Rousseau P, Fierens R M
Gynécologue-obstétricien, Office de la Naissance et de l'Enfance de la Communauté Française de Belgique O.N.E.
J Gynecol Obstet Biol Reprod (Paris). 1994;23(2):166-74.
Semi-structured interviews were conducted with 33 mothers one to 9 years after the death of a child in the perinatal period: 15/33 mothers (45.5%) are dissatisfied with care givers attitudes, 8/33 (24.2%) showed pathological grief reactions, 11/29 (37.9%) had established a pathological relationship with at least one of their living children, 5/29 (17.2%) were in disagreement with the child's father. Univariable analysis of interviews and obstetrical data showed that some factors where significantly correlated with pathological evolution. The relative risk (RR) of mothers' dissatisfaction was significantly decreased by positive attitudes: support by their obstetrician (RR 0.22, p < 0.01), by midwives and nurses (RR 0.24, p < 0.05), showing the dead baby (RR 0.39, p < 0.05), and increased by caregivers negative altitudes RR 13.18 p < 0.01) as well as by a concurrent bereavement (RR 2.29, p < 0.05). Pathological grief was more frequent amongst foreign culture mothers (RR 5.25, p < 0.01). Pathological mother-child relationships were increased by negative attitudes (RR 8.13, p < 0.05), by dissatisfaction (RR 4.82, p 0.01), by another bereavement (RR 2.86, p < 0.05) and decreased by seeing the dead baby (RR 0.35, p < 0.05) and understanding the cause of the death (RR 0.35, p < 0.05).
在围产期孩子死亡一至九年后,对33位母亲进行了半结构式访谈:33位母亲中有15位(45.5%)对护理人员的态度不满意,33位中有8位(24.2%)表现出病理性悲伤反应,29位中有11位(37.9%)与至少一个在世子女建立了病理性关系,29位中有5位(17.2%)与孩子的父亲意见不一致。对访谈和产科数据的单变量分析表明,一些因素与病理性演变显著相关。母亲不满的相对风险(RR)因积极态度而显著降低:产科医生的支持(RR 0.22,p<0.01)、助产士和护士的支持(RR 0.24,p<0.05)、看到死婴(RR 0.39,p<0.05),而因护理人员的消极态度(RR 13.18,p<0.01)以及同时发生的丧亲之痛(RR 2.29,p<0.05)而增加。病理性悲伤在外国文化背景的母亲中更为常见(RR 5.25,p<0.01)。消极态度(RR 8.13,p<0.05)、不满(RR 4.82,p 0.01)、另一次丧亲之痛(RR 2.86,p<0.05)会增加病理性的母子关系,而看到死婴(RR 0.35,p<0.05)和了解死亡原因(RR 0.35,p<0.05)则会减少这种关系。