Lloyd Caroline A, Hutti Marianne H
School of Education, Trinity College Dublin, Ireland.
College of Nursing, University of Kentucky, KY, USA.
Heliyon. 2024 Jul 2;10(13):e33634. doi: 10.1016/j.heliyon.2024.e33634. eCollection 2024 Jul 15.
The purpose of this study was to examine women's recollected lifespan perceptions of the effect of grief intensity following adolescent perinatal death.
Nineteen adult women who had experienced either a miscarriage or an abortion during adolescence. The study involved the recollection of events surrounding the experience which had occurred between three and 28 years previously.
A 55-item online survey was used to gather recollected perceptions of adolescent miscarriage and abortion experiences. The Perinatal Grief Intensity Scale was embedded within this survey. The participants were instructed to recall their responses to the perinatal loss at the time of the event as an adolescent (T1; