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Filippa S, Jayaweera RT, Blanchard K, Grossman D. Do miscarriage care practice recommendations align with individuals' needs?: a scoping review. Contraception 2024:110448. [PMID: 38588848 DOI: 10.1016/j.contraception.2024.110448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Miscarriage is a common experience; yet individuals often have negative experiences when receiving miscarriage care, signaling a gap in the quality of miscarriage care. We explore the literature on individuals' experiences with miscarriage care across a variety of dimensions and assess how these experiences align with practice recommendations. METHODS We conducted a scoping review of peer-reviewed studies in PubMed published in English through April 30, 2022, and focused on individuals' experiences with miscarriage care in healthcare settings and on practice recommendations for providing care in a variety of countries. The search returned 1,812 studies; after screening, 41 studies were included in the analysis. RESULTS Included studies reported on individuals' experiences with miscarriage care settings and accessibility, information provision, emotional support, decision-making and follow-up. Overall, individuals are often dissatisfied with their miscarriage care experiences. Practice recommendations are generally responsive to these issues, but more research is needed to address some key gaps and improve the implementation of current practice recommendations. CONCLUSIONS Future research should focus on documenting the miscarriage experiences and developing relevant practice recommendations for communities that face the greatest barriers to care, generating evidence on the dimensions that constitute high-quality miscarriage care from patients' perspectives and assessing the barriers and facilitators to effectively implementing existing practice recommendations.
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Affiliation(s)
- Sofía Filippa
- Ibis Reproductive Health, 1736 Franklin St, Suite 600, Oakland, CA, 94612, USA.
| | - Ruvani T Jayaweera
- Ibis Reproductive Health, 1736 Franklin St, Suite 600, Oakland, CA, 94612, USA
| | - Kelly Blanchard
- Ibis Reproductive Health, 1736 Franklin St, Suite 600, Oakland, CA, 94612, USA
| | - Daniel Grossman
- Ibis Reproductive Health, 1736 Franklin St, Suite 600, Oakland, CA, 94612, USA; Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA. 94612, USA
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Nisa M, Laila S, Muzzamil M, Ghafoor A, Zakir N, Zulfiqar T, Malik A, Malikzai A. "Translation, cultural adaptation, and validation of perinatal grief scale in Urdu: Addressing a gap in the research of perinatal loss in Pakistan-Cross-sectional validation study". Health Sci Rep 2024; 7:e1999. [PMID: 38605729 PMCID: PMC11007656 DOI: 10.1002/hsr2.1999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/05/2024] [Accepted: 03/07/2024] [Indexed: 04/13/2024] Open
Abstract
Background and Aims Perinatal grief have a significant influence on maternal mental health, hence appropriate tools for assessment are necessary. In this study, we translated and validated the Perinatal Grief Scale in Urdu (PGS-Urdu) for use in Pakistan, therefore filling the gap in validated tools. Methods Data was collected from 165 women using consecutive sampling. Initially, "forward/backward" translation was used. For validity, content validity index and confirmatory factor analysis (CFA) were used respectively, and "Cronbach's-Alpha" for reliability. In the validity stage, items 8, 11, 23, and 32 of the original scale were eliminated based on feedback from the target groups and the expert panel. For data-analysis, SPSS 26 and Amos 26 were used. Results In analyzing the "Confirmatory factor analysis", the "all-fitness indicators" validated the three-factor structure of 29-item main scale. Cronbach alpha value was 0.83 for the entire scale The CFA results showed that all fitness indicators, with the exception of four, had loadings greater than 0.20, supporting the main scale's three-factor structure. With a Cronbach's Alpha value of 0.83 for overall reliability, and varied from 0.81 to 0.87 for the PGS-U variables. the PGS-U exhibits an acceptable level of internal consistency. Conclusion The PGS-U identifies women in perinatal grief for medical and social care. This research supports using the Urdu perinatal grief scale in obstetrics and bereavement counseling to reduce maternal mental health issues.
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Affiliation(s)
| | | | | | | | - Najma Zakir
- Department of BiosciencesCOMSATS University IslamabadIslamabadPakistan
| | - Tehzeeb Zulfiqar
- Department of Applied EpidemiologyNational Centre for Epidemiology and Population Health, ANU College of Health and Medicine the Australian National UniversityCanberraAustralia
| | - Abid Malik
- Health Services AcademyIslamabadPakistan
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Ennis N, Bottomley J, Sawyer J, Moreland AD, Rheingold AA. Measuring Grief in the Context of Traumatic Loss: A Systematic Review of Assessment Instruments. TRAUMA, VIOLENCE & ABUSE 2023; 24:2346-2362. [PMID: 35616367 PMCID: PMC9699905 DOI: 10.1177/15248380221093694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Following traumatic loss, defined as the death of a loved one due to unexpected or violent circumstances, adults may experience a myriad of grief-related problems. Given the addition of Prolonged Grief Disorders into the Diagnostic and Statistical Manual for Mental Disorders Fifth Edition, Text-Revision and influx of unexpected deaths due to the global Coronavirus pandemic, there is heightened interest in the measurement of grief-related processes. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify measures of grief used in studies of adults who experienced traumatic loss. Searches yielded 164 studies that used 31 unique measures of grief-related constructs. The most commonly used instrument was the Inventory of Complicated Grief-Revised. Half of the measures assessed constructs beyond diagnosable pathological grief responses. Given the wide variation and adaptations of measures reviewed, we recommend greater testing and uniformity of measurement across the field. Future research is needed to adapt and/or design measures to evaluate new criteria for Prolonged Grief Disorder.
