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Resolution of Depression and Grief during the First Year after Miscarriage: A Randomized Controlled Clinical Trial of Couples-Focused Interventions

Kristen M. Swanson · Hsien-Tzu Chen · J. Christopher Graham · Danuta Wojnar · Anthippy Petras

131 citations0/0 files storedJournal of Women s Health

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Grief, Bereavement, and Mental Health Maternal Mental Health During Pregnancy and Postpartum Reproductive Health and Technologies

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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References

1977The CES-D Scale 2007Psychological morbidity following miscarriage 1988The Perinatal Grief Scale: Development and initial validation.1996Miscarriage as a traumatic event: A review of the literature and new implications for intervention 1996The influence of psychological debriefing on emotional adaptation in women following early miscarriage: A preliminary study 1982Measuring symptoms of grief and bereavement 1999Effects of Caring, Measurement, and Time on Miscarriage Impact and Women's Well-Being 1996Similarities and differences in couples' grief reactions following a miscarriage: Results from a longitudinal study

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2011Efficacy of cognitive behavioral internet-based therapy in parents after the loss of a child during pregnancy: pilot data from a randomized controlled trial 2010Satisfaction with pregnancy loss aftercare: are women getting what they want?2021Psychosocial interventions on psychological outcomes of parents with perinatal loss: A systematic review and meta-analysis 2018Longitudinal study of emotional experiences, grief and depressive symptoms in women and men after miscarriage

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