles. The global survey received 236 responses from participants in 26 countries, after which nine principles met a priori criteria for inclusion. The final stakeholder meeting and internet-based survey of all participants confirmed consensus on eight core principles. Highest quality bereavement care should be enabled through training of healthcare staff to reduce stigma and establish respectful care, including acknowledgement and support for grief responses, and provision for physical and psychologic needs. Women and families should be supported to make informed choices, including those concerning their future reproductive health.
Consensus was established for eight principles for stillbirth bereavement care. Further work should explore implementation and involve the voices of women and families globally.
就一套基于循证的胎儿死亡后哀伤护理核心原则达成全球共识。
采用改良的政策 Delphi 方法,于 2017 年 9 月至 2018 年 10 月间咨询国际利益相关者和具有胎儿死亡护理经验的医护人员。该方法共包含 5 个连续回合,涉及 2 次专家利益相关者会议和 3 次基于互联网的调查,其中包括一项针对广泛医疗环境下医护人员的全球基于互联网的调查。
最初,23 名专家利益相关者审议了源自系统评价的 43 个基于循证的主题,确定了 10 项核心原则。全球调查收到了来自 26 个国家的 236 名参与者的回应,之后有 9 项原则符合纳入标准。最终的专家会议和所有参与者的互联网调查确认了对 8 项核心原则的共识。应通过培训医护人员来实现最高质量的哀伤护理,以减少污名化并建立尊重关怀,包括对悲伤反应的认可和支持,以及满足身体和心理需求。应支持妇女和家庭做出知情选择,包括与未来生殖健康相关的选择。
就胎儿死亡哀伤护理的 8 项原则达成了共识。进一步的工作应探讨实施情况,并让全球妇女和家庭的声音参与其中。