胎儿丢失女性丧亲之痛的混合研究

A mixed study of bereavement in women with fetal loss

目的 调查与胎儿丢失女性丧亲之痛相关的悲伤及体验,为胎儿丢失女性的丧亲支持提供借鉴。方法 采用定量与定性相结合的混合性研究设计,于2020年11月至2021年12月应用围产期悲伤量表对北京协和医院怀孕12周以上胎儿丢失的77名女性进行悲伤状况调查。按照目的性抽样原则,选择其中10名女性在引产一周内及引产一个月后分别进行两次书写表达,通过描述性现象学方法对20封书写信件进行分析,深入了解丧亲之痛的多种表现。结果 回收有效问卷68份,胎儿丢失女性悲伤总分为(87.31±22.19)分,3个维度的得分为现存悲伤(36.16±8.23)分,困难应对(24.91±7.02)分,绝望(26.24±8.16)分,复杂性悲伤的检出率为42.6%;对书写信件的分析显示,胎儿丢失女性的丧亲之痛表现为以下4个方面:深刻而复杂的悲伤、个体化的哀悼方式、沉重的心理负担、对再次怀孕的强烈渴望。结论 胎儿丢失女性的丧亲之痛沉重且复杂,医护人员应加强对丧亲之痛的理解,进而提供个体化的关怀与照护,帮助女性更好度过这一艰难时期。

Objective To investigate the grief and experience related to bereavement of women with fetal loss, and provide reference for bereavement support of women with fetal loss.Methods A mixed research design of quantitative and qualitative was adopted, from November 2020 to December 2021,perinatal grief scale(PGS)was used to investigate the grief status of 77 women with fetal loss over 12 weeks of gestation in Peking Union Medical College Hospital.According to the principle of purposive sampling, 10 women were selected for twice written expression tasks within one week of labor induction and one month after labor induction.Descriptive phenomenological method was used to analyze 20 written letters, so as to deeply understand the multiple manifestations of women’s bereavement.Results A total of 68 valid questionnaires were collected.The total score of grief in women with fetal loss was(87.31±22.19),the scores of the three dimensions were(36.16±8.23) for existing grief,(24.91±7.02) for difficulty coping,(26.24±8.16) for despair, and the detection rate of complex grief was 42.6%.The analysis of the written letters shows that the bereavement of the women who lost their fetuses was manifested in the following four aspects: profound and complex grief, individualized mourning method, heavy psychological burden, and strong desire for pregnancy again.Conclusion The bereavement of women with fetal loss is heavy and complex.Medical staff should strengthen the understanding of women’s bereavement and then provide individualized care to help women get through this difficult period.