https://www.um.edu.mt/library/oar/handle/123456789/52016 2026-04-10T16:43:54Z https://www.um.edu.mt/library/oar/handle/123456789/53274 Title: Our worst nightmare : the couples’ lived experiences of miscarriage Abstract: Background: Miscarriage is recognised as one of the most common complications of pregnancy and is associated with stigma, isolation, loss of dreams, hopes and identity of parenthood, for the couple. However, there is a dearth of literature, both local and international, on the lived experiences of the couple who have undergone a miscarriage. Objectives: The aim of this study was to explore the primigravida couples’ lived experiences of early miscarriage. The objectives of this study were to gain insight on the impact of miscarriage on the couples; to identify their support systems, needs and concerns; and to explore the coping strategies adopted. Design: A qualitative phenomenological study using the principles of Interpretative Phenomenological Analysis. Setting: The study took place in the local general state hospital. Participants: Five primagravida heterosexual adult couples who had experienced a first and early stage miscarriage. The females were at an advanced maternal age. Methods: Purposive sampling was used to recruit participants for this study using semistructured interviews which were audio recorded. The data was transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Results: Three super-ordinate themes emerged that highlight the couples’ lived experiences of miscarriage. These were: A Worst Nightmare; The Aftermath of the Storm; Striving to Ride the Waves. Conclusion: The lived experience of miscarriage had a profound physical and emotional impact on the couples describing it as their ‘worst nightmare’ while also commenting on struggling with an identity as parents, which has now been lost. Couples also commented on how the miscarriage setting, hospital environment and the management of care provided by healthcare professionals shaped their experience when dealing with loss. They also expressed the support or lack thereof that they received after their loss from significant others, family, friends, colleagues, health care professionals, online support groups and society. Couples further recalled utilising different coping strategies in an effort to acknowledge their loss and initiate the healing process. Furthermore, they felt insecure about the possibility of future pregnancies and the difficulties that they might encounter to achieve a successful pregnancy. All participants, especially females, highlighted that their desire of parenthood was a race against time due to their advancing maternal age and the implications on their biological clock. Description: M.SC.MENTAL HEALTH NURSING 2019-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/53273 Title: Nurses’ attitudes towards trauma-informed care at the state psychiatric hospital in Malta Abstract: Background: Notwithstanding the possibility of a forthcoming, official diagnosis of Complex Post Traumatic Stress Disorder and the contemporary, international appeals for mental health care services to become trauma-informed, trauma-informed care is a foreign concept locally. Service providers’ attitudes towards trauma-informed care have been identified as a particularly mensurable outcome for ascertaining whether a system is trauma-informed. Objectives: The study gained an initial understanding of nurses’ attitudes towards trauma-informed care at the state psychiatric hospital in Malta. Design: A sequential explanatory, mixed method design was used. Settings: All the wards and units at the hospital. Participants: 136 completed questionnaires were returned, yielding a response rate of 68.3%. Ten nurses participated in a focus group interview. Methods: The quantitative phase consisted of a cross-sectional survey among all the 199 nurses working at the hospital. Participants completed the Attitudes Related to Trauma-Informed Care scale and provided some demographic data. Data was analysed through descriptive and inferential statistics. The qualitative phase involved formulation of the focus group interview schedule upon careful scrutiny of quantitative findings. The interview was audio-taped and transcribed verbatim. Thematic analysis was used to analyse qualitative data. Results: Mean scores for the five subscales of the questionnaire were positive, indicating favourable trauma-informed care attitudes of individual nurses. There was a statistically significant difference between subscale mean ranks for the subscale ‘Job behaviour’ by length of time working at the hospital. Moreover, statistically significant differences were obtained between subscale mean ranks for the subscales ‘Job behaviour’, ‘Self-efficacy’ and ‘Reactions’ by work setting of respondents. The three themes which emerged from the analysis of the focus group interview transcript were ‘Awareness’, ‘Unhealthy Boundaries’ and ‘Inhibition’. These revealed a shared reality among the nurses which encompasses an awareness of trauma-informed care issues, but also a series of contextual factors which inhibit their wellbeing and their capacity to provide trauma-informed care. Conclusions: Trauma-informed care was perceived as an important framework and more awareness is both needed and desired. Nurse educators must adequately respond to this growing need. For the hospital to become trauma-informed, the ambiguities in the context and the promotion of employee wellbeing need to be addressed. Description: M.SC.MENTAL HEALTH NURSING 2019-01-01T00:00:00Z