title: The experiences and needs of healthcare professionals facing perinatal death: A scoping review.
abstract: BACKGROUND
  Globally, perinatal death is on a decline. However, its impact on the healthcare profession is huge. The existing literature focuses on examining perinatal death from parents' perspectives and patient death from the perspectives of nurses and a few doctors in critical care, oncology, and neonatology in the West. Due to the unique setting of maternity units where death is not routinely anticipated, as well as distinctive socio-cultural views surrounding death, there is a need to comprehensively review literature examining the impact of perinatal death on the perspectives of healthcare professionals working in maternity units.
  
  
  OBJECTIVE
  To examine available literature on the needs and experiences of healthcare professionals working in maternity units who have experienced perinatal death.
  
  
  METHODS
  A scoping review of published and unpublished data.
  
  
  METHODS
  A systematic literature search from 1st January 1996 to 5th August 2016 was made in the following databases: PubMed, CINAHL, Embase, PsycINFO, ScienceDirect, and Web of Science. Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews, York Centre for Reviews and Dissemination, Open Grey, ProQuest Dissertation and Theses, and Mednar were reviewed for grey literature. A hand search of the reference lists of the included papers was performed.
  
  
  METHODS
  Based on the pre-set inclusion criteria, 1519 articles were screened for their titles and abstracts. Eighty-five full-text papers were reviewed, resulting in 30 papers included for this review. The data were extracted and cross-checked between the reviewers. Any discrepancy between the authors' views would be discussed with a third reviewer until consensus was reached. Thematic analysis was used to categorise the results into themes.
  
  
  RESULTS
  Two major themes emerged from the review: the experiences and needs of healthcare professionals. Six subthemes emerged from the experiences of healthcare professionals: 1) psychological impact, 2) physical impact, 3) positive feelings, 4) coping strategies, 5) personal factors influencing the experience, and 6) cultural factors influencing the experience. Three subthemes including 1) social support, 2) training and education, and 3) other needs explained the needs of healthcare professionals. Studies focusing on the experiences and needs of physicians were scarce.
  
  
  CONCLUSIONS
  Perinatal death has a profound impact on the psychological and physical wellbeing of healthcare professionals. They have unmet needs that need to be addressed. Though they use internal and external resources to combat their stress, institutional support acknowledging their stress and their needs is essential. Culturally-sensitive education and training are needed to provide support to these professionals.
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address: nurssh@nus.edu.sg.
authors.forename: Shefaly
authors.initials: S
authors.lastname: Shorey
authors.affiliation: Faculty of Nursing- Centre for Health Promotion Research, NTNU- Norwegian University of Science and Technology, 7491 Trondheim, Norway. Electronic address: beate.andre@ntnu.no.
authors.forename: Beate
authors.initials: B
authors.lastname: André
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address: violeta_lopez@nuhs.edu.sg.
authors.forename: Violeta
authors.initials: V
authors.lastname: Lopez
mesh_terms: D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006301:Health Services Needs and Demand; D006801:Humans; D008427:Maternal Health Services; D011247:Pregnancy; D050497:Stillbirth; D000078329:Workforce
keywords: Experiences; Healthcare professionals; Maternity care; Needs; Perinatal death; Scoping review