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Affiliation(s)
- Naomi Ennis
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
| | - Jamison Bottomley
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
| | | | - Angela D. Moreland
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
| | - Alyssa A. Rheingold
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
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Buskmiller C, Grauerholz KR, Bute J, Brann M, Fredenburg M, Refuerzo JS. Validation of a Brief Measure for Complicated Grief Specific to Reproductive Loss. Cureus 2023; 15:e37884. [PMID: 37214013 PMCID: PMC10199718 DOI: 10.7759/cureus.37884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023] Open
Abstract
Objective Complicated grief reactions follow some pregnancy outcomes, like miscarriage, stillbirth, neonatal death, infant death, selective reduction, or termination of pregnancy. Stigma can delay treatment and worsen outcomes. Screening tools such as the Edinburgh Postnatal Depression Scale detect complicated grief poorly, and specific tools for prolonged or complicated grief after a reproductive loss are cumbersome. In this study, a five-item questionnaire to detect complicated grief after reproductive loss of any type was designed and preliminary validated. Methods A questionnaire patterned after the extensively validated Brief Grief Questionnaire (BGQ) was created by a group of physicians and lay advocates to employ non-traumatic but specific language related to grief after miscarriage, stillbirth, neonatal death, infant death, selective reduction, or termination of pregnancy. One hundred and forty women at a large academic center were recruited in person and via social media to validate the questionnaire with well-studied instruments for anxiety (7-item Panic Disorder Severity Scale, PDSS), trauma (22-item Impact of Events Scale), and reproductive grief and depressive symptoms (33-item Perinatal Grief Scale [PGS]). Results The response rate was 74.9%. Of the 140 participants, 18 (12.8%) experienced their loss during high-risk pregnancies, and 65 (46.4%) were recruited via social media. Seventy-one (51%) respondents had a score > 4, a positive screen for the BGQ. On average, women experienced their loss 2 years prior to participation (IQR 1-5 years). Cronbach's alpha was 0.77 (95% CI: 0.69-0.83). The goodness of fit indices of the model met Fornell and Larker criteria (RMSEA = 0.167, CFI = 0.89, SRMR = 0.06). The AVE was 0.42 and the CR 0.78. Conclusions This investigator-created screening tool is internally consistent and meets preliminary criteria for discriminant validity. This tool can be refined prior to testing for sensitivity and specificity in screening for complicated grief after a reproductive loss.
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Affiliation(s)
- Cara Buskmiller
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, USA
| | | | - Jennifer Bute
- Communication, Indiana University-Purdue University Indianapolis (IUPUI), Indianpolis, USA
| | - Maria Brann
- Communication Studies, Indiana University Purdue University Indianapolis, Indianapolis, USA
| | | | - Jerrie S Refuerzo
- Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston McGovern Medical School, Houston, USA
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Yoon MS, Jeon YB, Lee SB. Grief, Partner Support, Posttraumatic Growth among Women with Pregnancy Loss in Korea. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2106682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Myeong-Sook Yoon
- Department of Social Welfare, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Ye-Bin Jeon
- Department of Social Welfare, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Soo-Bi Lee
- Department of Social Welfare, Jeonbuk National University, Jeonju-si, Republic of Korea
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Richardson E, McEwen A, Newton-John T, Crook A, Jacobs C. Incorporating patient perspectives in the development of a core outcome set for reproductive genetic carrier screening: a sequential systematic review. Eur J Hum Genet 2022; 30:756-765. [PMID: 35347269 PMCID: PMC9259674 DOI: 10.1038/s41431-022-01090-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 11/09/2022] Open
Abstract
There is currently no consensus on the key outcomes of reproductive genetic carrier screening (RGCS). This has led to a large amount of variability in approaches to research, limiting direct comparison and synthesis of findings. In a recently published systematic review of quantitative studies on RGCS, we found that few studies incorporated patient-reported outcomes. In response to this gap, we conducted a sequential systematic review of qualitative studies to identify outcomes exploring the patient experience of RGCS. In conjunction with the review of quantitative studies, these outcomes will be used to inform the development of a core outcome set. Text excerpts relevant to outcomes, including quotes and themes, were extracted verbatim and deductively coded as outcomes. We conducted a narrative synthesis to group outcomes within domains previously defined in our review of quantitative studies, and identify any new domains that were unique to qualitative studies. Seventy-eight outcomes were derived from qualitative studies and grouped into 19 outcome domains. Three new outcome domains were identified; 'goals of pre- and post-test genetic counselling', 'acceptability of further testing and alternative reproductive options', and 'perceived utility of RGCS'. The identification of outcome domains that were not identified in quantitative studies indicates that outcomes reflecting the patient perspective may be under-represented in the quantitative literature on this topic. Further work should focus on ensuring that outcomes reflect the real world needs and concerns of patients in order to maximise translation of research findings into clinical practice.
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Affiliation(s)
- Ebony Richardson
- grid.117476.20000 0004 1936 7611Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Alison McEwen
- grid.117476.20000 0004 1936 7611Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Toby Newton-John
- grid.117476.20000 0004 1936 7611Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Ashley Crook
- grid.117476.20000 0004 1936 7611Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Chris Jacobs
- grid.117476.20000 0004 1936 7611Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
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Wesselmann ED, Parris L. Miscarriage, Perceived Ostracism, and Trauma: A Preliminary Investigation. Front Psychol 2022; 12:747860. [PMID: 35153890 PMCID: PMC8828504 DOI: 10.3389/fpsyg.2021.747860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/23/2021] [Indexed: 11/28/2022] Open
Abstract
Miscarriage often is a traumatic experience with serious mental health implications. Friends and family members are often uncomfortable with and avoid discussing the topic with bereaved individuals, potentially making them feel ostracized (i.e., being ignored and excluded), contributing to their mental health concerns. We investigated the correlation between posttraumatic stress symptoms, perceived ostracism, and recalled grief intensity measures in a sample of cisgender women (N = 97) who have had a miscarriage. These participants were recruited using Qualtrics’s Panel Recruitment Services. Women’s perceived ostracism correlated positively with posttraumatic stress symptoms and negatively with grief congruence (i.e., the degree to which they felt that their miscarriage process was as satisfactory as possible, given they had to experience it). Perceived ostracism also explained additional variance in posttraumatic stress symptoms when considered alongside grief intensity measures (e.g., congruence).
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Affiliation(s)
- Eric D Wesselmann
- Department of Psychology, Illinois State University, Normal, IL, United States
| | - Leandra Parris
- College of William & Mary, Williamsburg, VA, United States
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A systematic review of instruments measuring grief after perinatal loss and factors associated with grief reactions. Palliat Support Care 2020; 19:246-256. [PMID: 32867873 DOI: 10.1017/s1478951520000826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Expectant parents who live through perinatal loss experience intense grief, which is not always acknowledged or accepted. A screening tool to detect bereaved parents' grief reactions can guide professionals, including perinatal palliative care teams, to provide follow-up for those in need. This review's goal is to identify and synthesize the international published literature on existent instruments specifically measuring the grieving process after any perinatal loss and to identify factors that could moderate grief reactions. METHOD Systematic review (PROSPERO # CRD42018092555) with critical synthesis. PUBMED, Cochrane, and PsycINFO databases were searched in English language articles using the keywords "perinatal" AND ("grief" OR "bereavement" OR mourning) AND ("scale" OR "questionnaire" OR "measure" OR "assessment") up to May 2018. Eligibility criteria included every study using a measure to assess perinatal grief after all kinds of perinatal losses, including validations and translations to other languages and interventions designed to alleviate grief symptoms. RESULTS A total of 67 papers met inclusion criteria. Seven instruments measuring perinatal grief published between 1984 and 2002 are described. The Perinatal Grief Scale (PGS) was used in 53 of the selected studies. Of those, 39 analyzed factors associated with grief reactions. Six articles used PGS scores to evaluate pre- and post-bereavement interventions. Studies in English language only might have limited the number of articles. SIGNIFICANCE OF RESULTS The PGS is the most used standardized measures to assess grief after perinatal loss. All parents living through any kind of perinatal loss should be screened.
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Hutti MH, Myers JA, Hall LA, Polivka BJ, White S, Hill J, Grisanti M, Hayden J, Kloenne E. Predicting Need for Follow-Up Due to Severe Anxiety and Depression Symptoms After Perinatal Loss. J Obstet Gynecol Neonatal Nurs 2018; 47:125-136. [DOI: 10.1016/j.jogn.2018.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2018] [Indexed: 10/17/2022] Open
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Hutti MH, Myers J, Hall LA, Polivka BJ, White S, Hill J, Kloenne E, Hayden J, Grisanti MM. Predicting grief intensity after recent perinatal loss. J Psychosom Res 2017; 101:128-134. [PMID: 28867418 DOI: 10.1016/j.jpsychores.2017.07.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/17/2017] [Accepted: 07/31/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The Perinatal Grief Intensity Scale (PGIS) was developed for clinical use to identify and predict intense grief and need for follow-up after perinatal loss. This study evaluates the validity of the PGIS via its ability to predict future intense grief based on a PGIS score obtained early after a loss. METHODS A prospective observational study was conducted with 103 international, English-speaking women recruited at hospital discharge or via the internet who experienced a miscarriage, stillbirth, or neonatal death within the previous 8weeks. Survey data were collected at baseline using the PGIS and the Perinatal Grief Scale (PGS). Follow-up data on the PGS were obtained 3months later. Data analysis included descriptive statistics, Cronbach's alpha, receiver operating characteristic curve analysis, and confirmatory factor analysis. RESULTS Cronbach's alphas were ≥0.70 for both instruments. PGIS factor analysis yielded three factors as predicted, explaining 57.7% of the variance. The optimal cutoff identified for the PGIS was 3.535. No difference was found when the ability of the PGIS to identify intense grief was compared to the PGS (p=0.754). The PGIS was not inferior to the PGS (AUC=0.78, 95% CI 0.68-0.88, p<0.001) in predicting intense grief at the follow-up. A PGIS score≥3.53 at baseline was associated with increased grief intensity at Time 2 (PGS: OR=1.97, 95% CI 1.59-2.34, p<0.001). CONCLUSIONS The PGIS is comparable to the PGS, has a lower response burden, and can reliably and validly predict women who may experience future intense grief associated with perinatal loss.
