We will discuss ‘Post-traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross-sectional retrospective survey‘ by Wahlberg and coauthors on the 26th April 2017. This paper is free to view from 17th April.
Start date: 26 April 2017. The discussion will continue for 7 days until 2nd May 2017.
First hosted discussion session(s) on Twitter starts at BST 8pm (3pm EST/12 noon PST) on 26 April 2017 (using hashtag #BlueJC).
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The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues.
The discussion points are below:
A colleague working in another part country calls to tell you that she delivered a patient whose full term baby died in the NICU a few days after delivery. During the course of the hospital safety committee’s review of the case, it was determined that a delay in delivery likely contributed to complications leading to the neonate’s death. Your colleague asks for advice and help “sorting it all out”.
How will you help?
Description of Research:
|Participants||1,459 midwives and 706 obstetricians from Sweden. Mostly women.|
|Exposure||A serious and potentially traumatic event on the delivery unit, such as (1) a child died or had severe asphyxia, (2) maternal near-miss or death during delivery, or (3) other difficult event such as violence or threat.|
|Outcomes||Provider experience of probably post-traumatic stress disorder (PTSD) or partial PTSD.|
|Study design||Cross-sectional survey.|
|Authors’ conclusion||A substantial proportion of obstetricians and midwives experiences PTSD-like symptoms after serous traumatic events related to delivery.|
- Describe a time when you have been the “second victim” of an adverse event. How did it affect you? Did it have an effect on your other patients?
- Did the authors have an adequate response rate to their survey? What means could they have used to improve response rates?
- The authors cite probable selection bias and recall bias as limitations of the study. How would you design a study addressing the same objective, but with less potential for these biases?
- In what ways might non-responders have biased this study?
- What were the main differences between obstetrician responders and midwife responders in this study?
- Obstetricians reported negative experiences with debriefings (or reassembly) in this study. In your experience, what are the ways debriefings can be helpful or harmful?
- How would you use the results of this study in your own practice?
- Scott et al. The natural history of recovery for healthcare provider “second victim” after adverse patient events. Qual Saf Health Care Care 2009;18:325-330.
- Schroder et al. Guilt without fault: a qualitative study into the ethics of forgiveness after traumatic childbirth. Social Science & Medicine 2017;176:14-20.
- Grimes and Schulz. Descriptive studies: what they can and cannot do. Lancet 2002;359:145-49.