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AnteayerInternacionales

The thriving of older people assessment scale: Psychometric evaluation and short‐form development

Abstract

Aim

To evaluate the psychometric properties and performance of the 32‐item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short‐form.

Background

The 32‐item TOPAS has been used in studies of place‐related well‐being as a positive measure in long‐term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.

Design

Cross‐sectional study.

Method

Staff members completed the 32‐item TOPAS as proxy raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 ‐ September 2014. Reliability analysis, exploratory factor analysis and item response theory‐based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.

Results

Psychometric properties of the 32‐item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short‐form TOPAS exhibited a high level of internal consistency (α = 0.90) and strong correlation (r = 0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.

Conclusion

The 32‐item and short‐form TOPAS’ indicated sound validity and reliability to measure resident thriving in the nursing home context.

Impact

There is a lack of positive life‐world measures for use in nursing homes. The short‐form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health‐promoting purposes in nursing homes.

Nurses’ perceptions of high‐alert medication administration safety: A qualitative descriptive study

Abstract

Aims

The aim of this study was to determine nurses’ perceptions of supports and barriers to high‐alert medication (HAM) administration safety.

Design

A qualitative descriptive design was used.

Methods

Eighteen acute care nurses were interviewed about HAM administration practices. Registered nurses (RNs) working with acutely ill adults in two hospitals participated in one‐on‐one interviews from July–September, 2017. Content analysis was conducted for data analysis.

Results

Three themes contributed to HAM administration safety: Organizational Culture of Safety, Collaboration, and RN Competence and Engagement. Error factors included distractions, workload and acuity. Work arounds bypassing bar code scanning and independent double check procedures were common. Findings highlighted the importance of intra‐ and interprofessional collaboration, nurse engagement and incorporating the patient in HAM safety.

Conclusions

Current HAM safety strategies are not consistently used. An organizational culture that supports collaboration, education on safe HAM practices, pragmatic HAM policies and enhanced technology are recommended to prevent HAM errors.

Impact

Hospitals incorporating these findings could reduce HAM errors. Research on nurse engagement, intra‐ and interprofessional collaboration and inclusion of patients in HAM safety strategies is needed.

The mental health needs and concerns of older people who identify as LGBTQ+: A narrative review of the international evidence

Abstract

Aims

To synthesize the best available evidence on the experiences and perceptions of older people who identify as LGBTQ+ regarding their mental health needs and concerns.

Design

A narrative review and critical appraisal of qualitative, quantitative and mixed methods studies.

Data sources

A systematic search was undertaken across all of the databases including PsycINFO, MEDLINE, CINAHL and Sociological Abstracts. International studies published in academic journals in the English language, from January 1995 to January 2019 were appraised. Studies had to involve older people identifying as LGBTQ+ and who had experiences mental health issues.

Review Methods

Fourteen papers were selected for inclusion in the systematic review. A narrative analysis of the papers was used by synthesizing the key findings and organizing them into themes and concepts.

Results

Following analysis of the data, the themes that emerged were: (i) LGBTQ+ identity issues (ii) risk and vulnerability factors, (iii) coping strategies and resilience, (iv) interventions and supports.

Conclusion

This review highlights key mental health‐related issues that need to be taken into account in the creation and provision of appropriate, responsive and inclusive supports and services.

This article is protected by copyright. All rights reserved.

Fuzzy cognitive mapping: an old tool with new uses in nursing research

Abstract

Aims

Describe the implementation and uses of fuzzy cognitive mapping as a constructive method for meeting the unique and rapidly evolving needs of nursing inquiry and practice.

Design

Discussion paper.

Data Sources

Drawing on published scholarship of cognitive mapping from the fields of ecological management, information technology, economics, organizational behavior and health development, we consider how fuzzy cognitive mapping can contribute to contemporary challenges and aspirations of nursing research.

Implications for nursing

Fuzzy cognitive mapping can generate theory, describe knowledge systems in comparable terms and inform questionnaire design and dialogue. It can help build participant‐researcher partnerships, elevate marginalized voices and facilitate intercultural dialogue. As a relatively culturally safe and foundational approach in participatory research, we suggest fuzzy cognitive mapping should be used in settings of transcultural nursing, patient engagement, person and family centered care and research with marginalized populations. Fuzzy cognitive mapping is amenable to rigorous analysis and simultaneously allows for greater participation of stakeholders.

