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Optimising Psychosocial Interventions for Parents Following Perinatal Bereavement: A Qualitative Study of Midwives' Perspectives

ABSTRACT

Aim

To explore midwives' experiences of providing psychosocial interventions to parents following perinatal bereavement in maternity care settings.

Design

A descriptive qualitative study.

Methods

Twenty-two midwives were recruited from three maternity services in Ireland using purposive and snowball sampling. Semi-structured interviews were conducted between July and November 2024. Reflexive thematic analysis was used to analyse the data.

Results

Four themes were identified: (1) Building relationships as a foundation for psychosocial intervention delivery; (2) Psychosocial intervention as the core element of perinatal bereavement care; (3) Negotiating intervention delivery in a constrained system; and (4) Navigating emotional labour and professional growth. Midwives advocated provision of compassionate and relationship-based psychosocial interventions, but often faced systemic barriers, limited guidance, and insufficient training. Supportive structures and psychosocial intervention focused training were seen as critical to sustaining care quality and midwives' wellbeing.

Conclusion

Applying the Socio-Ecological Model (SEM) revealed that midwives' delivery of PSIs to support grieving parents after perinatal bereavement is influenced by multi-level factors, underscoring the need for policy integration, institutional support, and contextually grounded, midwife-led approaches.

Implications for the Profession and/or Patient Care

Integrating SEM into intervention design can guide the development of multi-component PSIs that address multilevel influences and align with both parents' needs and midwives' capacities.

Impact

This adds to the understanding of how midwives deliver psychosocial interventions in perinatal bereavement care. Midwives view the delivery of these interventions as central to their role, while acknowledging the need for the development of, and training in structured, midwife-led psychosocial interventions in perinatal bereavement care.

Reporting Method

COREQ.

Patient or Public Contribution

Patients and members of the public were involved in study design, data collection and validation of findings. Their contributions included reviewing protocols and recruiting materials, facilitating recruitment and participating in advisory groups, ensuring the relevance and sensitivity of the research.

Ignite the Parent–Child Bond: A Qualitative Exploration of Perspective and Need About Family Functioning Among Patients With Advanced Cancer and Their Adolescent Children

ABSTRACT

Background

Advanced cancer not only affects the physical, psychological, and social functions of patients, but it also impacts their adolescent children. There is a dearth of information regarding the understanding of family functioning and specific needs of patients with advanced cancer and their adolescent children.

Purpose

This qualitative study aimed to explore the experience and needs regarding family functioning of patients with advanced cancer and their adolescent children, as well as understanding potential approaches for maintaining positive family functioning.

Design

A descriptive qualitative study was employed.

Settings and Participants

This study was conducted at three tertiary hospitals in Changsha, China, from January to September 2023. Purposive sampling was adopted to recruit participants. 17 stage III and IV patients with cancer and 11 adolescent children were interviewed.

Methods

Face-to-face individual interviews were conducted among patients with advanced cancer and their adolescent children. The data analysis employed Braun and Clarke's thematic analysis method. The McMaster family functional model theoretical framework was utilised to facilitate the identification and organisation of topics, ensuring a comprehensive analysis of the data.

Findings

Six themes were identified: communication challenges; impaired family role functioning; positive/negative feelings; over-involvement; change of behaviour control pattern; Needs for medical and psychological support. Both patients with advanced cancer and their adolescent children expressed collective views and needs regarding family functioning.

Conclusions

The findings of this study reveal an understanding of family functioning and needs among patients with advanced cancer and their adolescent children. The identified themes provide valuable insights for designing and implementing targeted intervention strategies.

Clinical Relevance

Nursing interventions should focus on helping patients with advanced cancer and their adolescent children improve family functioning and communication skills. The findings indicate that communication challenges are a significant aspect of impaired family functioning, necessitating targeted interventions to enhance communication. Healthcare providers should be trained to recognise the diverse communication needs of families, which include providing resources for age-appropriate communication, counselling, and guidance on maintaining family routines. Enhancing the communication skills of patients and their children is crucial for addressing problem-solving needs and mitigating negative feelings, thereby fostering a more supportive family environment.

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