1
|
Xie J, Hunter A, Biesty L, Grealish A. The impact of midwife/nurse-led psychosocial interventions on parents experiencing perinatal bereavement: An integrative review. Int J Nurs Stud 2024; 157:104814. [PMID: 38833996 DOI: 10.1016/j.ijnurstu.2024.104814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/07/2024] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Perinatal loss is a traumatic event associated with a high risk of parents experiencing negative psychological outcomes. Despite most parents being in regular contact with midwives and nurses during the perinatal period, there is a lack of evidence which hampers these professionals from using effective psychosocial interventions with parents. AIM This study aims to synthesise the existing evidence on the types of psychosocial interventions delivered by midwives/nurses for parents with perinatal bereavement, their impacts on bereaved parents' mental health and the experiences of midwives and nurses in delivering psychosocial interventions for parents experiencing perinatal loss. DESIGN An integrative review of the literature. METHODS Whittemore and Knafl's five-stage integrative review framework guided this review. A systematic literature search of the Medline, PsycINFO, Embase, CINAHL and ASSIA, Cochrane Library and ProQuest databases was conducted from inception to January 2023, with no language or geographical limiters set due to the paucity of research published in this subject area. Two researchers independently screened and reviewed each study's data extraction and methodological quality using the Joanna Briggs Institute and Mixed Method Appraisal Tool. Results were analysed and synthesised using narrative synthesis. RESULTS A total of 21 studies met the inclusion criteria. From these, we identified nine types of psychosocial interventions for perinatal bereavement that can be delivered by midwives and nurses. The positive impacts of midwife/nurse-led psychosocial interventions on grief, anxiety, depression posttraumatic stress disorder and other psychosocial outcomes amongst parents experiencing perinatal loss have been demonstrated. In addition, we identified the useful components of these interventions and the experiences of midwives and nurses in delivering psychosocial interventions, thereby highlighting barriers such as lack of knowledge and skills, stressful working environments and inadequate emotional support. CONCLUSION Our findings demonstrate that midwife/nurse-led psychosocial interventions have the potential to improve grief, anxiety, depression, posttraumatic stress disorder symptoms and other psychosocial outcomes for parents experiencing perinatal loss. Thus, future research should consider training, workload, time cost and emotional support for midwives/nurses when developing midwife/nurse-led psychosocial interventions for parents with perinatal loss. REGISTRATION NUMBER CRD42022369032. TWEETABLE ABSTRACT Midwife/nurse-led psychosocial interventions have the potential to improve mental health amongst parents experiencing perinatal loss.
Collapse
Affiliation(s)
- Jiaying Xie
- School of Nursing and Midwifery, University of Galway, Galway, Ireland.
| | - Andrew Hunter
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Linda Biesty
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland; Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| |
Collapse
|
2
|
Peng Z, Liu J, Liu B, Zhou J, Zhang L, Zhang Y. Psychological interventions to pregnancy-related complications in patients with post-traumatic stress disorder: a scoping review. BMC Psychiatry 2024; 24:478. [PMID: 38937748 PMCID: PMC11212442 DOI: 10.1186/s12888-024-05926-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/21/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE This scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then summarize effective psychological interventions for pregnancy-related PTSD or sub-PTSD. METHOD Publications in English and Chinese were searched in PubMed, Embase, Cochrane, ISI Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang databases using the subject headings of "Stress Disorders, Post-Traumatic", "Pregnant Women", and "psychotherapy". To ensure that as many relevant studies are incorporated as possible, free terms such as prenatal, postnatal, perinatal and gestation were also used. Intervention studies and related cases published by July 1st, 2023, were also searched. RESULTS Twenty-one articles (including 3,901 mothers) were included in this review. Evidence showed that typical psychological interventions exhibited great effect, and family support programs, peer support, online yoga, and music therapy were also effective in reducing risk and improving the psychological well-being of the studied population. CONCLUSION Fetal abnormalities, miscarriage, premature birth, infants with low birth weights, hypertension, pre-eclampsia, HELLP syndrome, and hyperemesis gravidarum are associated with an increased risk of PTSD. Moreover, high-risk pregnant women may benefit from psychological interventions such as cognitive behavioral therapy (CBT). It may also be feasible and well-accepted for music therapy and exposure therapy to lessen the intensity of PTSD in mothers.
