Dissertations / Theses on the topic 'Perinatal bereavement'

Aim. The aim of the present research was to investigate the relationship of personality guilt- and shame-proneness to grief and psychological dysphoria following bereavement due to stillbirth or death in the newborn period. Methods. Participating parents completed self-report questionnaire measures of proneness to situational guilt and shame (Test of Self-Conscious Affect-2), chronic guilt and shame (Personal Feelings Questionnaire-2) and interpersonal guilt (Interpersonal Guilt Questionnaire-67), grief (Perinatal Grief Scale-33) and psychological dysphoria (General Health Questionnaire-28) one month (�early�, N = 158) and 13 months (�late�, N = 149) after a perinatal death. Results. Women compared with men self-reported more intense grief, anxiety and depression one month after the death, but there were no significant sex differences in grief or psychological dysphoria one year later. Hierarchical multiple regression analyses showed that composite shame (situational and chronic) explained a small but statistically significant proportion of the variance in early total grief (adjusted R 2 = .09) and anxiety (adjusted R 2 = .07) in women, and early total grief (adjusted R 2 = .19), anxiety (adjusted R 2 = .13) and depression (adjusted R 2 = .10) in men. Composite guilt (situational, chronic and interpersonal) controlled for shame did not make a significant further contribution to the variance in early total grief, anxiety or depression in either sex. Composite shame explained not only significant but meaningful proportions of the variance in late grief (adjusted R2=.27), anxiety (adjusted R2=.21) and depression (adjusted R2=.27) in women, and late grief (adjusted R2= .56),anxiety (adjusted R 2= .30) and depression (adjusted R2= .51) in men. Composite guilt controlled for shame made significant further contributions to the variancein late grief (∆R 2 = .21), anxiety (∆R 2 = .16) and depression (∆R 2 = .25) in women, and late grief (∆R 2 = .11) in men. Shame and guilt together explained a substantial proportion of the variance in late grief (adjusted R2= .45), anxiety (adjusted R2= .33) and depression (adjusted R2= .49) in women, and late grief (adjusted R2= .64), anxiety (adjusted R2= .35) and depression (adjusted R2= .56) in men. Situational shame, chronic guilt and survivor guilt made positive unique contributions to the variance in late grief in women. Chronic shame and survivor guilt made unique contributions to the variance in late grief in men. Situational guilt made a significant unique negatively valenced contribution to the variance in late grief in women. Early composite shame, but not guilt, predicted late grief, anxiety and depression in men. Early composite shame and/or guilt did not predict late grief, anxiety or depression in women. Conclusion. Personality proneness to shame was more relevant to late grief, anxiety and depression in men than in women, but survivor guilt was equally important to late grief in both sexes. Chronic guilt and functional situational guilt were pertinent to late grief, anxiety and depression in women, but not in men. Personality shame- and guilt-proneness have important relationships with parental grief after perinatal death that have not hitherto been recognised.

The purpose of this study was to gain a better understanding of the paternal experience of perinatal loss. Perinatal loss is a significant life experience for childbearing families and this study helped to reveal the meaning of the paternal experience, how meaning was constructed and what factors both contributed and/or hindered coping following the loss. Although extensive research in grief and loss has been conducted there existed a significant knowledge gap related to the experience of perinatal loss and even more of a paucity concerning the understanding of the paternal experience. A qualitative study with a phenomenological approach was conducted with a purposeful sample of seven fathers who had experienced a perinatal loss. These fathers helped provide a basis for understanding through partaking in interviews conducted in a venue chosen by fathers. Data analysis involved procedures with roots in Heideggerian traditions of phenomenology, to allow for meaning interpretation of the father's narratives. The analysis resulted in four shared meanings 1) Perinatal Loss - Unexpected Reality, 2) Acknowledgment and Remembrance, 3) Significance and Strength and 4) Crisis, which consisted of 12 themes (World Falling Apart, Absolute Shock, Stoicism, Wishing for Answers, Silent Shelter, Concern for Wife, Communication, Time Heals - Though Never Forgotten, Continued Support and Understanding, Life Changing Moment, Opportunity of Growth and Avoidable Choice). Results indicated that fathers felt ill prepared for this unexpected life event and that they needed to remain strong or to live up to perceived expectations. Although the loss was never forgotten, through reflection, communication and continued support and understanding healing transpired over time and crisis was an avoidable choice. Further exploration of the paternal experience of perinatal loss with varying socio-cultural backgrounds, younger aged population group as well as different religious and cultural backgrounds is recommended. Research is also indicated to explore: 1) educational interventions focusing on both short and long term supportive care to bereaved families, 2) the impact of substantive bereavement programs on healing and meaning-making, 3) the impact of a perinatal loss experience on other members of the family unit, and 4) the impact of recurrent perinatal loss to a family.

