Nournorouzi Leila, Nourizadeh Roghaiyeh, Hakimi Sevil, Esmaeilpour Khalil, Najmi Leila
Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Psychology Department, Faculty of Psychology, Tabriz University, Tabriz, Iran.
J Educ Health Promot. 2022 Aug 25;11:248. doi: 10.4103/jehp.jehp_1156_21. eCollection 2022.
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.
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 SPSS The groups were compared through t-test, and ANCOVA after adjusting the effect of baseline score.
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 ( = 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].
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.
母婴依恋在孕期早期形成，在孕中期达到高峰，并持续到产后。胎儿或新生儿死亡作为一个悲剧性事件，可能会导致父母尤其是母亲的悲伤体验。本研究旨在确定应对方案对围产期死亡后母亲悲伤情绪的影响。
本试验研究对2020年9月至2021年6月期间转诊至伊朗大不里士健康中心的56名在过去1 - 3个月内有围产期死亡经历且围产期悲伤量表（PGS）得分≥91的女性进行。使用随机分配软件，根据死产和新生儿死亡情况，按分层区组法将参与者随机分为干预组和对照组，区组大小为4和6，比例为1:1。干预组在三个疗程中接受个体应对方案，每周一次，每次45 - 60分钟。数据收集工具包括人口统计学和产科特征问卷以及PGS。使用SPSS对数据进行分析。通过t检验对两组进行比较，并在调整基线得分的影响后进行协方差分析。
在应对方案实施前，干预组悲伤总分的平均标准差为108.32（14.31），对照组为107.92（6.65）（t = 0.89）。应对方案实施后，干预组悲伤总分的平均值为82.28（16.72），对照组为101.05（12.78）。在调整基线得分和分层因素的影响后，干预组悲伤总分的平均值显著低于对照组[调整后平均差值（AMD）：-18.77，95%置信区间：-26.79至-10.75，P≤0.001]。
在经历围产期死亡后的1 - 3个月内实施应对方案可有效减轻母亲的悲伤反应。建议在进一步研究中对围产期死亡后的父母双方进行更长随访期的相同干预效果评估。
