Department of Psychology, University of Bath, 10 West Building, Bath, BA2 7AY, UK.
BMC Pregnancy Childbirth. 2020 Mar 18;20(1):175. doi: 10.1186/s12884-020-02865-4.
Best practice in perinatal bereavement care suggests offering parents the opportunity to spend time with their baby. Cold cots facilitate this purpose by reducing the deterioration of the body and evidence indicates their wide availability in maternity and neonatal units in the UK. This study aimed to examine healthcare professionals' perceptions and experiences of using a cold cot following the loss of a baby.
A qualitative cross-sectional study was designed. In-depth, semi-structured interviews were conducted with 33 maternity and neonatal unit healthcare professionals who worked across three UK hospital settings. Data were analysed using inductive reflexive thematic analysis.
Findings revealed that staff had predominantly positive views about, and experiences of, using a cold cot. The technology was highly valued because it facilitated parents to spend time with their baby and participants reported that it was generally easy to use and smoothly embedded into the clinical environment. Cold cots were deemed useful when mothers were medically unwell and needed time to recover, when parents struggled to say goodbye to their baby, wished to take the baby home, or wanted their baby to stay in the unit instead of going straight to the mortuary. The use of technology was further perceived to be relevant in scenarios of unexpected loss, post-mortem examination and with babies of late gestations or neonates. Despite staff expressing comfort with the delay of visual and olfactory body changes, the coldness of the baby's body that was accelerated with the use of a cold cot was a major concern as it connoted and possibly exacerbated the reality of death.
Cold cots allow the materialisation of modern bereavement care practices that recognise the importance of continuing bonds with the deceased that is made possible through the creation of memories within an extremely restricted timeframe. Simultaneously, the body coldness concentrates the ambivalence toward an inherently paradoxical death, that of a baby. Training in perinatal bereavement care, including the use of cold cots, would help staff support bereaved parents whilst acknowledging dilemmas and managing contradictions encompassed in death at the time or near the time of birth.
围产期丧亲护理的最佳实践建议为父母提供与婴儿共度时光的机会。冷箱通过减少尸体的恶化来实现这一目的，并且有证据表明它们在英国的产科和新生儿病房中广泛可用。本研究旨在检查医护人员在失去婴儿后使用冷箱的看法和经验。
设计了一项定性的横断面研究。对在三个英国医院工作的 33 名产科和新生儿病房医护人员进行了深入的半结构化访谈。使用归纳性反思主题分析对数据进行了分析。
研究结果表明，工作人员对使用冷箱的看法和经验主要是积极的。该技术受到高度重视，因为它方便父母与婴儿共度时光，参与者报告说它通常易于使用，并顺利融入临床环境。当母亲身体不适需要时间恢复、父母难以与婴儿道别、希望将婴儿带回家、或希望婴儿留在病房而不是直接送往太平间时，冷箱被认为很有用。技术的使用还被认为与意外死亡、尸检以及胎龄较大的婴儿或新生儿的情况有关。尽管工作人员对视觉和嗅觉身体变化的延迟表示舒适，但使用冷箱加速婴儿身体的寒冷是一个主要问题，因为它暗示并可能加剧了死亡的现实。
冷箱允许实施现代丧亲护理实践，这些实践认识到通过在极其有限的时间内创建记忆来继续与死者建立联系的重要性。同时，身体的寒冷集中了对婴儿死亡这种内在悖论的矛盾心理。围产期丧亲护理培训，包括使用冷箱，可以帮助工作人员在承认出生时或临近出生时死亡所包含的困境和管理矛盾的同时，支持丧亲的父母。
