'In the hospital there are no care guidelines': experiences and practices in perinatal loss in Spain.

BACKGROUND AND OBJECTIVES: Healthcare professionals play an important role in supporting and attending to families that experience a perinatal loss. Previous research has identified the existence of obstacles that professionals may encounter during their practices. The main objective of the current research was to identify and examine the subjective experiences and practices of experienced professionals attending to perinatal loss in the hospital context in Spain. DESIGN: Qualitative descriptive design. SETTING: Three different hospitals in Spain. PARTICIPANTS: Sixteen professionals were interviewed, including doctors, nurses, midwives, nursing assistants, a psychologist and a funeral home manager. METHODS: Individual semi-structured interviews focusing on three areas were carried out: practices with the baby-foetus, practices with parents and interaction with the team. A thematic analysis was performed using the three main focuses of the semi-structured interview (deductive approach) and the codes that emerged from the data (inductive approach). RESULTS: Regarding guideline-based care for the baby/foetus, participants made a distinction between the initial process of care for the baby and the decision-making process with parents. Where support for families was concerned, participants identified considerable variability in the practices used and lack of organisational and care guidelines, psychological support and follow-up. Finally, interactions with other team members were perceived as a source of support, although participants identified a significant lack of coordination. CONCLUSION: Participants reported variability of practices in care for the baby and parents, lack of continuity-of-care guidelines and the importance of support from a coordinated healthcare team.

The concept of death in children aged from 9 to 11 years: Evidence through inductive and deductive analysis of drawings.

The objective of the research was to analyze children's conceptualization of death through drawings, using a mixed approach, which combines deductive and inductive qualitative analysis. The sample consisted of 99 children aged 9-11 years, who were asked to elaborate a drawing about their idea of death and to explain it to the researchers. Drawings were coded basing on Tamm and Granqvist's model (deductive analysis) and codes and categories were created and modified (inductive analysis). Three main categories were identified in the analysis and four sub-categories were modified and/or created: causes of death, good death, anxiety-fear and symbolization.

Efectividad de un plan de apoyo a cuidadores en dos hospitales públicos de Granada (España) / Effectiveness of a Plan to Support Caregivers at Two Public Hospitals in Granada (Spain) / Efetividade de um plano de apoio a cuidadores em dois hospitais públicos de Granada (Espanha)

Objetivo: dos hospitales granadinos realizan una experiencia pionera implementando medidas de apoyo innovadoras para personas cuidadoras. Transcurridos dos años desde su implantación se plantea: ¿Las medidas implementadas han logrado los beneficios esperados en personas cuidadoras en hospitalización? Para responder se realiza un estudio con el objetivo de evaluar la efectividad de las medidas de apoyo a personas cuidadoras incluyendo propuestas de mejora. Materiales y métodos: estudio cualitativo, interpretativo, basado en la Teoría Fundamentada. Se realizaron 45 entrevistas en profundidad a personas cuidadoras con distintos perfiles, en los hospitales Virgen de las Nieves y Baza. Se ha seguido como estrategia de análisis la comparación constante y la codificación abierta y axial. Se contó con el apoyo del software Atlas.ti®. Resultados: las personas cuidadoras valoran positivamente la mayoría de las medidas, destacando personalización, educación, hostelería y accesos prioritarios. La identificación de enfermera y auxiliar referentes no siempre ha funcionado bien. La utilización de zonas de descanso habilitadas ha sido escasa, debido principalmente a su ubicación. Conclusiones: las medidas implementadas han mejorado el bienestar y la autoestima de las personas cuidadoras durante la hospitalización. Aportan una evidencia que anima a extenderlas a otros hospitales y mejorar el trato y el apoyo a este colectivo.

Purpose: Two hospitals in Granada are involved in a pioneering experience to implement innovative measures to support caregivers. Two years after the onset of that initiative, the question is: Are the measures implemented achieving the expected benefits for caregivers during hospitalization? A study was conducted to answer that question by evaluating the effectiveness of those measures, including suggestions for improvement. Study Materials and Methods: This is a qualitative, interpretive study based on grounded theory. Forty-five (45) in-depth interviews were conducted at the Virgen de las Nieves and Baza hospitals with caregivers who have different profiles. The strategy for analysis involved constant comparison and open and axial coding, supported by Atlas.ti® software. Results: The caregivers reacted positively to most of the measures, highlighting personalization, education, accommodation and priority access. Use of the term nurse and auxiliary nurse as a form of identification has not always worked well. Only limited use has been made of the areas outfitted for rest and relaxation, mainly due to their location. Conclusions: The measures implemented have improved the well-being and self-esteem of caregivers during hospitalization. Moreover, they provide evidence that encourages their extension to other hospitals to improve the way this group is treated and the support it receives.

Objetivo: dois hospitais granadinos realizam uma experiência pioneira implementando medidas de apoio inovadoras para pessoas cuidadoras. Transcorridos dois anos de sua implantação, propõe-se: as medidas implantadas têm atingido os benefícios esperados em pessoas cuidadoras em hospitalização? Para responder a essa pergunta, realiza-se um estudo com o objetivo de avaliar a efetividade das medidas de apoio a pessoas cuidadoras em que são incluídas propostas de melhoria. Materiais e métodos: estudo qualitativo, interpretativo, baseado na Teoria Fundamentada. Realizaram-se 45 entrevistas em profundidade a pessoas cuidadoras com diferentes perfis, nos hospitais Virgen de las Nieves e Baza. Como estratégia de análise, foi seguida a comparação constante e a codificação aberta e axial. Contou-se com o apoio do software Atlas.ti®. Resultados: as pessoas cuidadoras valorizam positivamente a maioria das medidas e destacam: personalização, educação, hotelaria e acessos prioritários. A identificação de enfermeira e auxiliar referentes nem sempre tem funcionado bem. A utilização de áreas de descanso habilitadas é escassa, devido, principalmente, a sua localização. Conclusões: as medidas implantadas têm melhorado o bem-estar e a autoestima das pessoas cuidadoras durante a hospitalização. Além disso, estimulam sua extensão a outros hospitais e melhoram o tratamento e o apoio a esse coletivo.