Collapse
Affiliation(s)
- Zhuo Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Li Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| |
Collapse
|
3
|
Pedraza EC, Vokinger AK, Cleves D, Michel G, Wrigley J, Baker JN, Garcia-Quintero X, McNeil MJ. Grief and Bereavement Support for Parents in Low- or Middle-Income Countries: A Systematic Review. J Pain Symptom Manage 2024; 67:e453-e471. [PMID: 38244706 DOI: 10.1016/j.jpainsymman.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
INTRODUCTION The death of a child may be the most traumatic event a family can experience. Bereavement care for parents is essential for their physical and mental well-being and is a psychosocial standard of care. Childhood mortality is higher in low- or middle-income countries (LMICs); however, little is known regarding bereavement support or interventions for parents in LMICs. AIM To identify programs, services, initiatives, or interventions offered to bereaved parents in LMICs in hospital settings. METHODS A systematic search was executed following the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles from LMICs describing interventions, programs, or resources provided to parents after the death of a child (0-18 years old) from any cause were included. Extracted data was categorized by demographics, study design, outcomes, and quality assessment using the McGill Mixed Methods Appraisal Tool (MMAT). RESULTS We retrieved 4428 papers and screened their titles and abstracts, 36 articles were selected for full-text assessment, resulting in nine articles included in the final analysis. Most interventions described support for parents whose child died during the prenatal or neonatal period. The primary interventions included psychological counseling, creating mementos (such as photographs or footprints), and bereavement workshops. Only one paper described a fully established bereavement program for parents. Eight of the papers met high-quality criteria. DISCUSSION Although bereavement care is crucial for parents whose child has died, only a few studies have documented bereavement interventions in LMICs. More research may help with bereavement program implementation and improved care for bereaved parents in LMICs.
Collapse
Affiliation(s)
- Eddy Carolina Pedraza
- Faculty of Health Sciences and Medicine (P.E.C., V.A.K., M.G.), University of Lucerne, Lucerne, Switzerland.
| | - Anna Katharina Vokinger
- Faculty of Health Sciences and Medicine (P.E.C., V.A.K., M.G.), University of Lucerne, Lucerne, Switzerland
| | - Daniela Cleves
- Department of Global Pediatric Medicine (C.D., B.J.N., G.-Q.X., M.M.J.), St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Gisela Michel
- Faculty of Health Sciences and Medicine (P.E.C., V.A.K., M.G.), University of Lucerne, Lucerne, Switzerland
| | - Jordan Wrigley
- Biomedical Library (W.J.), St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Justin N Baker
- Department of Global Pediatric Medicine (C.D., B.J.N., G.-Q.X., M.M.J.), St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Division of Quality of Life and Pediatric Palliative Care (B.J.N.), Stanford Medicine Children's Health, Palo Alto, California, USA
| | - Ximena Garcia-Quintero
- Department of Global Pediatric Medicine (C.D., B.J.N., G.-Q.X., M.M.J.), St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Michael J McNeil
- Department of Global Pediatric Medicine (C.D., B.J.N., G.-Q.X., M.M.J.), St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
4
|
Hollins Martin CJ, Reid K. A scoping review of therapies used to treat psychological trauma post perinatal bereavement. J Reprod Infant Psychol 2023; 41:582-598. [PMID: 34989287 DOI: 10.1080/02646838.2021.2021477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Up to 39% of women who experience perinatal bereavement proceed to develop Post-Traumatic-Stress-Disorder (PTSD), with this large proportion meriting treatment. Before setting-up a treatment service for postnatal women who are experiencing psychological trauma, it is important to identify what therapies have been used in-the-past to address this problem. AIM To scope for research that has implemented therapies to treat psychological trauma post perinatal bereavement, for potential inclusion in a flexible treatment package. METHOD A scoping review mapped coverage, range, and type of research that has reported on prior therapies used to treat psychological trauma post perinatal bereavement. FINDINGS Due to the dearth of papers that directly addressed perinatal bereavement, we widened the scope of the review to view what treatments had been used to treat psychological trauma post-childbirth. Out of 23 studies that report on effectiveness of therapies used to treat psychological trauma post-childbirth, only 4-focused upon treating PTSD post perinatal bereavement (3 effective/1 ineffective). Successful treatments were reported by Kersting et al. (2013), who found CBT effective at reducing PTSD symptoms post-miscarriage, termination for medical reasons, and stillbirth (n = 33 & n = 115), and Navidian et al. (2s017)) found that 4-sessions of grief-counselling reduced trauma symptoms post-stillbirth in (n = 50) women. One study by Huberty et al. (2020found on-line yoga to be ineffective at reducing PTSD symptoms post-stillbirth. CONCLUSIONS A dearth of research has explored effectiveness of therapies for treating psychological trauma post perinatal bereavement and post-childbirth, with need to develop and test a research informed flexible counselling package.
