Study On Construction Of Perinatal Bereavement Care Training Program For Obstetric Nurses

ObjectiveThe aim of this study was to construct a training program for perinatal bereavement care for obstetric nurses that is appropriate to China’s cultural background and medical environment.MethodsPart I: The qualitative study of the care needs of women experiencing perinatal death and the training needs of obstetric nurses: A descriptive phenomenological research method was used for this study.We selected 12 perinatally bereaved women for one-to-one semi-structured online interviews by purposive sampling and snowball sampling and 13 obstetric nurses from a tertiary hospital in Lanzhou for one-to-one semi-structured face-to-face interviews by purposive sampling and convenience sampling.The text was collated using Nvivo12 Plus qualitative analysis software.The data was analyzed using the Colaizzi seven-step method.Part II: Literature analysis of clinical practice guidelines and training studies on perinatal bereavement care: A detailed search strategy was developed to systematically search the literature on perinatal bereavement care in China and abroad in English and Chinese electronic databases,guideline websites,and websites of professional organizations.The retrieved literature was screened,quality evaluated,and basic information extracted.Thematic analysis was used to summarise and integrate the content of the included literature.Part III: Revision and improvement of the training program for perinatal bereavement care for obstetric nurses: A draft training program for perinatal bereavement care for obstetric nurses was developed,taking into account the results of qualitative research and literature analysis.We selected 20 experts in the field of obstetrics from seven regions of the country for two rounds of Delphi expert consultation.Statistical analysis was carried out to determine the degree of positivity,authority,the concentration of opinion,and the coordination of opinion of the experts.The training program was revised and improved based on the results of the analysis and the experts’ opinions.Results1.The qualitative interviews with women with perinatal deaths identified four themes,namely needs related to the perinatal baby,needs related to the health care system,needs related to social support,and other needs,for a total of 16 sub-themes.The qualitative interviews with obstetric nurses identified four themes: differences in care experiences,barriers to clinical practice,identification with the role and responsibilities of the obstetric nurse,and expectations of professional training to enhance capacity for care,for a total of 12 sub-themes.The results of the interviews with both nurses and patients were analyzed to identify 16 training themes that required attention,and recommendations were summarised in relation to training formats,teaching methods,and evaluation of training outcomes.2.The literature study ultimately included eight clinical practice guidelines and expert consensus on perinatal bereavement care and 12 foreign studies on perinatal bereavement care training.Combining the results of the first part of the qualitative study,five training modules and 27 training topics were developed,namely basic knowledge of perinatal death,communication,shared decision-making,effective support,as well as nurses’ own competence and resilience enhancement.The training objectives,specific training content,training format,teaching methods,and evaluation of training effectiveness were also summarised.3.The questionnaire return rate of the two rounds of expert consultation was greater than 70%,and the comment rate was fair,indicating a high degree of positivity among the experts.The authority coefficient of the experts was more than 0.7,meaning that the results of the expert consultation were highly credible.The importance of each topic of the training program was higher than 4,and the full score ratio was higher than30%,which means that the experts’ opinions were more focused.The coefficient of variation for each topic was less than 0.25,and Kendall’s W-value for the whole training program was 0.144 in the first round and 0.155 in the second round,showing that the experts’ opinions are moderately coordinated and tend to be coordinated.The program was revised and improved according to the experts’ comments,and the final training program for perinatal bereavement care for obstetric nurses consisted of 5 training modules with 28 training topics.ConclusionA training program for perinatal bereavement care for obstetric nurses was developed through semi-structured in-depth interviews,literature research,and two rounds of Delphi expert consultation.The training program contained five training modules and training objectives,28 training topics and specific content,as well as recommendations on training formats,teaching methods,and training evaluation.The training program has been constructed with a more scientific and reliable methodology,and the training content is more comprehensive and detailed.It has many advantages over existing international studies on perinatal bereavement training.It not only took into account the needs and recommendations of nurses and patients but also sought evidence based on high-quality clinical practice guidelines,which will be of value in guiding future professional perinatal bereavement training in health care settings,enabling obstetric nurses to match the knowledge,skills,and attitudes of best clinical practice to meet the diverse needs of bereaved women and families and improve the perinatal bereavement experience and health outcomes.