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Affiliation(s)
- Marianne H Hutti
- University of Louisville, School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, USA.
| | - John Myers
- University of Louisville, School of Medicine, USA
| | - Lynne A Hall
- University of Louisville, School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, USA
| | - Barbara J Polivka
- University of Louisville, School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, USA
| | - Susan White
- University of Louisville, School of Nursing, Norton Healthcare, USA
| | - Janice Hill
- University of Louisville, School of Nursing, Norton Healthcare, USA
| | - Elizabeth Kloenne
- University of Louisville, School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, USA
| | - Jaclyn Hayden
- University of Louisville, School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, USA
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Creation of interdisciplinary guidelines for care of women presenting to the emergency department with pregnancy loss. J Perinatol 2017; 37:757-761. [PMID: 28617428 DOI: 10.1038/jp.2017.61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/14/2017] [Accepted: 01/30/2017] [Indexed: 11/08/2022]
Abstract
A research trajectory is reported that created state-of-the-art interdisciplinary guidelines for care of women and their families who arrive in the emergency department with pregnancy loss. These guidelines include attention to mother and family bereavement as well as care of the fetus. Design was a triangulated non-experimental exploratory action research for the purpose of changing practice. Included were: (1) A qualitative study of emergency room nurses and physicians to assess beliefs/barriers to providing optimal care for pregnancy loss patients. (2) A focus group of perinatal bereavement providers; (3) Another focus group in the form of a sponsored National Summit of professional and lay experts and (4) A Delphi Study to craft language for national position statement. Results allowed the creation of interdisciplinary guidelines from the National Perinatal Association. These guidelines are being adopted by organizations and facilities throughout the United States. Training programs for emergency department personnel have been created by pregnancy loss organizations and are available.
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Maniatelli E, Zervas Y, Halvatsiotis P, Tsartsara E, Tzavara C, Briana DD, Salakos N. Translation and validation of the Perinatal Grief Scale in a sample of Greek women with perinatal loss during the 1st and 2nd trimester of pregnancy. J Matern Fetal Neonatal Med 2017; 31:47-52. [DOI: 10.1080/14767058.2016.1274303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Elissavet Maniatelli
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece
| | - Yiannis Zervas
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Panagiotis Halvatsiotis
- 2nd Department of Internal Medicine-Propaedeutic and Diabetes Center, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Eirini Tsartsara
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Chara Tzavara
- Department of Hygiene, Epidemiology and Medical Statistics, Centre for Health Services Research, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina D. Briana
- 1st Department of Pediatrics, Neonatal Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Salakos
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece
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Abstract
Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy.
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Affiliation(s)
- Amritha Bhat
- Department of Psychiatry, University of Washington, Box 35650, Seattle, WA, 98195, USA.
| | - Nancy Byatt
- Departments of Psychiatry and Obstetrics and Gynecology, UMass Medical School, Worcester, MA, USA
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Ratislavová K, Kalvas F, Beran J. Validation of the Czech version of the Perinatal grief scale. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2015. [DOI: 10.15452/cejnm.2015.06.0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hutti MH, Armstrong DS, Myers JA, Hall LA. Grief Intensity, Psychological Well‐Being, and the Intimate Partner Relationship in the Subsequent Pregnancy after a Perinatal Loss. J Obstet Gynecol Neonatal Nurs 2015; 44:42-50. [DOI: 10.1111/1552-6909.12539] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Huffman CS, Swanson K, Lynn MR. Measuring the Meaning of Miscarriage: Revision of the Impact of Miscarriage Scale. J Nurs Meas 2014; 22:29-45. [DOI: 10.1891/1061-3749.22.1.29] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: The purpose of this study was to determine a factor structure for the Impact of Miscarriage Scale (IMS). The 24 items comprising the IMS were originally derived from a phenomenological study of miscarriage in women. Initial psychometric properties were established based on a sample of 188 women (Swanson, 1999a). Method: Data from 341 couples were subjected to confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Results: CFA did not confirm the original structure. EFA explained 57% of the variance through an 18-item, 4-factor structure: isolation and guilt, loss of baby, devastating event, and adjustment. Except for the Adjustment subscale, Cronbach’s alpha coefficients were ≥.78. Conclusion: Although a 3-factor solution is most defensible, with further refinement and additional items, the 4th factor (adjustment) may warrant retention.
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Hutti MH, Armstrong DS, Myers J. Evaluation of the Perinatal Grief Intensity Scale in the Subsequent Pregnancy After Perinatal Loss. J Obstet Gynecol Neonatal Nurs 2013; 42:697-706. [DOI: 10.1111/1552-6909.12249] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Fenstermacher K, Hupcey JE. Perinatal bereavement: a principle-based concept analysis. J Adv Nurs 2013; 69:2389-400. [PMID: 23458030 DOI: 10.1111/jan.12119] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2013] [Indexed: 11/29/2022]
Abstract
AIM To report an analysis of the concept of perinatal bereavement. BACKGROUND The concept of perinatal bereavement emerged in the scientific literature during the 1970s. Perinatal bereavement is a practice-based concept, although it is not well-defined in the scientific literature and is often intermingled with the concepts of mourning and grief. DESIGN Concept Analysis. DATA SOURCES Using the term 'perinatal bereavement' and limits of only English and human, Pub Med and CINAHL were searched to yield 278 available references dating from 1974-2011. Articles specific to the experience of perinatal bereavement were reviewed. The final data set was 143 articles. REVIEW METHODS The methods of principle-based concept analysis were used. Results reveal conceptual components (antecedents, attributes and outcomes) which are delineated to create a theoretical definition of perinatal bereavement. RESULTS The concept is epistemologically immature, with few explicit definitions to describe the phenomenon. Inconsistency in conceptual meaning threatens the construct validity of measurement tools for perinatal bereavement and contributes to incongruent theoretical definitions. This has implications for both nursing science (how the concept is studied and theoretically integrated) and clinical practice (timing and delivery of support interventions). CONCLUSIONS Perinatal bereavement is a multifaceted global phenomenon that follows perinatal loss. Lack of conceptual clarity and lack of a clearly articulated conceptual definition impede the synthesis and translation of research findings into practice. A theoretical definition of perinatal bereavement is offered as a platform for researchers to advance the concept through research and theory development.
