Evaluating the impact of a bereavement care training programme on the competencies and perceived organisational support of students and maternity care providers : a before and after study

Abstract

Bereavement care training in perinatal loss is crucial in meeting both the needs of healthcare professionals, but also those of grieving parents, ultimately leading to improved healthcare. However, although research on perinatal loss exists in Malta, it does not address the crucial aspect of bereavement care training for maternity staff and healthcare students.Thus, this study aimed to evaluate the impact of a perinatal loss training programme on bereavement care by assessing changes in knowledge, skills, confidence and self-awareness of local maternity care providers and students, as well as their perceptions of organisational support. It sought to determine their preparedness, demonstrate the impact and need of sustained bereavement care training, evaluate the importance and need of organisational support and identify key enablers and barriers for effective provision of bereavement care. A quantitative, before and after research design was employed. The training session was attended by midwives (n=67), student midwives (n=35), obstetricians (n=15), and other maternity care providers (n=31). The inclusion of various healthcare professionals was guided by a review of the literature, which highlights the need to involve all maternity care staff in bereavement support, as comprehensive, multidisciplinary care is essential for effectively supporting grieving parents. The training included a fully funded workshop, delivered by a psychotherapist from the United Kingdom, featuring discussions, videos and case scenarios on bereavement care in perinatal loss. This was repeated over three consecutive days, reaching a total of 148 participants, achieving a 98.7% response rate. Quantitative data was collected by the widely recognised Perinatal Bereavement Care Confidence Scale survey, which was administered before and after the bereavement care training workshop. Collected data was analysed using descriptive and inferential statistics, including internal consistency and correlational analysis, while qualitative data from responses to the three open-ended questions in the questionnaire underwent content analysis. Findings demonstrated significant improvement in knowledge, bereavement care skills, self-awareness and confidence across all healthcare professionals and students following the training session. However, there was no notable improvement in participants’ perceptions of organisational support. The open-ended responses highlighted key factors influencing healthcare professionals' confidence in delivering bereavement care. The most significant enablers reported across all subgroups included comprehensive bereavement care training and education, communication skills, past experience, and effective teamwork, with practical exposure particularly noted by student midwives. Emotional and psychological support, such as regular debriefing sessions, was also reported as being crucial. Barriers included inadequate education, high workloads, limited clinical experience and organisational support, emotional strain and burnout. Participants recommended improving confidence through regular bereavement care training, integrating such training into students’ curricula, increasing debriefing opportunities, expanding clinical exposure and supervision, providing better support for grieving parents, appointing additional bereavement midwives, and enhancing organisational support. These findings underscore the need for consistent bereavement care training in perinatal loss to ensure high-quality, sustainable care. Recommendations include the need for further research on extended training periods, greater managerial engagement, and longitudinal studies to evaluate the long-term impact of training at both individual and organisational levels.