Conclusion

In highly complex healthcare contexts, fuzzy cognitive mapping can act as a common language for defining challenges and articulating solutions identified within the nursing discipline.

Impact

There is a need to reconcile diverse sources of knowledge to meeting the needs of nursing inquiry. Fuzzy cognitive mapping can generate theory, describe knowledge systems, facilitate dialogue and support questionnaire design. In its capacity to engage multiple perspectives in defining problems and identifying solutions, fuzzy cognitive mapping can contribute to advancing nursing research and practice.

This article is protected by copyright. All rights reserved.

How Career Facilitators and Barriers Influence Nurses' Professional Turnover Intention

Abstract

Aims

Our study investigates the influence of career facilitators and barriers on nurses' improvement of their professional capabilities and their professional turnover intention.

Background

Reducing nurses' professional turnover intention could help alleviate the global nursing shortage. Nevertheless, little research has addressed how career facilitators and barriers, nurses' improvement of their professional capabilities and professional turnover intention are related, indicating a gap.

Design

This study used a cross‐sectional design.

Methods

We surveyed 502 out of 2,660 full‐time nurses who worked for a medical centre in Taiwan between January and March 2018. Our items were adapted from Cunningham et al. and Teng et al. and had adequate reliability and validity. Structural equation modeling was used to test the study hypotheses.

Results

Human capital, social capital and discrimination were positively related to intention to improve professional capabilities. Moreover, intention to improve professional capabilities was positively related to action to improve professional capabilities, which was negatively related to professional turnover intention.

Conclusion

Most of the career facilitators and even barriers, boost the improvement of professional capabilities and are useful for retaining nurses in the nursing profession.

Impact

Findings of this study should have an impact on nursing managers by offering them means to retain nurses, e.g., enhancing human capital and social capital among nurses to reduce their turnover intention.

This article is protected by copyright. All rights reserved.

A Quantitative Systematic Review of the association between nurse skill mix and nursing‐sensitive patient outcomes in the acute care setting

Abstract

Aims

To examine the association between nurse skill mix (the proportion of total hours provided by Registered Nurses) and patient outcomes in acute care hospitals.

Design

A quantitative systematic review included studies published in English between January 2000 and September 2018.

Data sources

Cochrane Library, CINAHL Plus with Full Text, MEDLINE, Scopus, Web of Science and Joanna Briggs Institute were searched. Observational and experimental study designs were included. Mix‐methods designs were included if the quantitative component met the criteria.

Review methods

The Systematic Review guidelines of the Joanna Briggs Institute and its critical appraisal instrument was used. An inverse association was determined when seventy‐five percent or more of studies with significant results found this association.

Results

Sixty‐three articles were included. Twelve patient outcomes were inversely associated with nursing skill mix (i.e. higher nursing skill mix was significantly associated with improved patient outcomes). These were length of stay; ulcer, gastritis and upper gastrointestinal bleeds; acute myocardial infarction; restraint use; failure‐ to‐ rescue; pneumonia; sepsis; urinary tract infection; mortality/30‐day mortality; pressure injury; infections and shock/cardiac arrest/ heart failure.

Conclusion

Nursing skill mix affected twelve patient outcomes. However, further investigation using experimental or longitudinal study designs are required to establish causal relationships. Consensus on the definition of skill mix is required to enable more robust evaluation of the impact of changes in skill mix on patient outcomes.

Impact

Skill mix is perhaps more important than the number of nurses in reducing adverse patient outcomes such as mortality and failure to rescue, albeit the optimal staffing profile remains elusive in workforce planning.

This article is protected by copyright. All rights reserved.

Patient safety culture among European cancer nurses—An exploratory, cross‐sectional survey comparing data from Estonia, Germany, Netherlands, and United Kingdom

Abstract

Aim

To explore the differences in perceived patient safety culture in cancer nurses working in Estonia, Germany, the Netherlands, and the United Kingdom.

Design

An exploratory cross‐sectional survey.

Methods

In 2018, 393 cancer nurses completed the 12 dimensions of the Hospital Survey on Patient Safety Culture.

