Abstract:

Objective To understand the needs and attitudes of grief counseling for women with fetal abnormalities,so as to provide references for the grief counseling work in the future. Methods A descriptive qualitative approach was conducted and a total of 19 women with fetal abnormalities were enrolled for semi-structural in-depth interviews between September and November 2020 from a women’s hospital in Hangzhou,Zhengjiang. Colaizzi method was used to analyze the data. Results 3 themes and 13 sub-themes were extracted,including characteristics of grief counseling needs（needs were hidden,needs correspond to stages of psychological development）,content of grief counseling needs （respectful care needs,needs for infant and parents identity,information needs for dead infant treatment,confirmation of decision of induced labor,emotional needs,continuous bonding）,influencing factors of grief counseling needs （popularization of grief counselling,attitudes of family members,traditional thoughts of reincarnation,opinion on grief counseling,attitudes towards the fetus）. Conclusion Nurses should accurately assess grief counseling needs of women with fetal abnormalities induced labor,provide multi-dimensional grief counseling support,and avoid increasing maternal grief reaction while providing grief counseling. Medical institutions should integrate various resources,reduce the factors influencing maternal grief counseling decision-making to alleviate the pressure of the clinical grief counseling and explore the grief counseling working mode based on the needs of women with fetal abnormalities in China.

Key words: Fetal Anomaly, Grief Counseling, Needs, Induced Labor, Qualitative Study, Obstetrical Nursing

摘要：

目的 了解胎儿畸形引产孕产妇哀伤辅导需求及态度,为今后开展该人群的哀伤辅导工作提供参考。 方法 采用描述性质性研究方法,于2020年9月—11月选取浙江省杭州市某妇产科医院的19例胎儿畸形引产孕产妇进行半结构式深入访谈,运用Colaizzi 7步分析法对访谈资料进行分析。结果 共提炼出3个主题、13个亚主题:哀伤辅导需求特征（需求被隐藏、需求与心理发展阶段相对应）、哀伤辅导需求内容（尊重性照护需求、婴儿及父母身份认同需求、死婴处理信息需求、确认引产决策的正确性、情感需求、持续性联结需求）、哀伤辅导需求的影响因素（哀伤辅导普及度、家庭成员态度、传统轮回思想、对哀伤辅导服务的认知、对待胎儿的态度）。 结论 护士应准确评估胎儿畸形引产孕产妇哀伤辅导需求,循序渐进地提供多维度的哀伤辅导支持,避免加重孕产妇哀伤反应。医疗机构应整合多方资源,降低客观因素对孕产妇哀伤辅导决策的影响,进一步探究适合中国胎儿畸形引产孕产妇需求的哀伤辅导工作模式。

关键词: 胎儿畸形, 哀伤辅导, 需求, 引产, 质性研究, 产科护理