Collapse
Affiliation(s)
- Caroline J Hollins Martin
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University (Enu), Edinburgh, Scotland, UK
| | - Katrina Reid
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University (Enu), Edinburgh, Scotland, UK
| |
Collapse
|
5
|
Dekel S, Papadakis JE, Quagliarini B, Jagodnik KM, Nandru R. A Systematic Review of Interventions for Prevention and Treatment of Post-Traumatic Stress Disorder Following Childbirth. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.17.23294230. [PMID: 37693410 PMCID: PMC10485880 DOI: 10.1101/2023.08.17.23294230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Objective Postpartum women can develop post-traumatic stress disorder (PTSD) in response to complicated, traumatic childbirth; prevalence of these events remains high in the U.S. Currently, there is no recommended treatment approach in routine peripartum care for preventing maternal childbirth-related PTSD (CB-PTSD) and lessening its severity. Here, we provide a systematic review of available clinical trials testing interventions for the prevention and indication of CB-PTSD. Data Sources We conducted a systematic review of PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, and Scopus through December 2022 to identify clinical trials involving CB-PTSD prevention and treatment. Study Eligibility Criteria Trials were included if they were interventional, evaluated CB-PTSD preventive strategies or treatments, and reported outcomes assessing CB-PTSD symptoms. Duplicate studies, case reports, protocols, active clinical trials, and studies of CB-PTSD following stillbirth were excluded. Study Appraisal and Synthesis Methods Two independent coders evaluated trials using a modified Downs and Black methodological quality assessment checklist. Sample characteristics and related intervention information were extracted via an Excel-based form. Results A total of 33 studies, including 25 randomized controlled trials (RCTs) and 8 non-RCTs, were included. Trial quality ranged from Poor to Excellent. Trials tested psychological therapies most often delivered as secondary prevention against CB-PTSD onset (n=21); some examined primary (n=3) and tertiary (n=9) therapies. Positive treatment effects were found for early interventions employing conventional trauma-focused therapies, psychological counseling, and mother-infant dyadic focused strategies. Therapies' utility to aid women with severe acute traumatic stress symptoms or reduce incidence of CB-PTSD diagnosis is unclear, as is whether they are effective as tertiary intervention. Educational birth plan-focused interventions during pregnancy may improve maternal health outcomes, but studies remain scarce. Conclusions An array of early psychological therapies delivered in response to traumatic childbirth, rather than universally, in the first postpartum days and weeks, may potentially buffer CB-PTSD development. Rather than one treatment being suitable for all, effective therapy should consider individual-specific factors. As additional RCTs generate critical information and guide recommendations for first-line preventive treatments for CB-PTSD, the psychiatric consequences associated with traumatic childbirth could be lessened.
Collapse
Affiliation(s)
- Sharon Dekel
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joanna E. Papadakis
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Beatrice Quagliarini
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kathleen M. Jagodnik
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rasvitha Nandru
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Haghighi M, Oladbaniadam K, Mohaddesi H, Rasuli J. Individual counseling in mothers bereaved by pregnancy loss: A randomized clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:209. [PMID: 36003258 PMCID: PMC9393948 DOI: 10.4103/jehp.jehp_1765_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The loss of a pregnancy can result in grief, guilt, self-doubt, anxiety, and post-traumatic stress disorder (PTSD). Considering the side effects mentioned for mental health and the fact that the symptoms will linger if left untreated and even adversely affect the subsequent pregnancies. The current study was designed to assess the impact of individual counseling on stress, anxiety, and depression in mothers with pregnancy loss. MATERIALS AND METHODS The study commenced 100 women who experienced pregnancy loss (in Urmia/2018-2019); they were enrolled using convenience sampling and block randomization. The intervention group received four individual counseling sessions (weekly sessions with a duration of 1 h) based on Warden's principles. The control group received routine care. The Depression Anxiety Stress Scale (DASS-42) was filled out at baseline, the pre- and post-intervention. Analyses were performed using the Chi-square, paired, or individual t-tests, when necessary. P value < 0.05 was considered significant. RESULTS There were no significant differences regarding socio-demographic characteristics and clinical features between groups at baseline. Intra-group analysis showed that all outcome measures in the intervention group were significantly improved. According to inter-groups analysis, a significant association was found between pre-test and post-test in the intervention group (P < 0.05). CONCLUSION Results of this study can clarify the psychological effects of pregnancy loss in these mothers and help the officials and responsible parties to plan the treatment and rehabilitation of these women and include them in the healthcare system.
