Abstract：
OBJECTIVE: To assess the attitudes and care practices of midwives and nurses in the province of Granada in relation to death care and perinatal bereavement, to determine their degree of adaptation to international standards and to identify possible differences in personal factors among those who best adapt to international recommendations.
METHODS: A local survey of 117 nurses and midwives from the five maternity hospitals in the province was conducted using the Lucina questionnaire developed to explore professionals\' emotions, opinions, and knowledge during perinatal bereavement care. Adaptation of practices to international recommendations was assessed using the CiaoLapo Stillbirth Support (CLASS) checklist. Socio-demographic data were collected to establish their association with increased compliance with recommendations.
RESULTS: The response rate was 75.4%, the majority were women (88.9%), with a mean age of 40.9 (SD=1.4) and 17.4 (SD= 10.58) years of work experience. Midwives were the most represented (67.5%) and reported having attended more cases of perinatal death (p = 0.010) and having more specific training (p<0.001.) Of these, 57.3% would recommend immediate delivery, 26.5% would recommend the use of pharmacological sedation during delivery and 47% would take the baby immediately if the parents expressed their wish not to watch them. On the other hand, only 58% would be in favour of taking photos for the creation of memories, 47% would bathe and dress the baby in all cases, and 33.3% would allow the company of other family members. The percentage that matched each recommendation on memory-making was 58%, 41.9% matched the recommendations on respect for the baby and parents, and 23% and 10.3% matched the appropriate delivery and follow-up options, respectively. The factors associated with 100% of the recommendations, according to the care sector, were being a woman, a midwife, having specific training and having personally experienced the situation.
CONCLUSIONS: Although the levels of adaptation observed are more favourable than in other nearby contexts, serious deficiencies are identified in the province of Granada with respect to internationally agreed recommendations on perinatal bereavement care. More training and awareness-raising of midwives and nurses is needed, which also considers factors related to better compliance.
CONCLUSIONS: This is the first study to quantify the degree of adaptation to international recommendations in Spain reported by midwives and nurses, as well as the individual factors associated with a higher level of compliance. Areas for improvement and explanatory variables of adaptation are identified, which allow support for possible training and awareness-raising programmes aimed at improving the quality of care provided to bereaved families.
METHODS: A local survey of 117 nurses and midwives from the five maternity hospitals in the province was conducted using the Lucina questionnaire developed to explore professionals\' emotions, opinions, and knowledge during perinatal bereavement care. Adaptation of practices to international recommendations was assessed using the CiaoLapo Stillbirth Support (CLASS) checklist. Socio-demographic data were collected to establish their association with increased compliance with recommendations.
RESULTS: The response rate was 75.4%, the majority were women (88.9%), with a mean age of 40.9 (SD=1.4) and 17.4 (SD= 10.58) years of work experience. Midwives were the most represented (67.5%) and reported having attended more cases of perinatal death (p = 0.010) and having more specific training (p<0.001.) Of these, 57.3% would recommend immediate delivery, 26.5% would recommend the use of pharmacological sedation during delivery and 47% would take the baby immediately if the parents expressed their wish not to watch them. On the other hand, only 58% would be in favour of taking photos for the creation of memories, 47% would bathe and dress the baby in all cases, and 33.3% would allow the company of other family members. The percentage that matched each recommendation on memory-making was 58%, 41.9% matched the recommendations on respect for the baby and parents, and 23% and 10.3% matched the appropriate delivery and follow-up options, respectively. The factors associated with 100% of the recommendations, according to the care sector, were being a woman, a midwife, having specific training and having personally experienced the situation.
CONCLUSIONS: Although the levels of adaptation observed are more favourable than in other nearby contexts, serious deficiencies are identified in the province of Granada with respect to internationally agreed recommendations on perinatal bereavement care. More training and awareness-raising of midwives and nurses is needed, which also considers factors related to better compliance.
CONCLUSIONS: This is the first study to quantify the degree of adaptation to international recommendations in Spain reported by midwives and nurses, as well as the individual factors associated with a higher level of compliance. Areas for improvement and explanatory variables of adaptation are identified, which allow support for possible training and awareness-raising programmes aimed at improving the quality of care provided to bereaved families.
摘要：
目的：评估格拉纳达省助产士和护士对死亡护理和围产期丧亲的态度和护理做法，确定他们对国际标准的适应程度，并确定最能适应国际建议的人之间个人因素的可能差异。
方法：使用Lucina问卷对该省五所妇产医院的117名护士和助产士进行了本地调查，以探索专业人士的情绪，意见,以及围产期丧亲护理期间的知识。使用CiaoLapo死产支持（CLASS）清单评估了实践对国际建议的适应性。收集了社会人口统计数据，以建立它们与提高对建议的遵守程度的关联。
结果：反应率为75.4%，大多数是女性(88.9%)，平均年龄为40.9（SD=1.4）和17.4（SD=10.58）年的工作经验。助产士的比例最高（67.5％），并报告参加了更多的围产期死亡病例（p=0.010），并接受了更具体的培训（p<0.001。)其中,57.3%的人会建议立即交货，26.5％的人建议在分娩期间使用药物镇静剂，47％的人会在父母表示不想看的情况下立即将婴儿带走。另一方面,只有58%的人赞成拍照创造记忆，在所有情况下，47%的人会给婴儿洗澡和穿衣服，33.3%的人会允许其他家庭成员的陪伴。与每个关于记忆制作的建议相匹配的百分比为58%，41.9%的人符合尊重婴儿和父母的建议，23%和10.3%与适当的交付和后续选项相匹配，分别。与100%的建议相关的因素，根据护理部门的说法，是个女人,助产士,经过专门的培训，并亲身经历过这种情况。
结论：尽管观察到的适应水平比附近的其他环境更有利，在国际商定的围产期丧亲护理建议方面，格拉纳达省发现了严重缺陷。需要对助产士和护士进行更多的培训和提高认识，其中还考虑了与更好的合规性相关的因素。
结论：这是第一个量化西班牙助产士和护士报告的国际建议适应程度的研究，以及与更高水平的合规性相关的个体因素。确定了适应的改进领域和解释变量，支持可能的培训和提高认识方案，旨在提高向失去亲人的家庭提供的护理质量。
方法：使用Lucina问卷对该省五所妇产医院的117名护士和助产士进行了本地调查，以探索专业人士的情绪，意见,以及围产期丧亲护理期间的知识。使用CiaoLapo死产支持（CLASS）清单评估了实践对国际建议的适应性。收集了社会人口统计数据，以建立它们与提高对建议的遵守程度的关联。
结果：反应率为75.4%，大多数是女性(88.9%)，平均年龄为40.9（SD=1.4）和17.4（SD=10.58）年的工作经验。助产士的比例最高（67.5％），并报告参加了更多的围产期死亡病例（p=0.010），并接受了更具体的培训（p<0.001。)其中,57.3%的人会建议立即交货，26.5％的人建议在分娩期间使用药物镇静剂，47％的人会在父母表示不想看的情况下立即将婴儿带走。另一方面,只有58%的人赞成拍照创造记忆，在所有情况下，47%的人会给婴儿洗澡和穿衣服，33.3%的人会允许其他家庭成员的陪伴。与每个关于记忆制作的建议相匹配的百分比为58%，41.9%的人符合尊重婴儿和父母的建议，23%和10.3%与适当的交付和后续选项相匹配，分别。与100%的建议相关的因素，根据护理部门的说法，是个女人,助产士,经过专门的培训，并亲身经历过这种情况。
结论：尽管观察到的适应水平比附近的其他环境更有利，在国际商定的围产期丧亲护理建议方面，格拉纳达省发现了严重缺陷。需要对助产士和护士进行更多的培训和提高认识，其中还考虑了与更好的合规性相关的因素。
结论：这是第一个量化西班牙助产士和护士报告的国际建议适应程度的研究，以及与更高水平的合规性相关的个体因素。确定了适应的改进领域和解释变量，支持可能的培训和提高认识方案，旨在提高向失去亲人的家庭提供的护理质量。
