Obst Kate Louise, Due Clemence, Oxlad Melissa, Middleton Philippa
School of Psychology, University of Adelaide, Adelaide, SA, Australia.
South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
J Clin Nurs. 2021 Sep;30(17-18):2718-2731. doi: 10.1111/jocn.15786. Epub 2021 Apr 25.
To explore men's experiences of termination of pregnancy for life-limiting foetal anomaly, including how healthcare providers, systems and policies can best support men and their families.
While there is a sizable body of research and recommendations relating to women's experiences of grief and support needs following a termination of pregnancy for foetal anomaly, very few studies specifically examine men's experiences.
Semi-structured interviews were completed with ten Australian men who had experienced termination of pregnancy for life-limiting foetal anomalies with a female partner between six months and 11 years ago. Interviews were completed over the telephone, and data were analysed using thematic analysis. COREQ guidelines were followed.
Thematic analysis resulted in the identification of three over-arching themes, each with two sub-themes. First, participants described the decision to terminate their pregnancy as The most difficult choice, with two sub-themes detailing 'Challenges of decision-making' and 'Stigma surrounding TOPFA'. Second, participants described that they were Neither patient, nor visitor in the hospital setting, with sub-themes 'Where do men fit?' and 'Dual need to support and be supported'. Finally, Meet me where I am described men's need for specific supports, including the sub-themes 'Contact men directly' and 'Tailor support and services'.
Findings indicated that termination of pregnancy for life-limiting foetal anomaly (TOPFA) is an extremely difficult experience for men, characterised by challenges in decision-making and perceived stigma. Men felt overlooked by current services and indicated that they need specific support to assist with their grief. Expansion of existing infrastructure and future research should acknowledge the central role of fathers and support them in addressing their grief following TOPFA.
Nursing/midwifery professionals are well situated to provide men with tailored information and to promote genuine inclusion, acknowledgement of their grief, and facilitate referrals to community supports.
探讨男性对于因胎儿存在危及生命的异常情况而终止妊娠的经历,包括医疗保健提供者、系统和政策如何能够最好地支持男性及其家庭。
虽然有大量关于女性在因胎儿异常而终止妊娠后的悲伤经历和支持需求的研究及建议,但很少有研究专门考察男性的经历。
对10名澳大利亚男性进行了半结构式访谈,这些男性在6个月至11年前与女性伴侣因胎儿存在危及生命的异常情况而终止妊娠。访谈通过电话完成,并使用主题分析法对数据进行分析。遵循了COREQ指南。
主题分析确定了三个总体主题,每个主题有两个子主题。首先,参与者将终止妊娠的决定描述为“最艰难的选择”,两个子主题详细阐述了“决策的挑战”和“围产期终止妊娠的污名”。其次,参与者表示在医院环境中他们“既不是患者,也不是访客”,子主题为“男性的角色定位”和“支持与被支持的双重需求”。最后,“在我所在之处与我相遇”描述了男性对特定支持的需求,包括子主题“直接联系男性”和“定制支持与服务”。
研究结果表明,因胎儿存在危及生命的异常情况而终止妊娠(TOPFA)对男性来说是极其艰难的经历,其特点是决策困难和存在污名感。男性感到当前的服务忽视了他们,并表示他们需要特定的支持来帮助他们缓解悲伤。扩大现有基础设施以及未来的研究应认识到父亲的核心作用,并在TOPFA后支持他们应对悲伤。
护理/助产专业人员处于有利位置,能够为男性提供量身定制的信息,促进真正的包容,承认他们的悲伤,并协助转介到社区支持机构。