Results

The mean score for the overall patient safety grade was 61.3. The highest rated dimension was “teamwork within units” while “staffing” was the lowest in all four countries. Nurses in the Netherlands and in the United Kingdom, scored higher on “communication openness”, the “frequency of events reported”, and “non‐punitive response to errors”, than nurses from Estonia or Germany. We found statistically significant differences between the countries for the association between five of the 12 dimensions with the overall patient safety grade: overall perception of patient safety, communication openness, staffing, handoffs and transitions and non‐punitive response to errors.

Conclusion

Patient safety culture, as reported by cancer nurses, varies between European countries and contextual factors, such as recognition of the nursing role and education have an impact on it. Cancer nurses’ role in promoting patient safety is a key concern and requires better recognition on a European and global level.

Impact

Cancer Nursing Societies in any country can use these data as an indication on how to improve patient care in their country. Recognition of cancer nursing as a distinct specialty in nursing will help to improve patient safety.

Reasons for choosing or refusing care from a nurse practitioner: Results from a national population‐based survey

Abstract

Aim

To understand the public's willingness or lack thereof, to be seen and treated by a nurse practitioner (NP) as the first point of contact when accessing healthcare services.

Design

This cross‐sectional, population‐based survey study used computer assisted telephone interviewing to elicit public opinions on the topic.

Methods

Data were collected in July and August 2015 from calls randomly placed to Australian households. Survey questions were developed from previous surveys and pilot tested. Summative content analysis was used to analyse open‐ended responses.

Results

Most respondents were always, or in some situations, willing to receive care from a nurse practitioner. The main themes identified from those willing to be seen by a nurse practitioner in any situation were, (a) appropriately qualified nurse practitioners, (b) the knowledge and experience to refer on if necessary. Description of situations from those unwilling to be seen by a nurse practitioner related to concern about appropriate care in a life‐threatening condition.

Conclusion

Respondents unwilling to consider any care from a nurse practitioner or care in an emergency situation, reveal a lack of understanding of their role in the wider healthcare team. As the number of nurse practitioners increase, professional groups and community awareness programmes should be focused on explaining and promoting their essential role.

Impact

This study addresses the increasing healthcare requirements of ageing populations through understanding acceptance by society to the provision of care from health professionals other than medical practitioners.

Most respondents were willing to be seen by a nurse practitioner for all or most of their healthcare needs. Lack of understanding of their scope of practice and role in the wider healthcare team, particularly in emergency situations, was reflected in responses. Those who would refuse care from a NP were in the minority. Appropriateness and acceptability of the roles of health professionals to provide quality care collaboration need consideration by policy makers.

Involving caregivers in self‐management interventions for patients with heart failure and chronic obstructive pulmonary disease. A systematic review and meta‐analysis

Abstract

Aim

To quantify the impact of involving caregivers in self‐management interventions on health‐related quality of life of patients with heart failure or chronic obstructive pulmonary disease.

Design

Systematic review, meta‐analysis.

Data sources

Searched: Medline Ebsco, PsycINFO, CINAHL, Embase, Web of Science, The British Library and ProQuest. Search time frame; January 1990–March 2018.

Review Methods

Randomized controlled trials involving caregivers in self‐management interventions (≥2 components) compared with usual care for patients with heart failure or chronic obstructive pulmonary disease. A matched sample based on publication year, geographic location and inclusion of an exercise intervention of studies not involving caregivers were identified. Primary outcome of analysis was patient health‐related quality of life.

Results

Thirteen randomized controlled trials (1,701 participants: 1,439 heart failure; 262 chronic obstructive pulmonary disease) involving caregivers (mean age 59; 58% female) were identified. Reported patient health‐related quality of life measures included; Minnesota Living with Heart Failure questionnaire, St. George's respiratory questionnaire and Short‐Form‐36. Compared with usual care, there was similar magnitude in mean improvement in patient health‐related quality of life with self‐management interventions in trials involving caregivers (SMD: 0.23, 95% confidence interval: −0.15–0.61) compared with trials without caregivers (SMD: 0.27, 0.08–0.46).

Conclusion

Within the methodological constraints of this study, our results indicate that involving caregivers in self‐management interventions does not result in additional improvement in patient health‐related quality of life in heart failure or chronic obstructive pulmonary disease. However, involvement of caregivers in intervention delivery remains an important consideration and key area of research.

Impact

Greater understanding and awareness is needed of the methodology of caregiver engagement in intervention development and delivery and its impact on patient outcomes.

