Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi Arabia
Abstract Background Neonatal intensive care unit (NICU) nurses face profound emotional distress due to frequent exposure to infant loss. This emotional burden, coupled with limited organizational support, can lead to significant psychological and professional challenges. Cultural and religious conte...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12912-025-03509-8 |
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| author | Nadia Bassuoni Elsharkawy Osama Mohamed Elsayed Ramadan Alaa Hussain Hafiz Nouran Essam Katooa Areej Abunar Dena Marwan A. Attallah Mashael Dewan Majed Mowanes Alruwaili Abeer Nuwayfi Alruwaili Enas Mahrous Abdelaziz Arab Qassim Alkhadam Marwa Mohamed Ouda |
| author_facet | Nadia Bassuoni Elsharkawy Osama Mohamed Elsayed Ramadan Alaa Hussain Hafiz Nouran Essam Katooa Areej Abunar Dena Marwan A. Attallah Mashael Dewan Majed Mowanes Alruwaili Abeer Nuwayfi Alruwaili Enas Mahrous Abdelaziz Arab Qassim Alkhadam Marwa Mohamed Ouda |
| author_sort | Nadia Bassuoni Elsharkawy |
| collection | DOAJ |
| description | Abstract Background Neonatal intensive care unit (NICU) nurses face profound emotional distress due to frequent exposure to infant loss. This emotional burden, coupled with limited organizational support, can lead to significant psychological and professional challenges. Cultural and religious contexts uniquely shape resilience and coping mechanisms, particularly within Saudi Arabia, where these aspects remain understudied. Aim To explore and describe the lived experience of resilience and coping strategies among neonatal intensive care nurses following infant loss in NICUs in northern Saudi Arabia. Methods An interpretive phenomenological design grounded in Heidegger’s hermeneutic tradition was employed, with Lazarus and Folkman’s stress and coping theory providing the theoretical framework for analysis. Eighteen registered nurses from four NICUs (three public, one private) participated in semi-structured interviews and completed reflective journals. Purposive sampling ensured diversity in professional experience, cultural backgrounds, and religious affiliations. Data were analyzed using thematic analysis with concurrent collection and interpretation. Results Four thematic domains characterized NICU nurses’ experiences: (1) Emotional Processing of Loss (initial grief, disenfranchised professional grief, cultural-religious interpretations); (2) Adaptive Coping (faith-based practices, selective detachment, end-of-life ritualization, meaning-making through family support); (3) Resilience Development (career-stage evolution, professional identity integration, post-traumatic growth); and (4) Contextual Influences (institutional support disparities, multicultural team dynamics, resource constraints). Conclusion NICU nurses’ experiences of infant loss profoundly impact their psychological and professional well-being. Despite emotional and organizational challenges, nurses actively employ diverse coping strategies that are deeply influenced by their cultural and religious beliefs. Over time, these strategies facilitate significant professional growth and sustained compassion. Implications for practice Healthcare institutions should adopt structured, culturally sensitive interventions, including formal debriefing, psychological support services, and education programs that focus on resilience-building, to enhance the well-being and professional sustainability of NICU nurses. Clinical trial number Not Applicable. |
| format | Article |
| id | doaj-art-e6de1f98bd254e9cbc71221bc8f477ce |
| institution | Kabale University |
| issn | 1472-6955 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Nursing |
| spelling | doaj-art-e6de1f98bd254e9cbc71221bc8f477ce2025-08-20T03:37:29ZengBMCBMC Nursing1472-69552025-07-0124111710.1186/s12912-025-03509-8Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi ArabiaNadia Bassuoni Elsharkawy0Osama Mohamed Elsayed Ramadan1Alaa Hussain Hafiz2Nouran Essam Katooa3Areej Abunar4Dena Marwan A. Attallah5Mashael Dewan6Majed Mowanes Alruwaili7Abeer Nuwayfi Alruwaili8Enas Mahrous Abdelaziz9Arab Qassim Alkhadam10Marwa Mohamed Ouda11Department of Maternal and Child Health Nursing, College of Nursing, Jouf UniversityDepartment of Maternal and Child Health Nursing, College of Nursing, Jouf UniversityMaternity and Child Health Department, Faculty of Nursing, King Abdulaziz UniversityMaternity and Child Health Department, Faculty of