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Estudo qualitativo de natureza interpretativa realizado com mães que vivenciaram a perda de um filho no período perinatal, a fim de apresentar os cenários da mortalidade perinatal, de acordo com a perspectiva materna e evidências epidemiológicas. Os achados deste estudo indicam que 52% das mães participantes da pesquisa foram classificadas como de baixo risco gestacional ou risco intermediário e que 78,27% das mortes dos bebês eram evitáveis. Também, destaca-se que o processo do luto é contínuo, doloroso e perdura, e as dificuldades vivenciadas pelas mães evidenciam que as mesmas não são assistidas integralmente por uma equipe de saúde capacitada para ajudar nessa situação angustiante. Dessa maneira, evidencia a necessidade de uma rede de apoio no momento que a mãe recebe a notícia do óbito do seu filho e que esse cuidado perdure até que a enlutada encontre um significado para sua perda. Assim, conclui-se a importância de uma equipe interdisciplinar, para o cuidado integral e ainda, garantir uma assistência humanizada com qualidade.
A qualitative study of an interpretative nature performed with mothers who experienced the loss of a child in the perinatal period, in order to present the scenarios of perinatal mortality according to maternal perspective and epidemiological evidence. The findings of this study indicate that 52% of the mothers participating in the research were classified as having low gestational risk or intermediate risk and that 78.27% of infant deaths were avoidable. It is also noteworthy that the process of mourning is continuous, painful and lasting, and the difficulties experienced by the mothers show that they are not fully assisted by a health team trained to help in this distressing situation. In this way, it is evident the need for a support network the moment the mother receives the news of her child's death and that this care lasts until the bereaved finds a meaning for her loss. Thus, we conclude the importance of an interdisciplinary team, for the integral care and also, guarantee a humanized assistance with quality.

Orientador: Milena Temer Jamas
Resumo: Os profissionais de saúde utilizam algumas táticas com intuito de se resguardar psiquicamente do sofrimento vivenciado por seus pacientes. Entre uma das maneiras de proteção está a concepção de que setor da maternidade seja um lugar onde surgem novas vidas e não onde elas acabam. Entretanto a maternidade pode ser marcada por acontecimentos negativos, acompanhados por perdas ao invés de ganhos, tornando a morte um assunto polêmico e desafiador nesse meio. Diante disso, o objetivo desta pesquisa foi melhorar a qualidade do atendimento da equipe de enfermagem diante das pacientes/familiares que sofreram uma perda perinatal a partir de um material instrutivo destinado aos cuidados de enfermagem em situação de óbito perinatal. Trata-se de um estudo do tipo metodológico, para construção de uma tecnologia educativa, o qual adotou as etapas de: submissão do projeto ao comitê de ética, levantamento de vivências e demandas da população alvo por meio de um estudo qualitativo, levantamento bibliográfico e elaboração do material educativo. A elaboração da cartilha seguiram as seguintes etapas: A sistematização do conteúdo; A seleção e elaboração das ilustrações; A composição da cartilha e os critérios editoriais utilizados. Foram entrevistados individualmente nove enfermeiros e dez técnicos de enfermagem que atuam na maternidade do Hospital das Clínicas de Botucatu (HC), maternidade referência regional para atendimentos de gestante alto risco. As entrevistas foram gravadas a partir da per... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Health professionals use some tactics to protect themselves psychically from the suffering experienced by their patients. One of the ways of protection is the conception that the maternity sector is a place where new lives emerge and not where they end. However, motherhood can be marked by negative events, accompanied by losses rather than gains, making death a controversial and challenging issue in this environment. Therefore, the objective of this research was to improve the quality of care provided by nursing staff to patients / family members who suffered a perinatal loss from an instructional material intended for nursing care in perinatal death situation. This is a methodological study, for the construction of an educational technology, which adopted the steps of: submission of the project to the ethics committee, survey of experiences and demands of the target population through a qualitative study, bibliographic survey and elaboration of educational material. The elaboration of the booklet followed the following steps: The systematization of the content; The selection and elaboration of the illustrations; The composition of the booklet and the editorial criteria used. Nine nurses and ten nursing technicians who work at the maternity ward of the Botucatu Hospital (HC), a regional reference maternity ward for high-risk pregnant women, were interviewed individually. The interviews were recorded from the guiding question: "What are the biggest difficulties faced by health... (Complete abstract click electronic access below)
Mestre