The prescribing needs of community practitioner nurse prescribers: A qualitative investigation using the theoretical domains framework and COM‐B

Abstract

Aim

With several qualified community practitioner nurse prescribers (CPNPs) not prescribing, this research aimed to understand what influences this behaviour.

Design

A qualitative research design.

Methods

Semi‐structured interviews, based on the theoretical domains framework (TDF) were conducted with 20 CPNPs. Data collection took place between March‐July 2018 and continued until data saturation was reached.

Results

Nine themes inductively explained prescribing behaviour: 1) ‘Knowledge and experience’; 2) ‘Consultation and communication skills’; 3) ‘Professional confidence and identity’; 4) ‘Wanting the best outcome’; 5) ‘NHS versus patient cost’; 6) ‘Emotion‐led decisions’; 7) ‘Time allocation’; 8) ‘Formulary access’ and 9) ‘Supporting environment for patient‐centred care’. Themes were then deductively mapped to the TDF and COM‐B.

Conclusion

There is an ongoing need to support community practitioner nurse prescribers’ ‘Capability’ to prescribe in terms of knowledge and aquired skills; ‘Opportunity’ to make prescribing easier, such as access to a wider and up to date nurse formulary alongside effective clinical support; and ‘Motivation’ to feel confident in prescribing behaviour, highlighting positive patient outcomes while reducing perceived issues such as cost and non‐adherence.

Impact

Findings show that Capability, Opportunity and Motivation all influence the decision to prescribe. Those responsible for professional regulation and training should ensure community practitioner nurse prescribers have access to the relevant knowledge, skills and formulary to facilitate their prescribing behaviour. Professional confidence and identity as a prescriber should be encouraged, with acknowledgment of influences such as cost and emotion. An environment that allows for patient‐centred care and the best outcome should be supported, this may mean increasing time allocated to consultations.

Implementation of Nurse‐Driven HIV Screening Targeting Key Populations in Emergency Departments: A Multilevel Analysis From the DICI‐VIH Trial

Abstract

Background

In countries with concentrated HIV epidemics, optimizing screening to reach individuals with undiagnosed infection is essential. The DICI‐VIH study, a cluster‐randomized crossover trial conducted in eight French emergency departments (EDs), found that a strategy combining nurse‐driven targeted HIV screening with routine diagnostic testing was effective.

Aim

The aim was to investigate factors associated with the implementation of HIV screening targeting key populations in EDs.

Methods

A self‐administered questionnaire was distributed at registration to patients aged 18–64 years and able to give consent during the DICI‐VIH intervention. Based on their responses, those belonging to key populations were offered a rapid test by triage nurses. Two key stages of the process were evaluated: questionnaire distribution by providers and test acceptance by patients. Patient information, daily workload, and ED characteristics were collected. The associations between these variables and (a) the proportion of questionnaires distributed and (b) the proportion of tests accepted were evaluated using multilevel modeling in order to examine differences in screening implementation between EDs.

Results

Questionnaire distribution proportions varied from 23% to 48% across EDs. They were higher on weekdays than weekends (odds ratio, OR: 3.77; 95% CI: 3.57–3.99) and when research staff participated (OR: 1.31; 95% CI: 1.26–1.37). They decreased over time (OR: 0.76; 95% CI: 0.71–0.82; 4th [Q3] vs. 1st quartile [Q0] of intervention days) and with increased patient flow (OR: 0.61; 95% CI: 0.56–0.67; Q3 vs. Q0 of eligible patients). Test acceptance varied from 64% to 77% across EDs, increased with research staff participation (OR 1.20; 95% CI: 1.03–1.40), and decreased over time (OR: 0.75; 95% CI: 0.60–0.92; Q3 vs. Q0). Patients who accepted were more likely to be younger (OR: 0.76; 95% CI: 0.61–0.96; 50–64‐year‐old vs. 30–39‐year‐old patients).

Linking Evidence to Action

Patient flow, intervention duration, weekdays, and research staff participation were important determinants of targeted screening implementation. These findings could help guide future implementation in similar settings.

Knowledge and Use of the ICM Global Standards for Midwifery Education

A skilled professional midwifery workforce has been promoted as a way to improve maternal and child health worldwide and decrease the rates of maternal mortality and morbidity (United Nations, 2015; World Health Organization (WHO), 2015; WHO, 2019). Where midwives are educated and regulated to international standards, it is estimated that they can provide 87% of the essential sexual and reproductive health services for women and neonates (United Nations Population Fund, 2014; Renfrew et al, 2014), “could avert over 80% of all maternal deaths, stillbirths and neonatal deaths” (Homer et al, 2014), as well as provide safe high-quality, culturally appropriate care to women and neonates.