Collapse
Affiliation(s)
| | - Khatereh Oladbaniadam
- M.Sc. Student of Counselling in Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Hamideh Mohaddesi
- Department of Midwifery, Maternal and Childhood Obesity Research Center, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Javad Rasuli
- Department of Epidemiology and Biostatistics, School of Medicine, University of Medical Sciences, Urmia, Iran
| |
Collapse
|
7
|
Fernández-Medina IM, Jiménez-Lasserrotte MDM, Ruíz-Fernández MD, Granero-Molina J, Fernández-Sola C, Hernández-Padilla JM. Milk Donation Following A Perinatal Loss: A Phenomenological Study. J Midwifery Womens Health 2022; 67:463-469. [PMID: 35166428 DOI: 10.1111/jmwh.13342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/02/2021] [Accepted: 12/27/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Perinatal loss is a traumatic event for women with negative consequences for their well-being and mental health. After perinatal loss, some women choose to not suppress lactation and to donate their breast milk. Donating milk can be a grief ritual to cope with the loss. The aim of this study was to explore women's experiences of donating their breast milk following a perinatal loss. METHODS A hermeneutic phenomenology was carried out. Thirteen semistructured interviews were conducted. Data was recorded, transcribed, and categorized into themes and subthemes. RESULTS Two main themes emerged from the data: (1) lactation after loss: a forgotten aspect of the care, with the subthemes "the silence surrounding grieving lactation" and "experiencing lactation amidst a sea of tears"; and (2) milk donation: a resource to alleviate pain and offer hope, with the subthemes "expressing and donating breast milk: a healing ritual" and "breaking the taboo of the grieving lactation." DISCUSSION Information about lactation options is not typically included in participants' care plan. Women's experiences highlight the need for the support of health care professionals. Donating milk helps some women to cope with the loss and accept and integrate it into their daily lives. Milk donation is also an opportunity to educate society about options following a perinatal loss.
Collapse
Affiliation(s)
| | | | | | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
| | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
| | - José Manuel Hernández-Padilla
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.,Department of Adult, Child and Midwifery, School of Health and Education, Middlesex University, London, United Kingdom
| |
Collapse
|
8
|
Fernández-Férez A, Ventura-Miranda MI, Camacho-Ávila M, Fernández-Caballero A, Granero-Molina J, Fernández-Medina IM, Requena-Mullor MDM. Nursing Interventions to Facilitate the Grieving Process after Perinatal Death: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115587. [PMID: 34073728 PMCID: PMC8197264 DOI: 10.3390/ijerph18115587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/26/2022]
Abstract
Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal death, parents experience the process of perinatal grief. Midwives and nurses can develop interventions to improve the perinatal grief process. The aim of this review was to determine the efficacy of nursing interventions to facilitate the process of grief as a result of perinatal death. A systematic review of the literature was carried out. Studies that met the selection criteria underwent a quality assessment using the Joanna Briggs Institute critical appraisal tool. Four articles were selected out of the 640 found. Two are quasi-experimental studies, and two are randomized controlled clinical studies. The interventions that were analyzed positively improve psychological self-concept and role functions, as well as mutual commitment, depression, post-traumatic stress and symptoms of grief. These interventions are effective if they are carried out both before perinatal loss and after it has occurred. The support of health professionals for affected parents, their participation in the loss, expressing feelings and emotions, using distraction methods, group sessions, social support, physical activity, and family education are some of the effective interventions.
Collapse
Affiliation(s)
- Alba Fernández-Férez
- Faculty of Health Sciences, University of Granada, Distrito Sanitario Almería, 04009 Almería, Spain;
| | - Maria Isabel Ventura-Miranda
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (J.G.-M.); (I.M.F.-M.); (M.d.M.R.-M.)
- Correspondence:
| | | | - Antonio Fernández-Caballero
- Faculty of Nursing, Univesity of Cádiz, 11207 Algeciras, Spain;
- Gynecology, Obstetrics and Delivery Service of the Hospital Punta Europa, 11207 Algeciras, Spain
| | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (J.G.-M.); (I.M.F.-M.); (M.d.M.R.-M.)
- Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago 7500000, Chile
| | - Isabel María Fernández-Medina
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (J.G.-M.); (I.M.F.-M.); (M.d.M.R.-M.)
| | - María del Mar Requena-Mullor
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (J.G.-M.); (I.M.F.-M.); (M.d.M.R.-M.)
| |
Collapse
|
9
|
Fogarty S. A role for massage after antenatal or neonatal loss: evaluations from a community program. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
10
|
Gao X, Wang Z, Kong C, Fan H, Zhang J, Wang J, Tan L, Wang J. Cross-Sectional Survey to Assess Health-Care Workers' Grief Counseling for Bereaved Families of COVID-19 Victims in Wuhan, China. Disaster Med Public Health Prep 2021; 16:1-6. [PMID: 33926611 PMCID: PMC8245329 DOI: 10.1017/dmp.2021.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This research aimed to examine health-care workers' grief counseling for bereaved families of coronavirus disease 2019 (COVID-19) victims in China. Our research may provide a new opportunity to stimulate development of grief counseling in China. METHODS A cross-sectional survey was conducted with 724 health-care workers selected by convenience sampling from 7 hospitals in Wuhan. Data collection tools included a sociodemographic questionnaire, the skills of grief counseling scale (SGCS), and the attitudes of grief counseling scale (AGCS). RESULTS The average SGCS score was 18.96 ± 4.66, whose influencing factors consisted of sense of responsibility, frequency of contact with bereaved families, and relevant training (P < 0.05). The average AGCS score was 33.36 ± 8.70, whose influencing factors consisted of other grief counseling skills, communication skills, education background, and relevant training (P < 0.05). CONCLUSIONS The skills and attitudes toward grief counseling among health-care workers combating COVID-19 were at a lower level in Wuhan, China, indicating the need to build a comprehensive grief counseling system, establish a standardized training course, and strengthen the popularization of grief counseling services to the public.
Collapse
Affiliation(s)
- Xudong Gao
- College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan, China
| | - Zhimin Wang
- Department of Nursing, Second Affiliated Hospital of University of South China, Hengyang, China
| | - Chan Kong
- General Medical Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongru Fan
- Department of Cardiovascular Diseases, First Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Zhang
- Department of Nursing, Second Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Neurosurgery, Fourth Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
| | - Lingling Tan
- Department of Nursing, Second Affiliated Hospital of University of South China, Hengyang, China
| | - Jinyao Wang
- Public Health Teaching Center, Department of Medicine, Shanxi Datong University, Datong, China
| |
Collapse
|
11
|
Martin CJH, Patterson J, Paterson C, Welsh N, Dougall N, Karatzias T, Williams B. ICD-11 complex Post Traumatic Stress Disorder (CPTSD) in parents with perinatal bereavement: Implications for treatment and care. Midwifery 2021; 96:102947. [PMID: 33610906 DOI: 10.1016/j.midw.2021.102947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 12/21/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The 11th revision of the WHO International Classification of Diseases (ICD-11) has identified Complex PTSD (CPTSD) as a new condition. AIM To explore whether the new diagnosis of CPTSD (ICD11) is relevant to women who have experienced perinatal bereavement and to advance knowledge about the acceptability, feasibility and perceived impact of delivering an innovative flexible Compassionate Focused Therapy (CFT) informed treatment package to alleviate symptoms of this condition. METHODS A mixed methods study using survey and interviews was conducted. Participants first completed the International Trauma Questionnaire (ITQ) to assess if they met the criteria for PTSD or CPTSD (n=72), and subsequent semi-structured interviews (n=12) identified participants' views about different treatment approaches. PARTICIPANTS A convenience sample of women who had experienced perinatal bereavement were recruited from one geographical region in Scotland. DATA COLLECTION Information was gathered about trauma experiences related to perinatal bereavement; participants' levels of PTSD or CPTSD using the ITQ; and views regarding the features of treatment options. In-depth interviews with women (n=12) and a focus group with staff (n=5) were also conducted. FINDINGS Of 74 participants (n=74) who fully completed the ITQ, 10.8% (n=8) met the criteria for PTSD and 29.7% (n=22) for CPTSD, equating to a total of 40.5% of participants experiencing traumatic stress. Results suggest that CPTSD is a more common condition than PTSD in people with perinatal bereavement, with qualitative data suggesting that CFT and EMDR can be useful and acceptable interventions for this population group. CONCLUSION A feasibility study is recommended next to evaluate acceptability of trial processes in preparation for a definitive randomised controlled trial of a new flexible CFT informed treatment package to address PTSD and CPTSD in people with perinatal bereavement. RECOMMENDATIONS FOR PRACTICE Routine assessment of ICD-11 CPTSD is recommended in this population group.
Collapse
Affiliation(s)
- Caroline J Hollins Martin
- Maternal Health, School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK, EH11 4BN.
| | - Jenny Patterson
- School of Health and Social Care, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN.
| | | | - Nicola Welsh
- 'Held in Our Hearts', 177, Colinton Road, Edinburgh, EH14 1BZ, UK.
| | - Nadine Dougall
- School of Health and Social Care, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN, UK.
| | - Thanos Karatzias
- School of Health and Social Care, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN.
| | - Brian Williams
- School of Health and Social Care, 4B06, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN.
| |
Collapse
|
12
|
Charrois EM, Bright KS, Wajid A, Mughal MK, Hayden KA, Kingston D. Effectiveness of psychotherapeutic interventions on psychological distress in women who have experienced perinatal loss: a systematic review protocol. Syst Rev 2020; 9:125. [PMID: 32487235 PMCID: PMC7268676 DOI: 10.1186/s13643-020-01387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 05/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perinatal loss is a traumatic and complex experience that contributes to negative maternal psychological states and adverse outcomes impacting fetal development, maternal-fetal/infant bonding, marital/partner relationships, and child cognitive, emotional, and behavioral development. These outcomes present preventable disease burden and financial liability to individuals, families, and the healthcare system. Psychological interventions have the potential to improve outcomes for women and their families after perinatal loss. A few studies have explored the effectiveness of individual psychotherapeutic interventions in reducing maternal psychological distress after perinatal loss; however, a systematic review to compare these interventions has not been conducted. The primary objective of this systematic review is to determine the effectiveness of psychotherapeutic intervention on psychological distress and perception, coping, and adjustment in women who have experienced perinatal loss. The secondary objective of this review is to examine the content and delivery methods of effective psychotherapeutic interventions. METHODS We endeavor to search electronic databases (PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, CINAHL, Social Work Abstracts, Family and Society Studies Worldwide, Family Studies Abstracts, Academic Search Premier), gray literature databases (Proquest Dissertation and Theses Global, Web of Science Conference Proceedings Citation Index, OAIster, Open-Grey, Canadian Electronic Library, Canadian Research Index), and relevant organizational websites and conduct forward and backward citation searches of included studies. Inclusion criteria will consider studies that (1) are randomized controlled trials (RCTs), quasi-experimental (e.g., before-after design), and observational (prospective cohort); (2) include women affected by perinatal loss accessing psychotherapeutic intervention or support; and (3) evaluate a mental health or related outcome. Two authors will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. The primary outcome(s) will be measurements on the severity of depressive, anxiety, grief, and post-traumatic stress symptoms. Secondary outcomes will include measurements on difficulties in perception, coping, social, or dyadic adjustment. Conducting a narrative synthesis will identify relationships within study findings, and if appropriate, a random effects meta-analysis will be performed. DISCUSSION This systematic review will summarize the effectiveness of psychological interventions, including their content and delivery method, in reducing psychological distress and improving outcomes for women affected by perinatal loss. The evidence generated from this review can inform researchers and policymakers in expanding on related research and developing customized interventions or programs. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019126456.