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Valizadeh L, Zamanzadeh V, Rahiminia E. Comparison of anticipatory grief reaction between fathers and mothers of premature infants in neonatal intensive care unit. Scand J Caring Sci 2012; 27:921-6. [DOI: 10.1111/scs.12005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 09/24/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Leila Valizadeh
- Department of Child and Family Health; School of Nursing and Midwifery; Tabriz university of Medical Sciences; Tabriz Iran
| | - Vahid Zamanzadeh
- Department of Medical Surgical Nursing; School of Nursing and Midwifery; Tabriz university of Medical Sciences; Tabriz Iran
| | - Elaheh Rahiminia
- Neonatal Intensive Care Nursing (NICN); Tabriz University of Medical Sciences; Tabriz Iran
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Adolfsson A. Meta-analysis to obtain a scale of psychological reaction after perinatal loss: focus on miscarriage. Psychol Res Behav Manag 2011; 4:29-39. [PMID: 22114533 PMCID: PMC3218782 DOI: 10.2147/prbm.s17330] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Pregnancy has different meanings to different women depending upon their circumstances. A number of qualitative studies have described the experience of miscarriage by women who had desired to carry their pregnancy to full term. The aim of this meta-analysis was to identify a scale of psychological reaction to miscarriage. Meta-analysis is a quantitative approach for reviewing articles from scientific journals through statistical analysis of findings from individual studies. In this review, a meta-analytic method was used to identify and analyze psychological reactions in women who have suffered a miscarriage. Different reactions to stress associated with the period following miscarriage were identified. The depression reaction had the highest average, weighted, unbiased estimate of effect (d+ = 0.99) and was frequently associated with the experience of perinatal loss. Psychiatric morbidity was found after miscarriage in 27% of cases by a diagnostic interview ten days after miscarriage. The grief reaction had a medium d+ of 0.56 in the studies included. However, grief after miscarriage differed from other types of grief after perinatal loss because the parents had no focus for their grief. The guilt is greater after miscarriage than after other types of perinatal loss. Measurement of the stress reaction and anxiety reaction seems to be difficult in the included studies, as evidenced by a low d+ (0.17 and 0.16, respectively). It has been recommended that grief after perinatal loss be measured by an adapted instrument called the Perinatal Grief Scale Short Version.
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Abstract
Perinatal loss can be emotionally devastating for couples who experience miscarriage, fetal or neonatal death. Nurses in a variety of settings can assist couples through their grief by providing emotional support, giving information about the grief process, and in planning for a future pregnancy or deciding to forego future childbearing. This article explicates the relationship between grief and perinatal loss and its effects on couples, specifically in the interconception period, when the initial grief and distress have begun to subside. Interconception care focuses on bridging the couple from the end of the postpartum period to the subsequent pregnancy or decision not to conceive again. Nurses assist couples in distinguishing between uncomplicated grief, complicated grief, and depression, and make appropriate referrals. Openness to expressions of grief, helping couples mobilize support, considering readiness for another pregnancy, and directing couples to useful Internet sites are essential nursing interventions.
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Sutan R, Amin RM, Ariffin KB, Teng TZ, Kamal MF, Rusli RZ. Psychosocial impact of mothers with perinatal loss and its contributing factors: an insight. J Zhejiang Univ Sci B 2010; 11:209-17. [PMID: 20205307 DOI: 10.1631/jzus.b0900245] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors. METHODS A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire. RESULTS Sixty-two respondents were included and most of them were working mothers (77.4%). The mean age of the respondents was (31.0+/-5.6) years and a majority of the subjects aged between 20-34 years (77.4%). According to the EPDS score, 53.2% of the respondents had a psychosocial impact with a total score of >9, out of 30. There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019). However, there were no significant differences between psychosocial impact and history of previous perinatal loss, ethnicity, occupation, educational level, age or total income. CONCLUSION Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed. Family and friends should continue to provide emotional support. People who have experienced similar problem before will be able to provide better support than those who have not.
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Affiliation(s)
- Rosnah Sutan
- Department of Community Health, University Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras 56000, KL, Malaysia
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Yan E, Tang CSK, Chung T. Validation of the Perinatal Grief Scale for use in Chinese women who have experienced recent reproductive loss. DEATH STUDIES 2010; 34:151-171. [PMID: 24479179 DOI: 10.1080/07481180903492539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The primary objective of this research was to validate the short version of the Perinatal Grief Scale (SVPGS) in the Chinese population. The Chinese SVPGS was administered to a sample of Chinese women who had experienced recent reproductive loss (N = 314). The results of the confirmatory factor analysis rejected the original 3-factor model delineated by Potvin (1989). A follow-up exploratory factor analysis suggested an alternative 3-factor model, consisting of a 12-item Sense of Worthlessness subscale, a 7-item Social Detachment subscale, and a 7-item Painful Recollection subscale. Further analysis showed that both the original and Chinese SVPGS demonstrated good internal consistency. Cronbach's alpha equaled .86, .83, .90, and .95, respectively, for the three subscales of Active Grief, Difficulty Coping, and Despair, and the total original SVPGS, and .85, .93, .91, and .95, respectively, for the new subscales of Sense of Worthlessness, Social Detachment, and Painful Recollection, and the total Chinese SVPGS. Both versions demonstrated satisfactory correlations with the participants' psychological distress and spousal emotional support. The authors suggest that both versions are useful in measuring the responses of Chinese women to reproductive loss; the original SVPGS should be used for cross-cultural studies, whereas the Chinese SVPGS should be used for local studies.
