Nursing interventions for perinatal bereavement care in neonatal intensive care units: A scoping review

Abstract

Background Despite technological advances and specialist training of neonatal teams, perinatal deaths still occur. Such events are traumatic experiences for the parents and increase the risk of pathological grieving. Nursing is one of the main sources of support. However, the important work of nurses in these situations is made more difficult by the lack of recognized strategies that can be implemented to assist parents and family members in the bereavement process.

Aim Identify nursing interventions to help parents of neonates admitted to neonatal intensive care units cope with perinatal loss.

Methods A scoping review based on the methodological framework established by Arksey and O'Malley was used. A total of 327 relevant studies were identified through a bibliographic search in Pubmed, CINAHL Plus, APA PsycNET and Scopus between 2000 and 2019. The screening process included an initial analysis of the relevance of the abstract and, when required, an extensive review of the full paper.

Results A total of 9 papers were finally selected which responded to the research question. All nine papers are from the USA and have different methodological characteristics. A number of effective interventions were identified, including legacy creation, support groups, family‐centred accompaniment and follow‐up, parental involvement in pre‐mortem care, intergenerational bereavement programmes, and the use of technological and spiritual resources.

Conclusion In general, the scant evidence that is available about nursing interventions around perinatal bereavement care underlines the requirement to thoroughly assess the effectiveness of those that have already been designed and implemented.

Implications for nursing practice and policy This scoping review contributes to the potential implementation of effective interventions to deal with and help parents and family members cope with perinatal bereavement, with nursing staff as the main source of support and leading interventions which have family members in the care team. This review also makes a substantial contribution to the development of a practical and evidence‐based clinical guide for nursing, with recommendations that can be adapted to effective quality care criteria. It is additionally intended to encourage visibility in health policies of care and attention to perinatal grief in neonatal intensive care units.