Collapse
Affiliation(s)
- Elyse M. Charrois
- Faculty of Nursing, University of Calgary, 2500 University Drive, N.W., Calgary, Alberta T2N 1 N4 Canada
| | - Katherine S. Bright
- Faculty of Nursing, University of Calgary, 2500 University Drive, N.W., Calgary, Alberta T2N 1 N4 Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
| | - Abdul Wajid
- Faculty of Nursing, University of Calgary, 2500 University Drive, N.W., Calgary, Alberta T2N 1 N4 Canada
| | - Muhammad Kashif Mughal
- Faculty of Nursing, University of Calgary, 2500 University Drive, N.W., Calgary, Alberta T2N 1 N4 Canada
- Alberta Health Services, Calgary, Alberta T2S 3C3 Canada
| | - K. Alix Hayden
- Libraries and Cultural Resources, University of Calgary, T2N 1 N4, Calgary, Alberta Canada
| | - Dawn Kingston
- Faculty of Nursing, University of Calgary, 2500 University Drive, N.W., Calgary, Alberta T2N 1 N4 Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
| |
Collapse
|
13
|
Roberts NP, Kitchiner NJ, Kenardy J, Robertson L, Lewis C, Bisson JI. Multiple session early psychological interventions for the prevention of post-traumatic stress disorder. Cochrane Database Syst Rev 2019; 8:CD006869. [PMID: 31425615 PMCID: PMC6699654 DOI: 10.1002/14651858.cd006869.pub3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The prevention of long-term psychological distress following traumatic events is a major concern. Systematic reviews have suggested that individual psychological debriefing is not an effective intervention at preventing post-traumatic stress disorder (PTSD). Over the past 20 years, other forms of intervention have been developed with the aim of preventing PTSD. OBJECTIVES To examine the efficacy of psychological interventions aimed at preventing PTSD in individuals exposed to a traumatic event but not identified as experiencing any specific psychological difficulties, in comparison with control conditions (e.g. usual care, waiting list and no treatment) and other psychological interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO and ProQuest's Published International Literature On Traumatic Stress (PILOTS) database to 3 March 2018. An earlier search of CENTRAL and the Ovid databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to May 2016). We handsearched reference lists of relevant guidelines, systematic reviews and included study reports. Identified studies were shared with key experts in the field.We conducted an update search (15 March 2019) and placed any new trials in the 'awaiting classification' section. These will be incorporated into the next version of this review, as appropriate. SELECTION CRITERIA We searched for randomised controlled trials of any multiple session (two or more sessions) early psychological intervention or treatment designed to prevent symptoms of PTSD. We excluded single session individual/group psychological interventions. Comparator interventions included waiting list/usual care and active control condition. We included studies of adults who experienced a traumatic event which met the criterion A1 according to the Diagnostic and Statistical Manual (DSM-IV) for PTSD. DATA COLLECTION AND ANALYSIS We entered data into Review Manager 5 software. We analysed categorical outcomes as risk ratios (RRs), and continuous outcomes as mean differences (MD) or standardised mean differences (SMDs), with 95% confidence intervals (CI). We pooled data with a fixed-effect meta-analysis, except where there was heterogeneity, in which case we used a random-effects model. Two review authors independently assessed the included studies for risk of bias and discussed any conflicts with a third review author. MAIN RESULTS This is an update of a previous review.We included 27 studies with 3963 participants. The meta-analysis included 21 studies of 2721 participants. Seventeen studies compared multiple session early psychological intervention versus treatment as usual and four studies compared a multiple session early psychological intervention with active control condition.Low-certainty evidence indicated that multiple session early psychological interventions may be more effective than usual care in reducing PTSD diagnosis at three to six months' follow-up (RR 0.62, 95% CI 0.41 to 0.93; I2 = 34%; studies = 5; participants = 758). However, there was no statistically significant difference post-treatment (RR 1.06, 95% CI 0.85 to 1.32; I2 = 0%; studies = 5; participants = 556; very low-certainty evidence) or at seven to 12 months (RR 0.94, 95% CI 0.20 to 4.49; studies = 1; participants = 132; very low-certainty evidence). Meta-analysis indicated that there was no statistical difference in dropouts compared with usual care (RR 1.34, 95% CI 0.91 to 1.95; I2 = 34%; studies = 11; participants = 1154; low-certainty evidence) .At the primary endpoint of three to six months, low-certainty evidence indicated no statistical difference between groups in reducing severity of PTSD (SMD -0.10, 95% CI -0.22 to 0.02; I2 = 34%; studies = 15; participants = 1921), depression (SMD -0.04, 95% CI -0.19 to 0.10; I2 = 6%; studies = 7; participants = 1009) or anxiety symptoms (SMD -0.05, 95% CI -0.19 to 0.10; I2 = 2%; studies = 6; participants = 945).No studies comparing an intervention and active control reported outcomes for PTSD diagnosis. Low-certainty evidence showed that interventions may be associated with a higher dropout rate than active control condition (RR 1.61, 95% CI 1.11 to 2.34; studies = 2; participants = 425). At three to six months, low-certainty evidence indicated no statistical difference between interventions in terms of severity of PTSD symptoms (SMD -0.02, 95% CI -0.31 to 0.26; I2 = 43%; studies = 4; participants = 465), depression (SMD 0.04, 95% CI -0.16 to 0.23; I2 = 0%; studies = 2; participants = 409), anxiety (SMD 0.00, 95% CI -0.19 to 0.19; I2 = 0%; studies = 2; participants = 414) or quality of life (MD -0.03, 95% CI -0.06 to 0.00; studies = 1; participants = 239).None of the included studies reported on adverse events or use of health-related resources. AUTHORS' CONCLUSIONS While the review found some beneficial effects of multiple session early psychological interventions in the prevention of PTSD, the certainty of the evidence was low due to the high risk of bias in the included trials. The clear practice implication of this is that, at present, multiple session interventions aimed at everyone exposed to traumatic events cannot be recommended. There are a number of ongoing studies, demonstrating that this is a fast moving field of research. Future updates of this review will integrate the results of these new studies.
