Protocol for evaluation of the continuum of primary care in the case of a miscarriage in the emergency room: a mixed-method study

• Published in: BMC pregnancy and childbirth Vol. 17; no. 1; p. 124
• Main Authors: de Montigny, Francine, Verdon, Chantal, Dubeau, Diane, Devault, Annie, St-André, Martin, Tchouaket Nguemeleu, Éric, Lacharité, Carl
• Format: Journal Article
• Language: English
• Published: England BioMed Central 20.04.2017; BMC
• Subjects: Abortion, Spontaneous - psychology; Abortion, Spontaneous - therapy; Adult; Anthropology, Cultural; Children & youth; Clinical Protocols; Continuity of Patient Care - standards; Couples; Emergency; Emergency medical care; Emergency Service, Hospital; Ethnography; Female; Gender; Grief; Healthcare services; Humans; Hypotheses; Institutional inscription; Medical personnel; Mental health; Miscarriage; Mixed methods research; Perinatal grief; Postpartum depression; Pregnancy; Primary care; Primary Health Care - standards; Professionals; Quality; Quebec; Retrospective Studies; Study Protocol; Surveys and Questionnaires; Womens health; Canada; Quebec Canada; Emergency; Healthcare services; Miscarriage; Institutional inscription; Perinatal grief; Mental health
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-017-1309-5

In Quebec (Canada), nearly 20,000 pregnancies end in miscarriage, and the majority of the miscarriages are dealt with in an emergency unit. Although there are studies documenting the effects of this type of grief on mental health, men's experiences are much less discussed than those of women. Similarly, no study has evaluated best practices in terms of service continuity, from emergency care to community resources. The aim of this study is to better understand the relationships that exist between the organization of emergency room and primary care health services for women presenting with miscarriage, on the one hand, and the positions and experiences of women and men within these services, on the other. The general objective of this mixed-method study can be broken down into three methodological sections. Focus 1. Institutional discourses and practices. This section is structured as a multiple case study of the mandates of five participant institutions. The study will involve (a) a documentary analysis; (b) a quantitative survey (N: 200) and (c) group interviews (N: 75) with caregivers and emergency unit managers. Focus 2. Women's and men's experiences of miscarriages and the institutional response. This section includes (a) a survey (N: 232) and (b) individual interviews (N: 80) designed to identify best practices in emergency involving women and their partners in each area. Focus 3. This section will integrate the information furnished by the first two sections in order to create an ethnographic overview of the situation. This innovative project will provide answers to critical questions on how to improve the effectiveness and quality of interdisciplinary and multisectoral interventions to promote the mental health and psychosocial well-being of couples having experienced a miscarriage. It will have a material effect on the organization of emergency services and of the primary care pathway for women experiencing a miscarriage and for their partners. Not applicable. This study involves a retrospective view of usual health care interventions. This study is not a clinical trial that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes.