Subject(s)
Caregivers , Translational Research, Biomedical , Humans , Chronic Disease , Child , Caregivers/education , Caregivers/psychology , Male , Female , Pediatric Nursing/educationSubject(s)
Parenting , Translational Research, Biomedical , Humans , Female , Adaptation, Psychological , MothersSubject(s)
COVID-19 , Nurses, Pediatric , Humans , Child , Translational Research, Biomedical , Pandemics , Pediatric Nursing , Anxiety/epidemiology , ParentsSubject(s)
Parenting , Translational Research, Biomedical , Child , Chronic Disease , Delivery of Health Care , Humans , Parents , Stress, PsychologicalABSTRACT
PURPOSE: To describe experiences of women disclosing a nonlethal fetal anomaly diagnosis to family and friends from initial prenatal diagnosis through postpartum. STUDY DESIGN AND METHODS: A descriptive, qualitative approach was used to explore women's perceptions of nonlethal fetal anomaly diagnosis in a high-risk obstetric clinic. In-depth interviews were conducted with 10 pregnant women, followed by postpartum interviews with 8 women. Data were analyzed using thematic analysis. RESULTS: Analysis of semistructured interviews revealed an overarching theme, Pregnancy Forever Changed, which captured the experience when expectant women first heard the news about their fetus. Prenatal themes were News of a Diagnosis, No Going Back; A Mother's Response: Managing Information; and Words from Others Matter. Women's struggles continued into postpartum, The Journey Continues: Echoing Past Concerns; and Not the Journey We Planned. CLINICAL IMPLICATIONS: Women with a nonlethal fetal anomaly diagnosis experienced distress and stigma about disclosure of the diagnosis to others. Distress with disclosure continued throughout the pregnancy and extended into postpartum. Women described negative responses from others and ongoing management of information as stressful and painful. Clinicians are aware disclosing a lethal diagnosis is distressing for women but may not understand the experience of women with a nonlethal diagnosis. An appreciation of women's distress on disclosure of nonlethal fetal anomaly diagnoses can guide practice for maternity, neonatal, and pediatric nurses providing interventions that include information and anticipatory guidance.
Subject(s)
Friends , Obstetric Labor Complications , Child , Female , Humans , Infant, Newborn , Postpartum Period , Pregnancy , Pregnant Women , Prenatal Diagnosis , Qualitative ResearchSubject(s)
Child, Hospitalized , Patient Safety , Child , Humans , Pediatric Nursing , Translational Research, BiomedicalSubject(s)
Parenting , Translational Research, Biomedical , Child , Family , Humans , Outcome Assessment, Health Care , Parent-Child Relations , ParentsSubject(s)
Nursing Research , Translational Research, Biomedical , Child , Humans , Knowledge , Pediatric NursingABSTRACT
Normalization of deviance is a phenomenon demonstrated by the gradual reduction of safety standards to a new normal after a period of absence from negative outcomes, which suggests that the absence of negative outcomes tends to reinforce the behaviors associated with cutting corners, bypassing safety checklists, and ignoring alarms. While the concept was first identified within the National Aeronautics and Space Administration, it has a strong, dangerous presence within health care, holding specific peril within high-risk environments such as the operating room. The aims of this article are to (1) analyze the concept of normalization of deviance and (2) identify the role of normalization of deviance with respect to the behavior of nurses in high-risk health care environments to prevent adverse patient outcomes. The steps outlined by Walker and Avant are applied to guide the concept analysis.