Mediterranean Diet, Body Composition, and Activity Associated With Bone Health in Women With Fibromyalgia Syndrome

imageBackground There is very little scientific literature on the potential relationships between modifiable factors, including body composition, dietary pattern and physical activity (PA), and bone status in patients with fibromyalgia—a musculoskeletal condition characterized by chronic, widespread pain that is often accompanied by a broad spectrum of symptoms. Objectives The aim of the study was to investigate the impact of body composition parameters, adherence to the Mediterranean diet (Med Diet), and PA on bone health in a population of premenopausal and postmenopausal women with fibromyalgia syndrome (FMS). Methods Ninety-five women diagnosed with FMS were included in this cross-sectional study. Body composition, including fat mass, percentage of fat mass, and lean mass (LM), were calculated using a body composition analyzer. Adherence to the Med Diet was measured through a validated 14-item questionnaire. The International Physical Activity Questionnaire was used to assess PA. Bone mass at the calcaneus was estimated through quantitative ultrasound. Results Linear regression analysis revealed that LM had a significant association with broadband ultrasound attenuation (β = 0.211, 95% CI [0.046, 1.259], p = .035) and stiffness index parameters (β = 0.201, 95% CI [0.019, 1.654], p = .045) after adjusting for age and menopausal status. The Med Diet was also significantly associated with broadband ultrasound attenuation (β = 1.693, 95% CI [0.508, 2.879], p = .006). Discussion LM and the Med Diet were consistently associated with calcaneal quantitative ultrasound parameters, supporting the hypothesis that LM and adherence to the Med Diet play determinant roles in bone health in FMS women. Training programs to maximize LM and strategies for promoting good adherence to the Med Diet should be considered in order to prevent the development of osteoporosis in FMS women. Because nurses are involved in implementing preventive programs, their roles in promoting this adherence to the Med Diet and maximizing LM in patients with FMS should help reduce the impact of osteoporosis.

Symptom Experience of Older Adults With Type 2 Diabetes and Diabetes-Related Distress

imageBackground An older, more diverse population and longer life spans are major contributors to the anticipated tripling of Type 2 diabetes prevalence by 2050. Diabetes-related distress affects up to 40% of people diagnosed with Type 2 diabetes and may be a greater risk for older adults due to greater prevalence of comorbidities. Objective The objective of this phenomenological study was to describe how diabetes-related distress in older adults (≥65 years) with Type 2 diabetes might be uniquely experienced. Methods Participants were recruited using convenience sampling and snowball sampling. Interpretive phenomenology guided the research design and analysis. With interpretive interviews, we investigated the everyday health, symptoms, and life experiences of living with Type 2 diabetes and elevated diabetes distress. Results Among the older adults in this study, the most prevalent symptoms were fatigue, hypoglycemia, diarrhea, pain, loss of balance, and falling. These diabetes-related symptoms led to substantial loss of independence, decreased quality of life, and constrained social lives due to restricted activities. Discussion Diabetes-related distress presents with some unique symptoms and responses in older adults. Improving knowledge regarding the symptom experience of older adults with diabetes-related distress may allow healthcare providers to tailor treatment and thus improve outcomes for older adults struggling with diabetes.

Addressing Health Disparities in America: Analysis of Community Health Improvement Plans

imageBackground Healthy People 2020 has made achieving health equity one of its overarching goals; another goal is increasing the number of accredited local agencies that have Community Health Improvement Plans (CHIPs). Community Health Improvement Plans are meant to serve agencies as guiding documents for multiple years. Objectives This study investigates the prevalence with which health disparities are addressed within CHIPs and the specific health disparities targeted by these objectives. Methods Researchers analyzed 4,094 objectives from CHIPs of 280 local Public Health Accreditation Board (PHAB)-accredited and nonaccredited public health agencies in the United States. Results Despite the PHAB's focus on addressing health equity, not all PHAB-accredited agencies addressed health disparities (85.4% of CHIPs analyzed). However, more accredited than nonaccredited agencies (73.9%) contained at least one objective focused on health disparities. Discussion Findings indicate that if health equity is truly a goal of national initiatives, agencies' planning documents (e.g., CHIPs) can do a better job addressing commonly ignored populations.