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Affiliation(s)
- Elsie Yan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR.
| | | | - Tony Chung
- Department of Obstetrics and Gynecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
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Swanson KM, Chen HT, Graham JC, Wojnar DM, Petras A. Resolution of depression and grief during the first year after miscarriage: a randomized controlled clinical trial of couples-focused interventions. J Womens Health (Larchmt) 2009; 18:1245-57. [PMID: 19630553 DOI: 10.1089/jwh.2008.1202] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS The purpose of this randomized controlled clinical trial was to examine the effects of three couples-focused interventions and a control condition on women and men's resolution of depression and grief during the first year after miscarriage. METHODS Three hundred forty-one couples were randomly assigned to nurse caring (NC) (three counseling sessions), self-caring (SC) (three video and workbook modules), combined caring (CC) (one counseling session plus three SC modules), or control (no treatment). Interventions, based on Swanson's Caring Theory and Meaning of Miscarriage Model, were offered 1, 5, and 11 weeks after enrollment. Outcomes included depression (CES-D) and grief, pure grief (PG) and grief-related emotions (GRE). Differences in rates of recovery were estimated via multilevel modeling conducted in a Bayesian framework. RESULTS Bayesian odds (BO) ranging from 3.0 to 7.9 favored NC over all other conditions for accelerating women's resolution of depression. BO of 3.2-6.6 favored NC and no treatment over SC and CC for resolving men's depression. BO of 3.1-7.0 favored all three interventions over no treatment for accelerating women's PG resolution, and BO of 18.7-22.6 favored NC and CC over SC or no treatment for resolving men's PG. BO ranging from 2.4 to 6.1 favored NC and SC over CC or no treatment for hastening women's resolution of GRE. BO from 3.5 to 17.9 favored NC, CC, and control over SC for resolving men's GRE. CONCLUSIONS NC had the overall broadest positive impact on couples' resolution of grief and depression. In addition, grief resolution (PG and GRE) was accelerated by SC for women and CC for men.
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Affiliation(s)
- Kristen M Swanson
- School of Nursing, University of North Carolina, Chapel Hill, NC 27599-7460, USA.
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Lawn JE, Yakoob MY, Haws RA, Soomro T, Darmstadt GL, Bhutta ZA. 3.2 million stillbirths: epidemiology and overview of the evidence review. BMC Pregnancy Childbirth 2009; 9 Suppl 1:S2. [PMID: 19426465 PMCID: PMC2679408 DOI: 10.1186/1471-2393-9-s1-s2] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
More than 3.2 million stillbirths occur globally each year, yet stillbirths are largely invisible in global data tracking, policy dialogue and programme implementation. This mismatch of burden to action is due to a number of factors that keep stillbirths hidden, notably a lack of data and a lack of consensus on priority interventions, but also to social taboos that reduce the visibility of stillbirths and the associated family mourning. Whilst there are estimates of the numbers of stillbirths, to date there has been no systematic global analysis of the causes of stillbirths. The multiple classifications systems in use are often complex and are primarily focused on high-income countries. We review available data and propose a programmatic classification that is feasible and comparable across settings. We undertook a comprehensive global review of available information on stillbirths in order to 1) identify studies that evaluated risk factors and interventions to reduce stillbirths, 2) evaluate the level of evidence for interventions, 3) place the available evidence for interventions in a health systems context to guide programme implementation, and 4) elucidate key implementation, monitoring, and research gaps. This first paper in the series outlines issues in stillbirth data availability and quality, the global epidemiology of stillbirths, and describes the methodology and framework used for the review of interventions and strategies.
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Affiliation(s)
- Joy E Lawn
- Saving Newborn Lives/Save the Children-US, Cape Town, South Africa
- Center for Health and Development, Institute of Child Health, London, UK
- Health Systems Research Unit, Medical Research Council of South Africa
| | - Mohammad Yawar Yakoob
- Division of Maternal and Child Health, The Aga Khan University, Karachi – 74800, Pakistan
| | - Rachel A Haws
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tanya Soomro
- Division of Maternal and Child Health, The Aga Khan University, Karachi – 74800, Pakistan
| | - Gary L Darmstadt
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zulfiqar A Bhutta
- Division of Maternal and Child Health, The Aga Khan University, Karachi – 74800, Pakistan
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Chung CW, Jung HS, Yun SN, Shin JC, Park HJ, Han MY. Factors of Physical and Psychological Symptoms in Women after Miscarriage. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2009. [DOI: 10.4069/kjwhn.2009.15.4.303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Chae Weon Chung
- Associate Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Korea
| | - Hye-Sun Jung
- Assistant Professor, Department of Preventive, College of Medicine, The Catholic University of Korea, Korea
| | - Soon Nyoung Yun
- Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Korea
| | - Jong Chul Shin
- Professor, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Hyun Ju Park
- Research Fellow, Department of Preventive, College of Medicine, The Catholic University of Korea, Korea
| | - Mi Yeoun Han
- Doctoral Student, College of Nursing, Research Institute of Nursing Science, Seoul National University, Korea
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Brier N. Grief Following Miscarriage: A Comprehensive Review of the Literature. J Womens Health (Larchmt) 2008; 17:451-64. [DOI: 10.1089/jwh.2007.0505] [Citation(s) in RCA: 152] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Norman Brier
- Department of Psychiatry and Pediatrics, Albert Einstein College of Medicine of Yeshiva University, Children's Evaluation and Rehabilitation Center, Bronx, New York
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Swanson KM, Connor S, Jolley SN, Pettinato M, Wang TJ. Contexts and evolution of women's responses to miscarriage during the first year after loss. Res Nurs Health 2007; 30:2-16. [PMID: 17243104 DOI: 10.1002/nur.20175] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Descriptions of 85 women's feelings about miscarriage at 1, 6, 16, and 52 weeks were inductively coded, rank-ordered, and clustered into 3 responses: healing, actively grieving, and overwhelmed. Women who were actively grieving or overwhelmed at 1 week experienced significantly less distress from 6 weeks on. Responses at 1 week differed with regards to those who had a history of perinatal loss or went on to experience negative life events or sexual distance after loss. One year responses differed based on who was pregnant or gave birth, miscarried again, lived through a higher number of post-loss negative life events, or experienced interpersonal or sexual distance from their mate. Responses were not influenced by gestational age at loss or having other children.
