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Gölçek ZK, Demir Yildirim A. Perinatal Grief Counseling and Its Effect on Grief Levels in Women Who Underwent Pregnancy Termination: A Comparative Experimental Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241285062. [PMID: 39292824 DOI: 10.1177/00302228241285062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2024]
Abstract
This study was designed as a two-group pre-test post-test comparative experimental study to examine the effects of grief counseling on perinatal grief levels in women who underwent pregnancy termination before discharge from the clinic. This study was conducted with 70 women who underwent medical termination of pregnancy. The intervention group (n = 35) received perinatal grief care, while the control group (n = 35) received only routine hospital care. In this study, the Introductory Information Form, Perinatal Grief Scale, and evaluation form of the care received were completed. While the perinatal grief level of the intervention group decreased after the application of grief care, a significant difference between the groups was detected only in women with a history of medical termination according to obstetric characteristics (p < .05). The findings obtained from this study showed that perinatal grief care support decreased grief scores on perinatal grief instruments and their sub-dimensions in the intervention group.
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Affiliation(s)
- Zeynep Kübra Gölçek
- Department of Midwifery, Üsküdar University, Institute of Health Sciences, Istanbul, Turkey
| | - Ayça Demir Yildirim
- Department of Midwifery Istanbul, Faculty of Health Sciences, Üsküdar University, Istanbul, Turkey
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Khoori E, Ziaei T, Lasker JN. Translated Perinatal Grief Scale-Persian Version Requires Modified Analysis. Oman Med J 2024; 39:e644. [PMID: 39021611 PMCID: PMC11253106 DOI: 10.5001/omj.2024.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 07/20/2024] Open
Affiliation(s)
- Elham Khoori
- Counselling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Tayebe Ziaei
- Counselling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Judith N. Lasker
- Department of Sociology, Lehigh University, Bethlehem, Pennsylvania, USA
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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.
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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
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Barbe C, Boiteux-Chabrier M, Charillon E, Bouazzi L, Maheas C, Merabet F, Graesslin O, Auer J, Hammami S, Rolland AC, Hurtaud A. Utility of early, short psychological care for women who experience early miscarriage: protocol for the randomized, controlled MisTher trial. BMC Psychol 2023; 11:368. [PMID: 37924101 PMCID: PMC10625184 DOI: 10.1186/s40359-023-01421-x] [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: 09/20/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Around one in ten women will have a miscarriage in their lifetime. Miscarriage is often considered a trivial event by caregivers, but it is associated with a high burden of psychological morbidity, especially during the first 6 months. There is no validated psychological management strategy for women who have had a miscarriage. The MisTher study aims to evaluate the utility of early, short psychological care for women who have had early miscarriage, in terms of anxiety, depression and post-traumatic stress disorder. METHODS This is a prospective, multicenter, randomized, controlled, superiority study. In total, 932 women who have experienced early miscarriage (spontaneous interruption of pregnancy prior to 14 weeks of gestation) will be randomly assigned to either the intervention or the control group. The intervention consists of 4 teleconsultations of 45 min with a psychologist. All women, regardless of their allocated group, will be encouraged to seek an early consultation with a general practitioner or midwife. The primary endpoint will be anxiety at 3 months after randomization evaluated using State Trait Anxiety Inventory. The secondary endpoints will be anxiety at 6 months evaluated using State Trait Anxiety Inventory, depression at 3 and 6 months evaluated with the Beck Depression Inventory, and post-traumatic stress disorder at 3 and 6 months, evaluated using the Posttraumatic stress disorder Checklist Scale. DISCUSSION This project will validate the importance of early psychological management, based on primary care and accessible to most women, via teleconsultation, in reducing the frequency of psychological disorders after early miscarriage. Our results should provide a basis for new recommendations for the management of women who have experienced miscarriage, notably by recommending the involvement of trained psychologists in the management pathway for these women. TRIAL REGISTRATION The trial is registered with ClinicalTrials.gov: NCT05653414. December 15th, 2022.
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Affiliation(s)
- Coralie Barbe
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France.
- Laboratoire C2S (Cognition, Santé, Société), EA6291, Université de Reims Champagne Ardenne, 51100, Reims, EA, France.