Perceived threats, benefits and barriers of e-cigarette use during pregnancy. A qualitative analysis of risk perception within existing threads in online discussion forums

Previous studies have shown that e-cigarettes are perceived as being less harmful than tobacco cigarettes by pregnant women and might be used to quit smoking during pregnancy. Our aim was to further explore and characterise perceived threats, benefits and barriers of e-cigarette use during pregnancy.

Revalidation of a Perioperative Risk Assessment Measure for Skin

imageBackground Validated perioperative pressure injury (PI) risk assessment measures are few and often cumbersome to complete, leading to missed opportunities to identify and target prevention interventions to those patients at increased risk for developing a postsurgical PI. Objectives Previous validation of a six-item perioperative risk assessment measure for skin (PRAMS) was conducted in our community hospital with positive findings. The purpose of this study was to increase generalizability by revalidating the PRAMS in a larger sample. Methods This was a retrospective chart review of all surgical patients aged ≥18 years positioned in the supine or lateral position in a Midwest quaternary care, multispecialty, 1,500-bed hospital during a 6-month period (n = 1,526). The intent of the study was to revalidate the PRAMS. The main outcome of interest was the development of PI after surgery. Risk indicators of interest included diabetes, age, surgical time, Braden score, previous surgery, and preexisting PI. The diagnostic ability of any of the risk indicators on the development of a postsurgical PI was evaluated using sensitivity, specificity, and predictive values. Results Postsurgical PIs occurred in 121 patients. Comparing current to previous study results, the PRAMS was effective in identifying surgical patients at risk for PI (sensitivity = .98). Those patients with a postsurgical PI had a lower mean Braden score, were more likely to have a preexisting PI, and were more likely to have a previous surgery during the same admission (p

Development of a Care Delivery Model for High-Need Older Adults in the Community

imageBackground High-need older adults have multiple needs and require different types of care services. Care coordinators in community care centers in Taiwan, however, often experience difficulties in providing sufficient care services because of the inadequate capacity of case management. Objective The aim of this study was to develop a realistic care delivery model for the care coordinators to manage the care of high-need, community-dwelling older adults. Methods Focus-group interviews concerning elements and process for establishing a care delivery model were conducted with 12 care management experts in two groups: the practical work group (three registered nurses and three social workers) and the care management group (three care managers and three care management supervisors). The interviews were video-recorded and subjected to content analysis. Results A five-stage care delivery model was formulated: case screening, case assessment, care plan, care delivery, and follow-up evaluation. Six types of high-need older adults were identified: those living with disability, solitude, dementia, depression, elder abuse, and poverty. A list of categorized care services, including care resources, social welfare resources, and caregiver resources, was then used as a guide for case management and care delivery. Discussion The developed model—consisting a classification of services for different types of high-need older adults—serves as a guide for care coordinators in community care centers to make better decisions on service linkages, resource management, and care plan monitoring.

Experience of Perinatal Death From the Father’s Perspective

imageBackground Although perinatal deaths are still a common pregnancy outcome in developing countries, little is known about the effect perinatal death has on fathers. Objective The aim of the study was to understand and describe the meaning of perinatal death in a sample of fathers from northeastern Colombia. Methods Using purposive and snowball sampling approaches, we identified 15 participants from northeastern Colombia who agreed to participate. We used a descriptive phenomenological design. Data were collected through in-depth, semistructured interviews. Results Men suffer in solitude and hide their emotions as they feel the need to be the main supporters of their partners. Three major themes emerged: experience of loss, coming to terms with an irreparable loss, and overcoming the loss. Discussion While women are receiving care, health staff may neglect or forget men. Men suffer alone while seeking ways of attunement with their partners’ emotions to support them during the grieving process. Fathers can overcome and adjust to the loss when they transcend it and find new meaning. Men felt neglected and marginalized at hospitals while their partners were receiving treatment. Health professionals should recognize and acknowledge the pain of fathers who face perinatal death and include them as much as possible in the standard of care. The results identify opportunities for healthcare providers in clinical and outpatient settings to acknowledge the importance of men within the context of pregnancy and to learn about their pain and suffering when they face a perinatal death.
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