Collapse
Affiliation(s)
- Neil P Roberts
- Cardiff University School of MedicineDivision of Psychological Medicine and Clinical NeurosciencesHadyn Ellis BuildingMaindy RoadCardiffUKCF24 4HQ
| | - Neil J Kitchiner
- Cardiff & Vale, University Health BoardVeterans' NHS WalesGlobal LinkDunleavy DriveCardiffUKCF11 0SN
| | - Justin Kenardy
- The University of QueenslandSchool of MedicineHerston RoadHerstonAustralia4006
| | - Lindsay Robertson
- University of YorkCochrane Common Mental DisordersHeslingtonYorkUKYO10 5DD
| | - Catrin Lewis
- Cardiff University School of MedicineDivision of Psychological Medicine and Clinical NeurosciencesHadyn Ellis BuildingMaindy RoadCardiffUKCF24 4HQ
| | - Jonathan I Bisson
- Cardiff University School of MedicineDivision of Psychological Medicine and Clinical NeurosciencesHadyn Ellis BuildingMaindy RoadCardiffUKCF24 4HQ
| |
Collapse
|
14
|
Furuta M, Horsch A, Ng ESW, Bick D, Spain D, Sin J. Effectiveness of Trauma-Focused Psychological Therapies for Treating Post-traumatic Stress Disorder Symptoms in Women Following Childbirth: A Systematic Review and Meta-Analysis. Front Psychiatry 2018; 9:591. [PMID: 30515108 PMCID: PMC6255986 DOI: 10.3389/fpsyt.2018.00591] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/25/2018] [Indexed: 12/13/2022] Open
Abstract
Background: Approximately 3% of women in community samples develop posttraumatic stress disorder (PTSD) after childbirth. Higher prevalence rates are reported for high risk samples. Postpartum PTSD can adversely affect women's wellbeing, mother-infant relationships and child development. This study aims to examine the effectiveness of trauma-focused psychological interventions (TFPT), for postnatal women. Methods: We conducted a systematic review and meta-analysis including all clinical trials which reported post-traumatic stress symptoms for both the intervention and control groups or at least two time-points, pre- and post-intervention. We searched four databases: CENTRAL, MEDLINE, PsycINFO, and OpenGrey. Screening of search results, data extraction, and risk of bias assessment were undertaken independently by two reviewers. Results: Eleven studies, reported in 12 papers, involving 2,677 postnatal women were included. All were RCTs, bar one case series. Interventions varied in modality, duration and intensity, and included exposure therapy, trauma-focused cognitive behavioral therapy, eye movement desensitization and reprocessing and other psychological approaches. Participants had experienced uncomplicated births, emergency cesarean sections and/or preterm births. Results suggest that TFPT are effective for reducing PTSD symptoms in the short term (up to 3 months postpartum [4 RCTs, n = 301, SMD = -0.50, 95% CI = -0.73 to -0.27]), and medium term (i.e., 3-6 months postpartum [2 RCTs, n = 174, SMD = -1.87, 95% CI = -2.60 to -1.13]). However, there is no robust evidence to suggest whether TFPT can also improve women's recovery from clinically significant PTSD symptoms. Conclusion: Further larger studies, distinguishing between low and high risk groups, and with adequate follow-up, are needed to establish which TFPT are most effective and acceptable for treating postnatal PTSD.
Collapse
Affiliation(s)
- Marie Furuta
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Antje Horsch
- Institute of Higher Education in Healthcare Research, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.,Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Edmond S W Ng
- Director's Office, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Debra Bick
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, United Kingdom
| | - Debbie Spain
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jacqueline Sin
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom.,Berkshire Traumatic Stress Service, Berkshire Healthcare NHS Foundation Trust, Bracknell, United Kingdom
| |
Collapse
|