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Affiliation(s)
- Kristen M Swanson
- Family and Child Nursing, University of Washington, Seattle, Washington, USA
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Abstract
Perinatal loss is a profound experience for childbearing families. Examples of perinatal loss include miscarriage, ectopic pregnancy, stillbirth, neonatal death, and other losses. Perinatal loss engenders a unique kind of mourning since the child is so much a part of the parental identity. Societal expectations for mourning associated with perinatal loss are noticeably absent. Gender differences in response to such loss, as well as sibling and grandparent grief have been identified in the literature. Descriptive studies provide information on cultural responses to perinatal loss. Nursing interventions have been refined over the past two decades as research studies have been performed, in order to more fully promote health and healing in the face of perinatal loss. These include helping to create meaning through the sharing of the story of parental loss, the facilitation of sociocultural rituals associated with loss, the provision of tangible mementos, sensitive presence, and the validation of the loss. Outcome evaluations of such interventions are recommended.
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32
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Hutti MH. Social and Professional Support Needs of Families After Perinatal Loss. J Obstet Gynecol Neonatal Nurs 2005; 34:630-8. [PMID: 16227519 DOI: 10.1177/0884217505279998] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Perinatal loss has been associated with depression, anxiety, obsessive-compulsive disorder, suicide, marital conflict, and post-traumatic stress disorder. Nurses may provide professional support through teaching, role modeling, encouragement, counseling, problem solving, and other interventions. Nurses also may encourage more effective social support by helping significant others to provide willing, well-intentioned action that will produce a positive response in the bereaved couple. Interventions to increase professional and social support after perinatal loss are described.
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Affiliation(s)
- Marianne H Hutti
- Women's Health Nurse Practitioner Program, University of Louisville, School of Nursing, Louisville, Kentucky 40292, USA.
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33
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Wright PM. Childbirth education for parents experiencing pregnancy after perinatal loss. J Perinat Educ 2005; 14:9-15. [PMID: 17273448 PMCID: PMC1595261 DOI: 10.1624/105812405x72285] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Expectant parents who have experienced previous perinatal loss have special concerns, which can be partially addressed by modifying prepared childbirth education courses. This article presents a review of current literature, highlighting the unique needs of expectant parents who have experienced previous pregnancy loss. Modifications to traditional childbirth education courses are suggested, which include addressing parents' grief, managing anxiety, and facilitating communication with health-care providers and others.
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Affiliation(s)
- Patricia Moyle Wright
- PATRICIA MOYLE WRIGHT is employed as a childbirth educator for the Wyoming Valley Health Care System in Pennsylvania and is pursuing a PhD in Nursing at Loyola University Chicago in Illinois
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Côté-Arsenault D. The Influence of Perinatal Loss on Anxiety in Multigravidas. J Obstet Gynecol Neonatal Nurs 2003; 32:623-9. [PMID: 14565741 DOI: 10.1177/0884217503257140] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare multigravid women with and without a history of perinatal loss on state anxiety, pregnancy anxiety, and optimism. DESIGN Comparative descriptive; cross-sectional. SETTING Private obstetric offices in a small northeastern city in the United States. PARTICIPANTS The sample included 160 women who were between 17 and 28 weeks gestation: 96 multigravidas with no history of loss and 74 women with a history of one or two losses. MAIN OUTCOME MEASURES State anxiety, pregnancy anxiety, optimism, and perinatal loss history. RESULTS No group differences were found on demographic variables, state anxiety, or optimism. However, pregnancy anxiety was higher in women with a history of perinatal loss. Pregnancy anxiety was also correlated with desire to see care provider more often and number of phone calls between visits, and was not correlated with the number of living children. CONCLUSION Women experiencing pregnancy subsequent to perinatal loss have greater pregnancy anxiety: That is, they are more concerned about their pregnancies and their babies than women without a history of perinatal loss. State anxiety and optimism do not differentiate these two groups. This heightened anxiety should be acknowledged and more frequent contact with the care provider should be offered.
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Affiliation(s)
- Denise Côté-Arsenault
- School of Nursing, College of Human Services and Health Professions, Syracuse University, NY 13244, USA.
