Tseng Ying-Fen, Cheng Hsiu-Rong, Chen Yu-Ping, Yang Shu-Fei, Cheng Pi-Tzu
Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan.
Department of Counseling and Guidance, National University of Tainan, Tainan, Taiwan.
J Clin Nurs. 2017 Dec;26(23-24):5133-5142. doi: 10.1111/jocn.14059. Epub 2017 Oct 6.
To explore couples' perceptions of the effects of perinatal loss on their marital relationship, social support and grief 1 year postloss, and analyse what factors changed the severity of their grief.
Perinatal losses are traumatic events in the lives of families and can have serious long-term consequences for the psychological health of parents and any subsequent children.
A prospective follow-up study.
We recruited, at a teaching hospital in southern Taiwan, a convenience sample of 30 couples whose babies either miscarried or were stillborn. At 1 month (T1), 3 months (T2), 6 months (T3) and 1 year (T4) after the pregnancy loss, all participants completed four questionnaires. To analyse the changing status of their grief and its related factors, we used a generalised estimating equation (GEE) to account for correlations between repeated observations.
Postbereavement grief levels fell over the four time-points. Mothers reported feeling more grief than did the fathers. Couples with a history of infertility, no religious beliefs or no living children before the loss felt more grief from a perinatal miscarriage or stillbirth. Furthermore, couples reported more grief if their marital satisfaction level was low, if their socioemotional support from husband's parents was low or if they had never participated in a ritual for their deceased baby.
Six months postloss is the crucial period for bereaved parents after a perinatal loss. Being a mother, having no previous living children and low-level socioemotional support from the husband's parents are significant high-risk factors for a high level of grief 1 year after perinatal death.
We recommend that health professionals increase their ability to identify the factors that psychologically affect postloss grief. Active postloss follow-up programmes should focus on these factors to offer specific support and counselling.
探讨夫妻双方在产后1年时对围产期丧亲之痛对其婚姻关系、社会支持和悲伤情绪的影响的认知,并分析哪些因素会改变他们悲伤情绪的严重程度。
围产期丧亲之痛是家庭生活中的创伤性事件,可能会对父母及后续子女的心理健康产生严重的长期影响。
前瞻性随访研究。
我们在台湾南部的一家教学医院,选取了30对夫妻作为便利样本,这些夫妻的婴儿要么流产要么死产。在妊娠丢失后的1个月(T1)、3个月(T2)、6个月(T3)和1年(T4),所有参与者均完成了四份问卷。为了分析他们悲伤情绪的变化状况及其相关因素,我们使用广义估计方程(GEE)来考虑重复观测之间的相关性。
丧亲后的悲伤程度在这四个时间点呈下降趋势。母亲报告的悲伤情绪比父亲更强烈。有不孕史、无宗教信仰或在丧亲前没有在世子女的夫妻,因围产期流产或死产而感到更悲伤。此外,如果夫妻的婚姻满意度较低、从丈夫父母那里获得的社会情感支持较少,或者他们从未为死去的婴儿举行过仪式,他们会报告更多的悲伤情绪。
丧亲后6个月是围产期丧亲后丧亲父母的关键时期。作为母亲、此前没有在世子女以及来自丈夫父母的社会情感支持水平较低,是围产期死亡1年后悲伤情绪强烈的重要高危因素。
我们建议医疗专业人员提高识别心理上影响丧亲后悲伤情绪的因素的能力。积极的丧亲后随访计划应关注这些因素,以提供特定的支持和咨询服务。