In the U.S., Black mothers experience fetal and infant mortality at alarming rates when compared to White and Latina mothers (Gregory, Drake, & Martin, 2018). The intent of this study was to examine perinatal loss among Black American women and to expand understanding of how the Strong Black Woman (SBW) ideology influences bereavement. Data were gathered from (N=109) Black American bereaved mothers. It was predicted that endorsement of differing aspects of the SBW would moderate the relationship between perinatal grief and psychosocial outcomes (i.e., depression and post-traumatic growth). Regression analyses, alongside a bootstrapping procedure via PROCESS (Hayes, 2017), were used to evaluate the moderation models. Results yielded a model of perinatal bereavement among Black American mothers. In particular, reliance on spirituality moderated the relationship between perinatal grief and depression, while the obligation to manifest strength moderated the relation between perinatal grief and posttraumatic growth (PTG). Neither moderated moderation model was significant. The model provided significant implications for clinical practice and intervention.

Thesis advisor: June Horowitz
Parents who simultaneously grieve the loss of one twin and nurture the surviving twin experience a paradox of grief and joy. The acute grief of losing a twin coincides with a critical time in the development of the parental role and relationship with the surviving twin. Very few researchers have addressed the unique parenting situation in which one twin infant dies. The aim of this qualitative descriptive study was to describe the experience of parents who lose one twin in utero, at birth, or in the neonatal period. The study question was "What is the parenting experience of mothers and fathers who simultaneously face the grief of the loss of one twin while nurturing the surviving twin during infancy?" Nine parents, recruited via a support group, were interviewed. Systematic content analysis, emphasizing in-vivo coding (participant's own words), was conducted until data saturation was reached. A comprehensive description of the experience of raising a surviving twin was constructed. Four descriptive themes were identified: (1) Living with ambiguity: the irony of raising a lone twin, belonging and not belonging, and at least there is one; (2) Communicating the family journey: telling or not telling, deciding who needs to know, and how many children; (3) Parenting with wonder and worry: doubt and hyper-vigilance, unanswered questions, and the living twin as a unique person; and (4) Life is different now: loss of innocence, honoring both twins, making and keeping relationships, work-life challenges, and accepting that it doesn't go away. Issues raised by parents included the ambiguity and irony of losing one twin, no one understands, multiple losses, and living with this loss. The description of this experience gives insight to the dynamics and burden of this loss. Data from this study can inform pediatric nurses about the issues, concerns, and needs of parents who sustain this kind of loss. Therapeutic interventions based by the tenets of family-centered nursing care can be developed by understanding the long-term effects of grief on parenting
Thesis (PhD) — Boston College, 2012
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing

Magister Curationis - MCur
Perinatal deaths are emotion-laden events not only for the mothers, but also for physicians and midwives. Hence, mothers experiencing the phenomenon need support to overcome the experience. If the loss occurs in a health institution, the responsibility of supporting the woman is borne by healthcare providers, particularly midwives. However, limited information exists on how midwives manage patients who experience perinatal loss in health institutions. Consequently, this study on midwives' experiences of managing patients' perinatal loss at a maternity hospital in the Western Cape, South Africa was conducted. The aim of the study was to explore midwives' management of patients with perinatal loss. The study utilised a qualitative research design and employs a phenomenological approach. Purposive sampling was used to select eight registered midwives to participate in the study. Data was collected by means of in-depth unstructured interviews, which were audio-recorded. It was then analysed by utilising Colaizzi's (1978) steps of phenomenological data analysis. Four themes emerged from the data, namely, knowledge of perinatal loss, challenges when managing patients, managing perinatal loss, and getting emotionally involved. Themes were informed by several subthemes. In addition, implication on practice indicates that improving support to mothers with pregnancy loss requires a multi-disciplinary approach or teamwork from various professionals in order to enhance mutual collaboration between families and healthcare workers. The study concludes that nursing education programmes should be reviewed to ensure that they include midwives' needs in the area of managing clients experiencing a perinatal loss. Hence, student midwives should be given more clinical experience of caring for bereaved couples under supervision, as well as compassionate support, which would assist them to develop these skills before they graduate.

This thesis is a study of a young woman coming to terms with her grief. It unpacks how an invitation to film an unusual and life-changing event developed into an opportunity to question the ethics of the interview. It examines how the intricacies of a trust relationship influence the very threads and textures of the resulting documentary. This paper is a partnership between a practical documentary project and a more traditional written discussion. The documentary Five Hours with Raja is weighted at eighty per cent of the final thesis and the written exegesis makes up the remaining twenty per cent. Together these two elements investigate the developing relationship between Claudia – the documentary’s key protagonist, and the filmmaker, investigating how their relationship has affected the style, method, content and even the fundamental story line of a documentary. It also discusses the consequential ethical considerations and dilemmas behind creative and practical decisions, investigating ways that a filmmaker can draw the participant into the process to allow a greater degree of ownership, a stronger voice and a more immediate sense of intimacy with the final audience.

Background: Each year, perinatal loss affects one million women and their families (National Vital Statistic Reports, 2011). Perinatal loss is the death of a fetus/infant during pregnancy or soon thereafter (Koppmans, Wilson, Cacciatore & Flenady, 2013). There are several different types of perinatal loss, including miscarriage, stillbirth, and neonatal death. Bereavement education related to miscarriage will be the main focus of this project. Miscarriage, also known as spontaneous abortion, is the body's natural termination of a pregnancy before 20 weeks gestation (Geller, Psaros, & Kornfield, 2010).

Objective: The clinical problem to be addressed by this project is the lack of a system of evidence based bereavement education for women who experience miscarriage and subsequent treatment when they are admitted to the hospital through the Pre-Admission Unit (PAU)at WVU Healthcare. The project plan involves the development, implementation, and evaluation of an evidence based bereavement education system for women who are treated in the PAU prior to surgical intervention for a miscarriage. This intervention has been designed to address knowledge, skills, and attitudes of staff in the PAU related to providing bereavement support for women who experience a miscarriage.

Methods: A computerized literature search of CINAHL, PUBMED, National Guideline Clearinghouse, and the Cochrane Library data bases were performed using the key words miscarriage, spontaneous abortion, emotional experience, grief, education of providers, and bereavement education. Search limits were set which included the dates of 2002–2013, peer reviewed, full text, and English language. Selection criteria included the provision of grief interventions to women and their families who have suffered a perinatal loss and staff who cared for women who suffered a miscarriage. These searches produced 58 hits. After reviewing abstracts and article fourteen articles were chosen for the review. There were five systematic reviews, two randomized controlled trial (RCT) studies, six descriptive qualitative studies, and one non-experimental, correlational study.

