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      Experiencias del personal de enfermería ante la muerte perinatal Translated title: Experiences of the Nursing Personnel in the Face of Perinatal Death

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          Abstract

          RESUMEN Introducción: Los profesionales de la salud se encuentran preparados principalmente para recibir vida, por lo cual, brindar cuidados a las mujeres con pérdidas durante la gestación o al inicio de la vida se torna una tarea difícil, cargada de sentimientos y emociones. La muerte perinatal es una situación compleja que tiene un fuerte impacto en las mujeres-madres y en sus familias. Objetivo: Analizar la literatura existente referente a estudios sobre las experiencias del personal de enfermería ante una muerte perinatal. Métodos: Revisión sistemática de la literatura, se realizó una búsqueda en las bases de datos PubMed, EBSCO, CINAHL, Scopus, SciELO y Dianet de febrero a abril del 2020. Los términos de búsqueda utilizados fueron “mortinato”, “muerte perinatal”, “enfermería” y “experiencias”. Se incluyeron artículos en idioma inglés y español, publicados de 2005 a 2020. Como estrategia de búsqueda se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), como resultado inicial se obtuvieron 476 artículos, de los cuales, 14 fueron seleccionados por cumplir los criterios de selección. Conclusiones: Las experiencias de los profesionales de enfermería que documentan los estudios recopilados y analizados enfatizan la necesidad de mejorar la formación profesional para acompañar el duelo, así como las estrategias de comunicación y acompañamiento. Las investigaciones reportan experiencias contradictorias, que van desde considerar las pérdidas perinatales como situaciones difíciles de tratar, hasta percepciones positivas que describen como un privilegio u honor el acompañamiento en esos momentos difíciles para las mujeres-madres y sus seres queridos.

          Translated abstract

          ABSTRACT Introduction: Health professionals are primarily trained to receive life; therefore, providing care for women with offspring or newborn loss becomes a difficult task, fraught with feelings and emotions. Perinatal death is a complex situation with a strong impact on women-mothers and their families. Objective: To analyze the existing literature regarding studies on the experiences of the nursing personnel in the face of perinatal death. Methods: To carry out the systematic review of the literature, a search was made in the PubMed, EBSCO, CINAHL, Scopus, SciELO and Dianet databases, from February to April 2020. The search terms used were mortinato [stillbirth], muerte perinatal [perinatal death], enfermería [nursing] and experiencias [experiences]. Articles in English and Spanish, published from 2005 to 2020, were included. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flowchart was used as search strategy. As an initial result, 476 articles were obtained, fourteen of which were selected because they met the selection criteria. Conclusions: The experiences of nursing professionals documented in the collected and analyzed studies emphasize the necessity to improve professional training to accompany bereavement, as well as communication and accompaniment strategies. The analyzed researches report contradictory experiences, ranging from considering perinatal losses as difficult situations to deal with, to positive perceptions that describe, as a privilege or honor, accompaniment in these difficult moments for women-mothers and their loved ones.

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          Stillbirths: economic and psychosocial consequences.

          Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.
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            Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences

            Background 2.7 million babies were stillborn in 2015 worldwide; behind these statistics lie the experiences of bereaved parents. The first Lancet series on stillbirth in 2011 described stillbirth as one of the “most shamefully neglected” areas of public health, recommended improving interaction between families and frontline caregivers and made a plea for increased investment in relevant research. Methods A systematic review of qualitative, quantitative and mixed-method studies researching parents and healthcare professionals experiences of care after stillbirth in high-income westernised countries (Europe, North America, Australia and South Africa) was conducted. The review was designed to inform research, training and improve care for parents who experience stillbirth. Results Four thousand four hundred eighty eight abstracts were identified; 52 studies were eligible for inclusion. Synthesis and quantitative aggregation (meta-summary) was used to extract findings and calculate frequency effect sizes (FES%) for each theme (shown in italics), a measure of the prevalence of that finding in the included studies. Researchers’ areas of interest may influence reporting of findings in the literature and result in higher FES sizes, such as; support memory making (53 %) and fathers have different needs (18 %). Other parental findings were more unexpected; Parents want increased public awareness (20 %) and for stillbirth care to be prioritised (5 %). Parental findings highlighted lessons for staff; prepare parents for vaginal birth (23 %), discuss concerns (13 %), give options & time (20 %), privacy not abandonment (30 %), tailored post-mortem discussions (20 %) and post-natal information (30 %). Parental and staff findings were often related; behaviours and actions of staff have a memorable impact on parents (53 %) whilst staff described emotional, knowledge and system-based barriers to providing effective care (100 %). Parents reported distress being caused by midwives hiding behind ‘doing’ and ritualising guidelines whilst staff described distancing themselves from parents and focusing on tasks as coping strategies. Parents and staff both identified the need for improved training (parents 25 % & staff 57 %); continuity of care (parents 15 % & staff 36 %); supportive systems & structures (parents 50 %); and clear care pathways (parents 5 %). Conclusions Parents’ and healthcare workers’ experiences of stillbirth can inform training, improve the provision of care and highlight areas for future research. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0806-2) contains supplementary material, which is available to authorized users.
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              Utilidad y tipos de revisión de literatura

              La rápida progresión del conocimiento científico mediado por la aparición creciente de publicaciones en un medio como la internet requiere la realización de revisiones de la literatura científica que nos permitan tener un conocimiento actualizado sobre un tema de interés. El progreso que se ha producido tras la aparición del movimiento de la práctica basada en la evidencia ha supuesto la aparición de nuevos tipos de revisiones de la literatura. El objetivo de este artículo es proporcionar un conocimiento global de lo que es una revisión de la literatura. Se explora su propósito y relevancia y las diferencias entre la revisión de la literatura y otras formas de escritura académica así como una categorización de los tipos de revisiones.
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                Author and article information

                Journal
                enf
                Revista Cubana de Enfermería
                Rev Cubana Enfermer
                Editorial Ciencias Médicas (Ciudad de la Habana, , Cuba )
                0864-0319
                1561-2961
                March 2022
                : 38
                : 1
                : e4064
                Affiliations
                [1] orgnameUniversidad de Sonora orgdiv1El Colegio de Sonora Mexico
                Article
                S0864-03192022000100016 S0864-0319(22)03800100016
                c09e0ee8-aeea-43ee-a5aa-74cc83cd1d89

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 30 September 2020
                : 09 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 0
                Product

                SciELO Cuba

                Categories
                ARTICULOS DE REVISION

                muerte perinatal,mortinato,enfermería,perinatal birth,stillbirth,nursing

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