Cited by 131Grief, Bereavement, and Mental HealthMaternal Mental Health During Pregnancy and PostpartumReproductive Health and Technologies

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

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Swanson, Kristen M., Chen, Hsien-Tzu, Graham, J. Christopher, Wojnar, Danuta M., Petras, Anthippy·2009·Journal of Women's Health

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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  • Two included studies acknowledged potential conflicts of interest relating to the first author being the developer of the intervention under investigation, and another employed by the bereavement service being evaluated.

    “Two studies also acknowledged potential conflicts of interest relating to the first author being the developer of the intervention under investigation [63], and another employed by the bereavement service being evaluated [92].”
  • A couple-focused intervention in a randomized controlled trial found a beneficial impact on grief resolution.

    “Swanson and colleagues evaluated a couple-focused intervention in a randomized controlled trial and found a beneficial impact on grief resolution.66”

    From Complicated grief after perinatal loss (2012) · cites this paper as [66]

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  1. [3]Neugebauer R. Ritsher J. Depression and grief following early pregnancy loss. Int J Childbirth Educ. 2005;20:21–24. [Google Scholar]
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Authors
Swanson, K. M., Chen, H.-T., Graham, J. C., Wojnar, D. M., & Petras, A.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Fred Hutch Cancer Center (US)
  • University of Washington (US)
  • Seattle University (US)
Corresponding author
Swanson, Kristen M.
Venue
Journal of Women's Health
Published
2009-08
Volume
18
Issue
8
Pages
1245-1257
ISSN
  • 1059-7115 (ISSN-L)
  • 1540-9996
  • 1931-843X
OpenAlex
W2044645941
Cited by
131
References
59
Citations by year
2026: 2 · 2025: 6 · 2024: 5 · 2023: 17 · 2022: 8 · 2021: 11 · 2020: 8 · 2019: 5 · 2018: 8 · 2017: 8 · 2016: 4 · 2015: 12 · 2014: 10 · 2013: 7 · 2012: 6
FWCI
6.74
Type
journal article
Language
en
Open access
Locations
  • Journal of Women s Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01nr005343-04)
  • National Institute of Nursing Research (5 R01 NR005343)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Keywords
miscarriage, depression, grief, nurse caring, self-care, grief resolution, paternal depression, postpartum depression, couple therapy
MeSH terms
Abortion, Spontaneous, Adaptation, Psychological, Adult, Combined Modality Therapy, Counseling, Depression, Female, Grief, Humans, Male, Patient Education as Topic, Pregnancy, Quality of Life, Research Design, United States, Comorbidity, Treatment Outcome, Spouses, Couples Therapy, Young Adult

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