Results: Strong evidence existed that grief education could assist healthcare providers to be able to provide evidence based interventions to women and families with a miscarriage. This project validated the literature by indicating that healthcare providers that were given bereavement education were much more comfortable presenting this education to women who suffered a miscarriage and required surgical intervention. The increase in knowledge of the healthcare providers was established with a pre-test, intervention of providing bereavement education, and a post-test. A t-test was used to compare means of the pre and post-tests and conclude that there was statistical significance in the mean scores of the pre and post-tests.

ANTECEDENTES. Un embarazo gemelar monocorial es un hecho poco frecuente, que conlleva ciertas complicaciones, con un aumento del riesgo de muerte de uno o los dos fetos. Ante la pérdida de un feto durante un embarazo múltiple, el duelo, junto a la presencia de sintomatología ansiosa y depresiva, es una respuesta común y normal (López, 2011). Sin embargo, por la complejidad intrínseca a esta condición, en muchos casos este duelo puede ser más complejo e intenso y puede derivar en un proceso de duelo complicado, así como estos síntomas ansiosos, depresivos y de estrés postraumático, pueden ser más acusados o generar la aparición de un trastorno psicopatológico (Ellis et al., 2016; Hutti, Armstrong, Myers y Hall, 2015 y Lisy, Peters, Riitano, Jordan y Aromataris, 2016). Esto hace necesario estudiar en mayor profundidad las características y los factores que pueden intervenir en la elaboración de este tipo de pérdidas. OBJETIVOS. El objetivo principal de esta tesis es conocer las características del proceso de duelo cuando se produce una pérdida perinatal en una gestación gemelar monocorial. Este objetivo principal se desplegó en diferentes objetivos específicos. En primer lugar, se analizó el impacto psicológico de la pérdida perinatal en las mujeres y se estudiaron las variables sociodemográficas, psicológicas y clínicas que podían influir en la elaboración del duelo, así como la vulnerabilidad psicológica ante este proceso. Y a continuación, se analizó la influencia de los rituales de despedida en el desarrollo del duelo. MÉTODO. Estudio con un diseño correlacional y descriptivo. Las participantes fueron mujeres atendidas en la Unidad de Medicina Materno-Fetal del Departamento de Obstetricia del Hospital Universitario de la Vall d’Hebron de Barcelona entre febrero de 2009 y mayo de 2012. Todas ellas cumplían los siguientes criterios de inclusión: 1) Mujeres que habían sufrido una pérdida de uno o de los dos bebés en la gestación gemelar monocorial tras la cirugía fetal por complicaciones, y 2) Mujeres de nacionalidad española, raza caucásica y con dominio del idioma castellano, con un nivel de estudios mínimos para rellenar el material requerido para la investigación. Se realizó una entrevista individual con cada participante donde se recogían los datos sociodemográficos, antecedentes psiquiátricos, datos clínicos sobre la gestación y las prácticas de rituales de despedida realizadas. Y se administraron los siguientes cuestionarios: Spanish Short Version Perinatal Grief Scale (SpSVPGS), Cuestionario de Ansiedad Estado-Rasgo (STAI), Inventario de Depresión de Beck (BDI) y Escala Revisada de Impacto del Estresor (Impact of Event Scale- Revised, IES-R). RESULTADOS. Los síntomas de duelo tras una pérdida perinatal en la gestación gemelar monocorial con complicaciones estaban relacionados con síntomas depresivos, ansiosos y de estrés postraumático. La intensidad del duelo no dependía de la semana de gestación en que se produjo la pérdida, los antecedentes de pérdidas gestacionales, la supervivencia de un gemelo, la presencia de hijos previos ni las variables sociodemográficas consideradas. Por el contrario, tener antecedentes de haber recibido atención terapéutica psicológica y/o psicofarmacológica resultaron predictores de mayor intensidad del duelo. La ausencia de la realización de rituales de despedida tampoco se relacionó con una mayor intensidad de la sintomatología del duelo. DISCUSIÓN Y CONCLUSIONES. La pérdida perinatal en un embarazo gemelar monocorial supone una situación de gran impacto emocional que coloca a la madre en una situación de mayor vulnerabilidad psicopatológica. La presencia de un hijo superviviente o de hijos previos no garantizan una mejor salud mental para la madre en duelo, así como tampoco la realización de rituales de despedida. Estas madres presentan unas necesidades específicas y complejas, que pueden complicar el proceso de duelo, especialmente en aquellas mujeres con mayor vulnerabilidad psicológica.
