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Published on: June 13, 2021
Experiences and impacts of psychological support following adverse neonatal experiences or perinatal loss: a
Gill Thomson1, Lara McNally2, Rebecca Nowland2
1School of Nursing and Midwifery, University of Central Lancashire, Preston, UK. Gthomson@uclan.ac.uk.
Insights
Psychological support for parents experiencing neonatal care or perinatal loss significantly improved well-being and coping. Key factors for effective support included flexibility, tailored communication, and independent, non-judgmental therapeutic relationships.
Area of Science:
- Perinatal mental health
- Psychological support services
- Qualitative research
Background:
- Parental mental health issues in the perinatal period negatively impact parents and infants.
- Parents of premature/sick infants or those experiencing perinatal loss face higher risks of adverse mental health outcomes.
- The Family Well-being Service (FWS) was established to provide psychological support for these at-risk parents.
Purpose of the Study:
- To qualitatively evaluate the effectiveness and user experience of the Family Well-being Service (FWS).
- To identify key mechanisms contributing to the success of psychological support for parents facing neonatal or perinatal loss challenges.
Main Methods:
- Conducted 37 semi-structured interviews with service users, FWS providers, and healthcare professionals.
- Utilized thematic analysis to code and interpret interview data.
Main Results:
- Thematic analysis revealed two key themes: 'Creating time and space for support' and 'making a difference'.
- Service users valued tailored communication, flexibility, independence from healthcare, and non-judgmental listening.
- Support led to improved coping strategies, enhanced well-being, better relationships, and increased confidence.
Conclusions:
- Findings offer new insights into therapeutic support for parents with adverse neonatal experiences or perinatal loss.
- Effective support mechanisms include clear information, flexibility, independence, individual focus, active listening, therapeutic tools, and positive therapist relationships.
- Further strategies are needed to engage individuals hesitant to seek mental health support.
Background:
Poor parental mental health in the perinatal period has detrimental impacts on the lives and relationships of parents and their babies. Parents whose babies are born premature and/or sick and require neonatal care or those who experience perinatal loss are at increased risk of adverse mental health outcomes. In 2021 a North-West charity received funding to offer psychological support to service users of infants admitted to neonatal care or those who had experienced perinatal loss, named the Family Well-being Service (FWS). The FWS offered three different types of support - ad hoc support at the neonatal units or specialist clinics; one-to-one person-centred therapy; or group counselling. Here we report the qualitative findings from an independent evaluation of the FWS.
Methods:
Thirty-seven interviews took place online or over the phone with 16 service users (of whom two took part in a follow-up interview), eight FWS providers and 11 healthcare professionals. Interviews were coded and analysed using thematic analysis.
Results:
The analysis revealed two themes. 'Creating time and space for support' detailed the informational, contextual, and relational basis of the service. This theme describes the importance of tailoring communications and having a flexible and proactive approach to service user engagement. Service users valued being listened to without judgement and having the space to discuss their own needs with a therapist who was independent of healthcare. Communication, access, and service delivery barriers are also highlighted. The second theme - 'making a difference' - describes the cognitive, emotional, and interpersonal benefits for service users. These included service users being provided with tools for positive coping, and how the support had led to enhanced well-being, improved relationships, and confidence in returning to work.
Conclusion:
The findings complement and extend the existing literature by offering new insights into therapeutic support for service users experiencing adverse neonatal experiences or perinatal loss. Key mechanisms of effective support, irrespective of whether it is provided on a one-to-one or group basis were identified. These mechanisms include clear information, flexibility (in access or delivery), being independent of statutory provision, focused on individual needs, active listening, the use of therapeutic tools, and positive relationships with the therapist. Further opportunities to engage with those less willing to take up mental health support should be developed.
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