Mills T A, Ayebare E, Mukhwana R, Mweteise J, Nabisere A, Nendela A, Ndungu P, Okello M, Omoni G, Wakasiaka S, Wood R, Lavender T
Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda.
BJOG. 2021 Jan;128(1):101-109. doi: 10.1111/1471-0528.16413. Epub 2020 Aug 16.
To explore parents' lived experiences of care and support following stillbirth in urban and rural health facilities.
Qualitative, interpretative, guided by Heideggerian phenomenology.
Nairobi and Western Kenya, Kampala and Central Uganda.
A purposive sample of 75 women and 59 men who had experienced the stillbirth of their baby (≤1 year previously) and received care in the included facilities.
In-depth interviews, analysed using Van Manen's reflexive approach.
Three main themes were identified; parents described devastating impacts and profound responses to their baby's death. Interactions with health workers were a key influence, but poor communication, environmental barriers and unsupportive facility policies/practices meant that needs were often unmet. After discharge, women and partners sought support in communities to help them cope with the death of their baby but frequently encountered stigma engendering feelings of blame and increasing isolation.
Parents in Kenya and Uganda were not always treated with compassion and lacked the care or support they needed after the death of their baby. Health workers in Kenya and Uganda, in common with other settings, have a key role in supporting bereaved parents. There is an urgent need for context and culturally appropriate interventions to improve communication, health system and community support for African parents.
Health-system response and community support for parents after stillbirth in Kenya and Uganda are inadequate.
探讨城乡卫生机构中父母在死胎后获得护理和支持的生活经历。
以海德格尔现象学为指导的定性、解释性研究。
肯尼亚内罗毕和西部、乌干达坎帕拉和中部。
从在纳入研究的机构接受护理的75名女性和59名男性中进行目的抽样，这些人曾经历过死胎（≤1年前）。
采用深入访谈法，运用范曼的反思性方法进行分析。
确定了三个主要主题；父母描述了死胎对他们的毁灭性影响和深刻反应。与医护人员的互动是一个关键影响因素，但沟通不畅、环境障碍以及不支持的机构政策/做法意味着需求往往得不到满足。出院后，女性及其伴侣在社区寻求支持以帮助他们应对婴儿的死亡，但经常遭遇污名化，从而产生自责感并加剧孤立感。
肯尼亚和乌干达的父母在婴儿死亡后并未总是得到同情，且缺乏他们所需的护理或支持。与其他地区一样，肯尼亚和乌干达的医护人员在支持失去亲人的父母方面发挥着关键作用。迫切需要针对具体情况和文化背景的干预措施，以改善对非洲父母的沟通、卫生系统和社区支持。
肯尼亚和乌干达卫生系统对死胎后父母的反应及社区支持不足。
