Abstract
Purpose
To determine the factors that influenced the difficulties faced by midwives and nurses when caring for fathers of stillborn infants.
Methods
This was a descriptive cross-sectional survey using an 18-item Difficulties questionnaire with a Cronbach's alpha .932 (range .77-.92) and established face validity. The score ranged from 18-72 and the higher score indicated greater difficulty. The survey was provided to a purposive sample of 730 midwives and nurses from 39 hospitals (perinatal medical centers and maternity wards of general hospitals) in the Kanto region. The 451 (85.3%) valid responses were analyzed statistically.
Results
1. The average Difficulties score when caring for fathers of stillborn infants was 54.0±9.2 points (range 18-72). Difficulties were characterized by four factors: (a) difficulty facing fathers showing their grief reactions (which scored the highest; (b) bringing out fathers' hopes; (c) dealing with fathers who showed denial and (d) managing midwives' and nurses' own emotions when dealing with fathers. Especially difficult for midwives and nurses to manage were fathers: distrusting health care providers, showing anger, not expressing their feelings, and keeping up appearances.
2. The relevant factors that affected the difficulties in caring for fathers of stillborns, particularly for the primary nurses were: knowledge of parents' grief, seeing and hearing the parents experience of loss, and experiencing the care of many cases of stillbirth.
3. Difficulties in caring for fathers of stillborn infants, weakly and negatively correlated with the knowledge of the parents' grief (r=-.38, p=.001), on the other hand, less difficulties in care was weakly and positively correlation with improvement of care for fathers (r=.27, p=.001).
Conclusion
Although the most difficult aspect in caring for fathers was facing fathers who were showing their grief reaction, increased knowledge about grief and how to care for them reduced midwives' and nurses' difficulties. Therefore there is a need to develop continuing education programs for midwives and nurses that focus on fathers regarding caring for pregnancy related losses such as stillbirth and infant.
