Application of Caring Theory to Nursing Care of Women Experiencing Stillbirth

Abstract

Purpose: The purpose of this study was to determine the extent to which labor and delivery nurses used the tenets of Swanson's middle-range theory to care for women whose babies were stillborn. Study Design and Methods: A secondary analysis of qualitative in-depth interview data from 20 labor and delivery nurses obtained during a recent grounded theory study was conducted using the directed content analysis method. The five caring processes as described in Swanson's theory were used as a priori codes to conduct the analysis. Results: Nursing care of a woman experiencing a stillbirth included finding a way to connect with her and to understand what she was experiencing (knowing), spending extra time with her (being with), protecting her and preserving her dignity (doing for), providing information and explanations in a clear and methodical manner (enabling), and ensuring that she did not blame herself to facilitate the grieving/healing process (maintaining belief). Clinical Implications: The caring processes outlined in Swanson's theory of caring provide a valuable guide that can be used when caring for women experiencing stillbirth.

Development and Psychometric Validation of the Perinatal Bereavement Care Competence Scale for Midwives

“…On the one hand, this yielded a six-factor model were consistent with Swanson's theoretical framework and our previous findings, demonstrating that the PBCCS has good content validity [23]. On the other hand, our findings provide empirical validation of Swanson's five caring processes and further promote the development of caring theory in the field of perinatal loss [12]. The factor structure of the scale was evaluated by CFA using Sample 2 (n ¼ 254).…”

“…Swanson's Caring Theory can serve as a guide for healthcare professionals offering care to parents who have experienced pregnancy loss [12]. The theory encompasses five processes: (1) ''maintaining belief,'' which refers to conveying confidence and faith that the bereaved parents can get through perinatal loss and face a meaningful future; (2) ''knowing,'' which is trying to understand the meaning of perinatal death for the women and assessing their partners' perspective and family support; (3) ''being with,'' which includes simply being there, sharing grief feelings, and conveying ongoing availability without burdening the bereaved parents; (4) "doing for," which is anticipating and meeting bereaved parents' needs, with a focus on protecting them from harm and protecting their dignity; and (5) "enabling," which is facilitating the bereaved parents' capacity to grow using professional knowledge and information and helping them focus on important issues and generating alternatives [13,14].…”

The implementation of a caring safety model to decrease adverse events

“…Nursing care interventions, maintaining belief, doing for, knowing, and being with, were found to be effective as spiritual therapy in lung cancer patients who suffer from spiritual disorders [34]. This nursing care can also be used as physical and psychological therapies for mothers who deliver babies who died (babies were stillborn) to avoid AEs during and after treatments [35]. Caring is the integration of nursing knowledge to optimize health care and avoid adverse events in patients [36].…”