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Van P, Meleis AI. Coping with grief after involuntary pregnancy loss: perspectives of African American women. J Obstet Gynecol Neonatal Nurs 2003; 32:28-39. [PMID: 12570179 DOI: 10.1177/0884217502239798] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To present the coping strategies used by African American women following their miscarriages, ectopic pregnancies, fetal deaths, and still-births, which the authors have termed involuntary pregnancy losses or IPLs. DESIGN Semistructured audiotaped interviews; grounded theory methods used to collect and analyze the data. SETTING Urban community-based sites in the Western United States. PARTICIPANTS 20 African American adult women who reported a history of involuntary pregnancy loss within 3 years of interview. RESULTS In this study, the women's responses to their IPL were grouped into four areas. They coped with personal reactions, reactions of others, memories of the baby, and subsequent pregnancies. CONCLUSION The women in this study used inner resources to develop self-help strategies to cope with reactions following IPL. Nurses are challenged to harness the influence of family, friends, religion, and cultural traditions to assist women in processing the cognitive, emotional, and social traumas associated with IPL. Educating women to recognize grief responses after IPL and to manage these responses effectively may prevent adverse outcomes to their physical and mental health. A culturally sensitive framework of clinical assessment and intervention for African American women experiencing IPL has been developed.
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Affiliation(s)
- Paulina Van
- University of California, San Francisco, School of Nursing, Department of Family Health Care Nursing, 94143-0606, USA.
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Lemon BS. Exploring Latino rituals in birthing. Understanding the need to bury the placenta. AWHONN LIFELINES 2002; 6:443-5. [PMID: 12420388 DOI: 10.1177/1091592302238934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
OBJECTIVE To identify the short-term grief response after elective abortion. DESIGN Descriptive, comparative study. SETTING Instruments were administered in a women's health clinic. PARTICIPANTS Ninety-three women, 45 who had a history of elective abortion within the past 1 to 14 months and 48 who had never had an abortion. Inclusion criteria included no perinatal losses within the past 5 years; no documented psychiatric history; and ability to read, write, and comprehend English. MAIN OUTCOME MEASURES Nature and intensity of short-term grief. RESULTS Women with a history of elective abortion experienced grief in terms of loss of control, death anxiety, and dependency. Although there were no statistically significant differences in the intensity of grief in women who had a history of elective abortion and the comparison group, there was an overall trend toward higher grief intensities in the abortion group. Presence of living children, perceived pressure to have the abortion, and the number of abortions appear to affect the intensity of the short-term grief response. CONCLUSION Elective abortion has the potential for eliciting a short-term grief response. Research is needed to identify which women are at greatest risk. This grief response should be acknowledged and appropriate interventions undertaken.
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Affiliation(s)
- G B Williams
- University of Texas Health Science Center at San Antonio School of Nursing, 78229-7951, USA.
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38
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Lasker JN, Toedter LJ. Predicting Outcomes after Pregnancy Loss: Results from Studies Using the Perinatal Grief Scale. ACTA ACUST UNITED AC 2000. [DOI: 10.1177/105413730000800402] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There are widely diverse findings in the literature on the types of variables that best predict grief following a pregnancy loss. This article compares the results from twenty-two studies, carried out in four countries, which all used the Perinatal Grief Scale as their outcome measure. Results of the comparison support the value of the measure for such investigations and indicate strong commonalities among the findings. Specifically, lower grief scores are consistently related to male gender, older age, shorter pregnancy, passage of more time since the loss, mental health, good marital relationship and social support, and a subsequent pregnancy. Conclusions suggest the need for studies that include more diverse populations and evaluate the impact of attributions, coping, and interventions following a loss.
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Friedrichs J, Daly MI, Kavanaugh K. Follow-up of Parents who Experience a Perinatal Loss: Facilitating Grief and Assessing for Grief Complicated by Depression. ACTA ACUST UNITED AC 2000. [DOI: 10.1177/105413730000800306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The importance of providing follow-up support to parents who have experienced a perinatal loss has been described in the literature. Anecdotal reports demonstrate that many health care professionals provide some type of telephone follow-up contact to bereaved parents in the weeks following the loss. Yet, limited information exists to guide the way that follow-up telephone calls are made, especially for assessing complicated grief. Health care professionals are often challenged as they attempt to identify parents at risk, especially when contacts are provided over the telephone. While it is never easy to talk to a parent during the very painful adjustment at home, guidelines for follow-up telephone calls can assist professionals in providing sensitive, individualized follow-up care.
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Swanson KM. Predicting depressive symptoms after miscarriage: a path analysis based on the Lazarus paradigm. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 2000; 9:191-206. [PMID: 10746523 DOI: 10.1089/152460900318696] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Twenty percent of all pregnancies end in miscarriage. Findings are mixed about who is most at risk for a depressive response. The purpose of this study was to develop and test a theory-based path model that would enable prediction of the intensity of women's depressive symptoms at 4 months and at 1 year after miscarriage. The model is based on Lazarus's theory of emotions and adaptation. Model constructs examined included stage I contextual variables (gestational age, number of miscarriages, number of children, maternal age, perceived provider caring at the time of loss, and family income), stage II interceding variables (perceived social support, emotional strength, and subsequent pregnancy/birth), stage III primary appraisal of meaning (personal significance of miscarrying), stage IV secondary appraisal (active or passive coping), and stage V emotional response (depressive symptoms). Path analysis employing a series of stepwise, multiple regression equations was used to test the hypothesized model. The sample consisted of 174 women whose pregnancies ended prior to 20 weeks gestation (mean = 10.51, SD = 3.32). The model accounted for 63% of the variance in women's depressive symptoms at 4 months and 54% at 1 year. Findings support the utility of the Lazarus model and confirm that women most at risk for increased depressive symptoms after miscarriage are those who attribute high personal significance to miscarriage, lack social support, have lower emotional strength, use passive coping strategies, have lower incomes, and do not conceive or give birth by 1 year after loss.
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Affiliation(s)
- K M Swanson
- Department of Family and Child Nursing, University ofWashington, Seattle 98195, USA
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