Nursing, King Abdulaziz UniversityMaternity and Child Health Department, Faculty of Nursing, King Abdulaziz UniversityNursing Department- Nursing Program, Fakeeh College for Medical SciencesNursing Department- Nursing Program, Fakeeh College for Medical SciencesDepartment of Nursing Administration and Education, College of Nursing, Jouf UniversityDepartment of Nursing Administration and Education, College of Nursing, Jouf UniversityDepartment of Psychiatric Mental Health Nursing, College of Nursing, Jouf UniversityDepartment of Medical Surgical Nursing, College of Nursing, Jouf UniversityDepartment of Maternal and Child Health Nursing, College of Nursing, Jouf UniversityAbstract Background Neonatal intensive care unit (NICU) nurses face profound emotional distress due to frequent exposure to infant loss. This emotional burden, coupled with limited organizational support, can lead to significant psychological and professional challenges. Cultural and religious contexts uniquely shape resilience and coping mechanisms, particularly within Saudi Arabia, where these aspects remain understudied. Aim To explore and describe the lived experience of resilience and coping strategies among neonatal intensive care nurses following infant loss in NICUs in northern Saudi Arabia. Methods An interpretive phenomenological design grounded in Heidegger’s hermeneutic tradition was employed, with Lazarus and Folkman’s stress and coping theory providing the theoretical framework for analysis. Eighteen registered nurses from four NICUs (three public, one private) participated in semi-structured interviews and completed reflective journals. Purposive sampling ensured diversity in professional experience, cultural backgrounds, and religious affiliations. Data were analyzed using thematic analysis with concurrent collection and interpretation. Results Four thematic domains characterized NICU nurses’ experiences: (1) Emotional Processing of Loss (initial grief, disenfranchised professional grief, cultural-religious interpretations); (2) Adaptive Coping (faith-based practices, selective detachment, end-of-life ritualization, meaning-making through family support); (3) Resilience Development (career-stage evolution, professional identity integration, post-traumatic growth); and (4) Contextual Influences (institutional support disparities, multicultural team dynamics, resource constraints). Conclusion NICU nurses’ experiences of infant loss profoundly impact their psychological and professional well-being. Despite emotional and organizational challenges, nurses actively employ diverse coping strategies that are deeply influenced by their cultural and religious beliefs. Over time, these strategies facilitate significant professional growth and sustained compassion. Implications for practice Healthcare institutions should adopt structured, culturally sensitive interventions, including formal debriefing, psychological support services, and education programs that focus on resilience-building, to enhance the well-being and professional sustainability of NICU nurses. Clinical trial number Not Applicable.https://doi.org/10.1186/s12912-025-03509-8ResilienceCoping strategiesNeonatal nursesInfant mortalityGriefInfant loss |
| spellingShingle | Nadia Bassuoni Elsharkawy Osama Mohamed Elsayed Ramadan Alaa Hussain Hafiz Nouran Essam Katooa Areej Abunar Dena Marwan A. Attallah Mashael Dewan Majed Mowanes Alruwaili Abeer Nuwayfi Alruwaili Enas Mahrous Abdelaziz Arab Qassim Alkhadam Marwa Mohamed Ouda Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi Arabia BMC Nursing Resilience Coping strategies Neonatal nurses Infant mortality Grief Infant loss |
| title | Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi Arabia |
| title_full | Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi Arabia |
| title_fullStr | Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi Arabia |
| title_full_unstemmed | Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi Arabia |
| title_short | Resilience in the shadows of loss: a hermeneutic phenomenological study of neonatal intensive care nurses’ coping after infant loss in Saudi Arabia |
| title_sort | resilience in the shadows of loss a hermeneutic phenomenological study of neonatal intensive care nurses coping after infant loss in saudi arabia |
| topic | Resilience Coping strategies Neonatal nurses Infant mortality Grief Infant loss |
| url | https://doi.org/10.1186/s12912-025-03509-8 |
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