Exploring the needs of parents who experience miscarriage in the emergency department: A qualitative study with parents and nurses

Abstract

Aims and objectives: To understand how parents experienced miscarriage in an emergency department setting. Objectives were to identify parents' needs, isolate factors that influenced their experience, and provide recommendations to improve care from the perspective of women, their partners, nurses and nurse managers.

Background: Miscarriage is the most prevalent complication encountered during pregnancy. It subjects parents to a multitude of emotions and may have significant consequences on mental health. Emergency department visits are frequently the only opportunity for parents to receive formal support during a miscarriage; it is thus crucial to understand the experiences of parents in this setting.

Design: The study employed a descriptive, exploratory, qualitative approach with semi-structured interviews.

Methods: The study was founded on the W.K. Kellogg Foundation's Logic Model Development Guide (2004) and Meleis' Transitions Theory (2015). A total of 26 participants were interviewed (17 parents, 7 emergency department nurses and 2 emergency department nurse managers). Consolidated criteria for reporting qualitative research was used to report results.

Results: Three categories of needs were identified: physical health, cognitive and emotional. For instance, parents expressed a need to receive more information during their visit to the emergency department (i.e., a cognitive need), whether about the diagnostic test results or how to ensure a better recovery. Parents also reported a desire for professionals to address their emotional concerns. Nurses were aware of the emotional impact of miscarriage but felt that they were not adequately trained in providing optimal care to parents in this situation.

Conclusions: Parents who visited the emergency department for miscarriage reported several unfulfilled needs that generated dissatisfaction with care. Emergency department organisational constraints hindered optimal nursing care practices.

Relevance to clinical practice: Nurses have an important role to play in improving parents' experience. They can do so by understanding the needs of parents and by being involved in developing new guidelines.

Keywords: bereavement; early pregnancy loss; emergency department; hospital emergency service; miscarriage; nurses; nursing; qualitative research; spontaneous abortion.