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Resolution of Depression and Grief during the First Year after Miscarriage: A Randomized Controlled Clinical Trial of Couples-Focused Interventions
Open accessAbstract
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 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].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [63]
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“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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Metadata
- 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
- Publisher
- SAGE Publications
- Published
- 2009-08
- Volume
- 18
- Issue
- 8
- Pages
- 1245-1257
- ISSN
- 1059-7115 (ISSN-L)
- 1540-9996
- 1931-843X
- PMC
- PMC2825726
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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