“你的心一直在流血”:乌干达北部一对经历围产期死亡的父母的生活经历。
"Your heart keeps bleeding": lived experiences of parents with a perinatal death in Northern Uganda.
机构信息
Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University, Lira, Uganda.
Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
出版信息
BMC Pregnancy Childbirth. 2022 Jun 15;22(1):491. doi: 10.1186/s12884-022-04788-8.
BACKGROUND
Worldwide, two million babies are stillborn and 1.8 million babies die before completing seven days of life. Approximately 4% of pregnant women in Uganda experience perinatal death. The response following a perinatal death tends to be socio-culturally constructed. Investigating the unique personal experiences of parents from a low-income setting with unique cultural beliefs and practices is crucial for the design and implementation of appropriate interventions.
OBJECTIVE
To describe the lived experiences of parents following perinatal death in Lira district, Northern Uganda.
METHODS
A qualitative study was carried out drawing on the tenets of descriptive phenomenology. We conducted 32 in-depth interviews in Lira district, Northern Uganda between August 2019 and September 2020 with 18 women and 14 men who had experienced a stillbirth or an early neonatal death within the preceding 2 years. Participants were selected from different families and interviewed. A local IRB approved the study. All in-depth interviews were audio-recorded, transcribed, translated, and data were analysed using a content thematic approach. Key findings were discussed based on Worden's Four Tasks of Mourning theory.
RESULTS
The themes that emerged from the analyses included reaction to the perinatal loss and suggestions for support. The participants' immediate reactions were pain, confusion, and feelings of guilt which were aggravated by the unsupportive behaviour of health care providers. Men cumulatively lost financial resources in addition to facing multiple stressful roles. Delayed reactions such as pain and worries were triggered by the sight of similar-age-babies, subsequent pregnancy losses, and marital challenges. Participants recommended emotional support and management of postnatal complications for parents faced with perinatal loss.
CONCLUSION
Losing a baby during the perinatal period in a resource-constrained setting negatively affected both gender. In addition, men suffered the loss of financial resources and the burden of multiple stressful roles. Acknowledging the pain and offering support to the grieving parents reinforce their coping with a perinatal loss. In addition to family and community members, health care providers need to provide emotional support and postnatal care to parents who experience perinatal death.
背景
全世界仍有 200 万婴儿胎死腹中,180 万婴儿在出生后七天内死亡。乌干达约有 4%的孕妇经历围产期死亡。围产期死亡后的反应往往是社会文化构建的。从具有独特文化信仰和习俗的低收入背景的父母的独特个人经历入手,对于设计和实施适当的干预措施至关重要。
目的
描述北乌干达利拉地区围产期死亡后父母的生活体验。
方法
本研究采用描述现象学的原则进行了一项定性研究。我们于 2019 年 8 月至 2020 年 9 月在利拉区进行了 32 次深入访谈,受访者为 18 名女性和 14 名男性,他们在过去 2 年内经历过死产或新生儿早期死亡。参与者是从不同的家庭中挑选出来的,并接受了访谈。当地的 IRB 批准了这项研究。所有的深入访谈都进行了录音、转录、翻译,并使用内容主题分析方法进行了数据分析。根据 Worden 的四个哀悼任务理论,讨论了主要发现。
结果
分析得出的主题包括对围产期损失的反应和对支持的建议。参与者的直接反应是痛苦、困惑和内疚感,而医疗保健提供者的不支持行为则加剧了这种反应。男性除了面临多重压力角色外,还逐渐失去了经济资源。类似年龄的婴儿、随后的妊娠损失和婚姻挑战触发了延迟反应,如疼痛和担忧。参与者建议为面临围产期损失的父母提供情感支持和产后并发症管理。
结论
在资源有限的环境中,围产期失去婴儿会对两性都产生负面影响。此外,男性还承受着经济资源的损失和多重压力角色的负担。承认痛苦并为悲痛的父母提供支持,会增强他们应对围产期损失的能力。除了家庭和社区成员外,医疗保健提供者还需要为经历围产期死亡的父母提供情感支持和产后护理。