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Recently, I had the honor of being selected as a visiting
professor at the National Defense Medical Center in
Taipei, Taiwan. This government agency has a funded
program of support for one to two visiting nurse scholars
per year for the School of Nursing.
Nearly all of the faculty in the School of Nursing
have completed their graduate studies (master's and
Ph.D.) at universities in the United States. I was invited
by Tsrong-Yeh Lee, now the director of Nursing at Tri-Service
General Hospital, and associate professor in the School
of Nursing at the National Defense Medical Center.
My relationship with her was initially formed during
her program of study on qualitative methods at the University
of Illinois at Chicago College of Nursing several years
ago.
At Lee's request, I delivered one presentation on a
research methodology for phenomenology and several presentations
on perinatal loss. She had requested the content on
perinatal loss because programs of support for parents
who experience a perinatal loss (miscarriage, stillbirth
or newborn death) are just developing in Taiwan.
As part of my visit, I delivered presentations in two
different facilities: Kaohsiung Military Hospital and
Tri-Service General Hospital, which is part of the National
Defense Medical Center.
At both hospitals, it was apparent that the importance
of family participation in a patient's hospitalization
is recognized and facilitated by staff. In the general
ward, each hospital bed is equipped with a chair that
reclines into a sleeping cot for >> a family member
to stay and assist with care 24 hours a day.
In the neonatal intensive care unit, a family room
has four beds for overnight stays. This practice of
enabling 24-hour family stays is a nice contrast to
practices in U.S. hospitals, where families often are
separated from their hospitalized family members.
My presentations on perinatal loss were divided into
three areas: an overview on the responses and caring
needs of families who experience a perinatal loss; a
review of selected national programs for bereaved parents,
such as RTS, Compassionate Friends, SHARE and Center
for Loss in Multiple Birth (CLIMB), and an illustration
of the programs developed by health care professionals
in Chicago-area hospitals; and general strategies to
implement a program of support for bereaved parents.
The audience at my presentations primarily consisted
of nursing faculty, nursing personnel (administrators,
specialists and staff nurses) from nearby hospitals
and nursing students. For many nurses, this information
on perinatal loss was new, and they asked many questions
on the cultural relevance of these programs.
For others, this information served to validate their
clinical impressions, especially for those mental health
nurses who had cared for women experiencing grief complicated
by depression after losing a child. These nurses wondered
if some of the depression they were observing might
be alleviated by instituting programs of support for
the parents.
The most enlightening aspect of my visit occurred after
I delivered the presentation on the responses and needs
of families at one of the hospitals. Just after I had
finished the presentation, a nurse in the audience,
who herself was a bereaved parent, came forward and
shared her story.
Two years earlier, she had experienced the death of
her baby, who was born at 23 weeks' gestation. She spoke
in Chinese and, although I could not understand what
she was saying, I could tell the depth of her pain as
she tearfully told us of her experience. The audience
was moved to tears as she described the isolation she
felt and the unwillingness of her family to let her
see her baby or even know her baby's gender.
I later learned through a translator that she recommended
the supportive interventions that I was describing.
I believe her personal story was more powerful than
anything I could have said to the audience and served
as a valuable lesson that the grief of parents may be
culturally specific, but is universal.
During my visit, I also consulted with Lee and members
of her research team, who are embarking on groundbreaking
research on perinatal loss in Taiwan. They will evaluate
a program of support for parents who have a stillborn
infant. Lee and her colleagues will examine the effects
of interventions to support bereaved parents that are
based on the RTS program.
Preliminary research findings on the responses of Taiwanese
mothers to having a stillborn infant have been strikingly
similar to the responses of mothers in the United States
and lend support for the planned intervention study.
This program of research on Taiwanese mothers is an
important contribution to the limited research on perinatal
loss in different cultural groups.
My visit to Taiwan was exceptionally rewarding. I was
able to establish new relationships with nurse scholars.
I also learned about perinatal loss among Taiwanese
families directly from a parent and from health care
professionals. These global relationships and knowledge
about other cultures is increasingly important as we
care for families from diverse cultural backgrounds.
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