| | - Marie Boiteux-Chabrier
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | - Emilie Charillon
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | - Leïla Bouazzi
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | - Chloe Maheas
- Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
| | | | - Olivier Graesslin
- Service de Gynécologie et d'Obstétrique, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Julie Auer
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Sabrina Hammami
- Laboratoire C2S (Cognition, Santé, Société), EA6291, Université de Reims Champagne Ardenne, 51100, Reims, EA, France
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Anne-Catherine Rolland
- Laboratoire C2S (Cognition, Santé, Société), EA6291, Université de Reims Champagne Ardenne, 51100, Reims, EA, France
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire de Reims, Avenue du Général Koenig, 51100, Reims, France
| | - Aline Hurtaud
- Département de Médecine Générale, Université de Reims Champagne-Ardenne, UFR Médecine, 51 rue Cognacq Jay, 51100, Reims, France
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Mendes DCG, Fonseca A, Cameirão MS. The psychological impact of Early Pregnancy Loss in Portugal: incidence and the effect on psychological morbidity. Front Public Health 2023; 11:1188060. [PMID: 37427267 PMCID: PMC10325666 DOI: 10.3389/fpubh.2023.1188060] [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] [Received: 03/16/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Worldwide, up to a quarter of all recognized pregnancies result in Early Pregnancy Loss (EPL), also known as miscarriage. For many women, this is a traumatic experience that leads to persistent negative mental health responses. The most common morbidity reported in studies from different countries is complicated grief, usually comorbid with depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). To our best knowledge, no studies characterizing the psychological impact of EPL have been made in Portugal. Methods An online survey was conducted to evaluate clinical symptoms of perinatal grief, anxiety, depression, and PTSD in women who suffered a spontaneous loss within 20 weeks of gestation. Out of 1,015 women who answered this survey, 873 were considered eligible, and subsequently distributed in 7 groups according to the time passed between their loss and their participation in the study. Results The proportion of women showing symptoms of all comorbidities was greater in those whose loss had happened within a month, and there was a significant gradual decrease over time in scores and proportions of clinical perinatal grief and PTSD. In terms of depression symptoms, scores dropped significantly in the group whose loss occurred 13-24 months before their participation but proportions oscillated without great changes in the other groups. Regarding anxiety, there were small oscillations, but there was no significant decrease of symptoms over time. Discussion Overall, despite a general drop in scores for most morbidities over time, substantial proportions of women showed persistent symptoms of clinical morbidities 3 years or more after the loss. Therefore, it is essential to promote monitoring of possible complicated responses to the event, to provide appropriate and timely intervention to those women in need.
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Affiliation(s)
- Diana C. Gonçalves Mendes
- Faculdade de Ciências Exatas e da Engenharia & NOVA LINCS, Universidade da Madeira, Funchal, Portugal
- Agência Regional para o Desenvolvimento de Investigação, Tecnologia e Inovação (ARDITI), Funchal, Portugal
| | - Ana Fonseca
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Mónica S. Cameirão
- Faculdade de Ciências Exatas e da Engenharia & NOVA LINCS, Universidade da Madeira, Funchal, Portugal
- Agência Regional para o Desenvolvimento de Investigação, Tecnologia e Inovação (ARDITI), Funchal, Portugal
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Nournorouzi L, Nourizadeh R, Hakimi S, Esmaeilpour K, Najmi L. The effect of a coping program on mothers' grief following perinatal deaths. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:248. [PMID: 36325232 PMCID: PMC9621366 DOI: 10.4103/jehp.jehp_1156_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/02/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mother-child attachment is formed from early stages of pregnancy and peaks in the second trimester and continues until after childbirth. The fetal or neonatal death as a tragic event could lead to the grief experience among parents, especially mothers. The present study aimed to determine the effect of a coping program on mothers' grief following perinatal deaths. MATERIALS AND METHODS This trial study was performed on 56 women with the experience of perinatal death during the last 1-3 months with a score of Perinatal Grief Scale (PGS) ≥91, who were referred to the health centers of Tabriz, Iran, from September 2020 to June 2021. Participants were randomly assigned into the intervention and control groups through stratified blocking on the basis of the stillbirth and neonatal death using Random Allocation Software with a block size of 4 and 6 with a ratio of 1:1. The intervention group received a coping program individually during three sessions, once a week for 45-60 min. Data collection tools included the demographic and obstetric characteristic questionnaire and PGS. The data were analyzed using SPSS24. The groups were compared through t-test, and ANCOVA after adjusting the effect of baseline score. RESULTS Prior to coping program, the mean standard deviation of the grief total score was 108.32 (14.31) in the intervention group and 107.92 (6.65) in the control group (P = 0.89). After coping program, the mean of the grief total score was 82.28 (16.72) in the intervention group and 101.05 (12.78) in the control group. After adjusting the effect of baseline score and stratified factors, the mean of the grief total score in the intervention group was significantly lower than that in the control group [Adjusted mean difference (AMD): -18.77, 95% confidence interval: -26.79 to - 10.75, P ≤ 0.001]. CONCLUSION Conducting a coping program during 1-3 months after experiencing perinatal deaths is effective in reducing the mothers' grief reactions. It is recommended to evaluate the effectiveness of the same intervention after perinatal deaths for both parents with a longer follow-up period in further studies.