BACKGROUND. Monochorionic twin pregnancy is a relatively uncommon phenomenon, but its associated complications are severe and may result in the loss of one or both fetuses. Grief, together with feelings of anxiety and depression, is a normal and common response to perinatal loss during a multiple pregnancy (López, 2011). However, the inherent complexity of such a loss means that the grief experienced is often more intense and complicated, and symptoms of anxiety, depression, and/or post-traumatic stress may develop into a full-blown psychological disorder (Ellis et al., 2016; Hutti, Armstrong, Myers, & Hall, 2015; Lisy, Peters, Riitano, Jordan, & Aromataris, 2016). It is therefore important to understand the factors which may influence a woman’s ability to work through and come to terms with a loss of this kind. AIMS. The overall aim of this thesis was to explore and describe the characteristics of the grieving process in the case of perinatal loss during a monochorionic twin pregnancy. More specifically, the aims were: 1) To analyze the emotional impact of perinatal loss on the mother, 2) to study the sociodemographic, psychological, and clinical variables that may influence her grieving process, as well as the impact of previous psychological vulnerability, and 3) to examine the influence of farewell rituals in relation to the grief experienced. METHOD. The research used a correlational and descriptive design. Participants were a sample of women recruited from among those attending the maternity unit of the Vall d’Hebron University Hospital in Barcelona between February 2009 and May 2012. They all met the following inclusion criteria: 1) Having lost one or both fetuses in a monochorionic twin pregnancy following fetal surgery due to complications, and 2) Spanish nationality and White ethnicity, with a level of education and command of the Spanish language that was sufficient for completion of the questionnaires. Individual interviews were used to collect sociodemographic information, data about the woman’s psychiatric and obstetric history, and information about any farewell rituals performed. The following questionnaires were also administered: Spanish Short Version of the Perinatal Grief Scale (SpSVPGS), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and the Impact of Event Scale—Revised (IES-R). RESULTS. High levels of grief following the loss of a fetus during a complicated monochorionic twin pregnancy were associated with higher levels of depression, anxiety, and post-traumatic stress. The intensity of grief did not depend on the point in the pregnancy at which the loss occurred, a history of miscarriage, the survival of one of the twins, the presence of living children, or any of the sociodemographic variables considered. A history of psychological and/or psychopharmacological treatment was, however, associated with a more intense grief reaction. There was no significant relationship between farewell rituals and the intensity of the grief experienced. DISCUSSION AND CONCLUSIONS. Perinatal loss during a monochorionic twin pregnancy has a major emotional impact on the mother and leaves her vulnerable to psychological problems. The survival of one of the twins or the presence of living children is no guarantee that the grieving mother’s mental health will be less affected, and neither do farewell rituals seem to have a significant protective effect. Women who have experienced a loss of this kind have specific and complex needs, and those with a history of psychological vulnerability are particularly at risk of complicated grief.

