文化信仰和习俗对乌干达和肯尼亚失独父母丧亲体验的影响:一项定性研究
The impact of cultural beliefs and practices on parents' experiences of bereavement following stillbirth: a qualitative study in Uganda and Kenya.
机构信息
Department of Nursing, College of Health Sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda.
Centre for Childbirth, Women's and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom.
出版信息
BMC Pregnancy Childbirth. 2021 Jun 25;21(1):443. doi: 10.1186/s12884-021-03912-4.
BACKGROUND
Stillbirth is an extremely traumatic and distressing experience for parents, with profound and long-lasting negative impacts. Cultural beliefs and practices surrounding death vary considerably across different contexts and groups, and are a key influence on individual experiences, impacting grief, adjustment, and support needs. Few studies have explored cultural influences surrounding stillbirth in an African context. This study explored the influence of cultural beliefs and practices on the experiences of bereaved parents and health workers after stillbirth in urban and rural settings in Kenya and Uganda.
METHODS
A qualitative descriptive study design was employed. Face to face interviews were conducted with parents (N = 134) who experienced a stillbirth (≤ 1 year) and health workers (N = 61) at five facilities in Uganda and Kenya. Interviews were conducted in English or the participants' local language, audio-recorded and transcribed verbatim. Analysis was conducted using descriptive thematic analysis.
RESULTS
Commonalities in cultural beliefs and practices existed across the two countries. Three main themes were identified: 1) Gathering round, describes the collective support parents received from family and friends after stillbirth. 2)'It is against our custom' addresses cultural constraints and prohibitions impacting parents' behaviour and coping in the immediate aftermath of the baby's death. 3) 'Maybe it's God's plan or witchcraft' summarises spiritual, supernatural, and social beliefs surrounding the causes of stillbirth.
CONCLUSIONS
Kinship and social support helped parents to cope with the loss and grief. However, other practices and beliefs surrounding stillbirth were sometimes a source of stress, fear, stigma and anxiety especially to the women. Conforming to cultural practices meant that parents were prevented from: holding and seeing their baby, openly discussing the death, memory-making and attending the burial. The conflict between addressing their own needs and complying with community norms hindered parents' grief and adjustment. There is an urgent need to develop culturally sensitive community programmes geared towards demystifying stillbirths and providing an avenue for parents to grieve in their own way.
背景
死产对父母来说是一种极其创伤和痛苦的经历,会产生深远而持久的负面影响。在不同的背景和群体中,死亡相关的文化信仰和习俗差异很大,对个体的经历有着重要影响,影响悲伤、调整和支持需求。很少有研究探讨非洲背景下与死产相关的文化影响。本研究探讨了文化信仰和习俗对肯尼亚和乌干达城乡地区死产父母和卫生工作者经历的影响。
方法
采用定性描述性研究设计。对在乌干达和肯尼亚的五家医疗机构经历死产(≤1 年)的父母(N=134)和卫生工作者(N=61)进行了面对面访谈。访谈以英语或参与者的当地语言进行,录音并逐字转录。采用描述性主题分析进行分析。
结果
两个国家的文化信仰和习俗存在共同点。确定了三个主要主题:1)聚集在一起,描述了父母在死产发生后得到的来自家人和朋友的集体支持。2)“这违背了我们的习俗”,涉及影响父母在婴儿死亡后行为和应对方式的文化限制和禁忌。3)“也许这是上帝的计划或巫术”,概括了与死产原因相关的精神、超自然和社会信仰。
结论
亲属关系和社会支持帮助父母应对失去和悲伤。然而,围绕死产的其他习俗和信仰有时会给父母带来压力、恐惧、耻辱和焦虑,尤其是对女性。遵守文化习俗意味着父母无法:抱着和看到他们的婴儿,公开讨论死亡,制作记忆和参加葬礼。满足自己的需求和遵守社区规范之间的冲突阻碍了父母的悲伤和调整。迫切需要制定文化敏感的社区计划,以消除对死产的神秘感,并为父母提供以自己的方式悲伤的途径。
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