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Affiliation(s)
- Leila Nournorouzi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghaiyeh Nourizadeh
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sevil Hakimi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khalil Esmaeilpour
- Psychology Department, Faculty of Psychology, Tabriz University, Tabriz, Iran
| | - Leila Najmi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Ren F, Ruan D, Hu W, Xiong Y, Wu Y, Huang S. The Effectiveness of Supportive Psychotherapy on the Anxiety and Depression Experienced by Patients Receiving Fiberoptic Bronchoscope. Front Psychol 2022; 13:960049. [PMID: 35959048 PMCID: PMC9358213 DOI: 10.3389/fpsyg.2022.960049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives As the largest cohort of healthcare workers and nurses can practice as psychotherapists to integrate the psychotherapeutic interventions as part of routine care. The present study aims to evaluate the effectiveness of supportive psychotherapy (SPT) on patients who had been scheduled to undergo a fiberoptic bronchoscopy (FOB) procedure. Methods This study retrospectively analyzed 92 patients who underwent FOB, which was divided into the SPT group and usual-care group based on whether patients were given SPT interventions or not. The Patient Health Questionnaire-9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS) were used to determine the severity of depression and anxiety, as well as the 36-Item Short-Form Health Survey questionnaire (SF-36) to evaluate the health-related quality of life (HRQoL). Moreover, the patients' satisfaction was assessed based on the Likert 5-Point Scale. Results The baseline status of anxiety, depression, and HRQoL in patients was similar in the SPT group and the usual-care group with no significant difference. Both PHQ-9 score and HADS-D score in the SPT group after intervention were lower than that in the usual-care group, accompanied by the deceased HADS-A subscale. Moreover, the improved HRQoL was found in the patients undergoing FOB after SPT interventions as compared to those receiving conventional nursing care using the SF-36 score. Additionally, the patient satisfaction in the SPT group was higher than in the usual-care group. Conclusions The study demonstrated that anxiety and depression, as negative emotions, can be reduced by supportive psychotherapy in patients receiving FOB with improved mental health and satisfaction with nursing care.
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Basirat Z, Kheirkhah F, Faramarzi M, Esmaelzadeh S, Khafri S, Tajali Z. Pharmacotherapy or Psychotherapy? Selective Treatment Depression in The Infertile Women with Recurrent Pregnancy Loss: A Triple-Arm Randomized Controlled Trial. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2022; 16:211-219. [PMID: 36029059 PMCID: PMC9395995 DOI: 10.22074/ijfs.2021.529258.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recurrent pregnancy loss (RPL) and infertility are associated with significant psychiatric complications.<br />The study aimed to investigate the effectiveness of cognitive behavioral therapy (CBT) and sertraline<br />in the treatment of in depression, anxiety, and infertility stress of depressed infertile women with RPL in comparison<br />with usual care.<br />Materials and Methods: A triple-arm randomized controlled trial was carried out on the 60 depressed infertile<br />women with RPL, a population of Infertility Center of Babol city, Iran, who were randomly assigned into three<br />groups: pharmacotherapy with sertraline (n=20), psychotherapy with CBT (n=20), and a usual care as control<br />group (n=20). The participants of psychotherapy received CBT sessions (90 minutes each) over 10 weeks. The<br />participants in the pharmacotherapy group took 50 mg/day sertraline daily for 22 weeks. Outcomes were assessed<br />using the Beck Depression Inventory (BDI-II), fertility problem inventory (FPI), and State-Trait Anxiety<br />Inventory Form Y (STAI-Y) at the beginning of the trial, 10-weeks post-trial, and three months of follow-up.<br />Using statistical package for the social sciences (SPSS) software, data were analyzed.<br />Results: CBT considerably reduced the depression symptoms more than sertraline with a moderate effect size<br />at the post-trial (g=0.11, 95% CI: -0.03 to -0.50). Sertraline showed reduced the scores of state-anxiety more<br />considerably in comparison with control group by a large effect size of post-trial (g=-1.04, 95% CI: -1.70 to<br />-0.38). CBT reduced the total scores of FPI more considerably than sertraline, with a large, small size at follow<br />up-trial [95% CI=-0.03(-0.65, -0.58)]. Both CBT and sertraline were superior to the control group in reducing<br />depression and infertility stress.<br />Conclusion: Depression and infertility stress diminished under CBT and sertraline in depressed infertile women with<br />RPL, with a significant advantage of CBT. Sertraline was superior to CBT in reduction of anxiety (registration number:<br />IRCT201304045931N3).
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Affiliation(s)
- Zahra Basirat
- Department of General Courses, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of
Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of General Courses, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of
Medical Sciences, Babol, Iran ,P.O.Box: 4717647745Department of General
CoursesInfertility and Reproductive Health Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
| | - Seddigheh Esmaelzadeh
- Department of General Courses, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of
Medical Sciences, Babol, Iran
| | - Soraya Khafri
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Tajali
- Department of General Courses, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of
Medical Sciences, Babol, Iran
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