Thesis (Ph.D.)--York University, 2007. Graduate Programme in Sociology.
Typescript. Includes bibliographical references (leaves 217-233). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR39000

The experience of perinatal bereavement can be devastating for women and their loved ones, and yet the experience has largely been overlooked by researchers. It is only recently that, along with changed sociocultural conditions, technological advances in neonatal care, and advanced understanding of maternal/fetal attachment, women’s experiences of perinatal loss have been empirically recognised. With an estimated 1 in 3 women experiencing perinatal loss, the profound sorrow that can accompany miscarriage, stillbirth, ectopic pregnancy, and terminations is now more readily acknowledged. Although some women accommodate perinatal loss in the longer-term, previous research has shown that approximately 20% continue to carry disabling symptoms in the years after perinatal loss. The challenge remains for researchers and practitioners alike to identify factors which influence longer-term perinatal grief trajectories. The present study aimed to examine perinatal grief experiences and mental health in a group of community-dwelling Australian women. One hundred and ninety-seven women participated in a clinical interview to assess perinatal history, depression, and personality disorders. It was hypothesised that previously-healthy women who developed de novo Major Depressive Disorder after experiencing perinatal loss would report more intense grief, with depression acting as a significant risk factor for complications in grief. Further, it was hypothesised that women with personality disorders would report more intense grief responses, with the presence of any personality disorder acting as a significant risk factor for greater complications in perinatal grief. These hypotheses were all supported. After an median 11 years post-loss, 6.5% of women continued to report clinically significant levels of perinatal grief. One in four women who were previously mentally healthy responded to perintal loss with the development of de novo depression. For women who did develop de novo depression, and for women with personality disorders, the risk of developing more problematic grief was between two and four times greater than women without such features. It may be that women with personality disorders are more at risk of developing a despair-related form of prolonged grief, whereas women with depression may be at risk of developing a form of prolonged grief associated with poorer coping. Such findings have theoretical and clinical implications whereby certain groups of women appear at greater risk of developing more complicated grief after perinatal loss. Further research should continue to identify these and other risk factors that modulate grief responses, so as to inform diagnosis and treatment of Persistent Complex Bereavement Disorder.

Cette étude avait pour but d’évaluer, à partir d’un processus de co-construction avec les personnes concernées, dans un contexte de 1ère ligne, la mise en application d’interventions infirmières inspirées du Guide des meilleures pratiques de soins pour les endeuillés (GMPSE) auprès d’un couple ayant vécu une perte périnatale au cours des six dernier mois. Un devis de recherche d’étude de cas basé sur la démarche d’évaluation de la quatrième génération de Guba et Lincoln (1989) a été utilisé. Une infirmière expérimentée auprès des familles endeuillées, s’est inspirée de la guidance du GMPSE pour intervenir auprès d’un couple lors de cinq rencontres thérapeutiques, dont quatre ont été précédées d’une entrevue avec les personnes concernées . Ces entrevues ont permis à ces personnes d’identifier ensemble les interventions les plus utiles et les moins utiles. Le verbatim des rencontres et entrevues ont été enregistrées et transcrites à des fins d’analyses qualitatives, Les résultats de ces analyses font ressortir la pertinence des interventions inspirées du GMPSE et l’apport spécifique de la pratique infirmière auprès de la population visée. Il appert que la sensibilisation des décideurs et des cliniciens aux enjeux des personnes endeuilles soit nécessaire pour favoriser l’implantation du Guide dans les milieux de soins. Enfin, une meilleure appropriation du GMPSE est recommandée autant dans le cadre de la formation, que de la recherche et de la pratique en sciences infirmières.
The purpose of this study was to evaluate from a constructivist perspective, partnering with the stakeholders , the usefulness of nursing interventions inspired from The Best Practice Guidelines in Bereavement Care (BPGBC) in a first line context, during the follow up a couple whom had experienced a prenatal lost in the last six months. A case study design was used along with The Fourth Evaluation’s methodological approach designed by Guba and Lincoln (1989). An experienced nurse in the care of bereaved families, used the BPGBC to guide her interventions in five therapeutic meetings with the couple, followed by four interviews with the stakeholders. The interventions considered the most helpful and the less useful were identified. The gathering of the data and their analysis followed an interactive and ongoing process. The results support the pertinence of the nursing interventions inspired from the BPGBC, as well as the specific contribution of the nursing profession in the bereavement work. Implementing the BPGBC becomes a realistic goal when the managers and the clinical professionals are made aware of the issues encompassed by the grieving population. The nursing profession could incorporate the BPGBC in its training curriculum, in the research field and in the care offered to the bereaved population in different care settings.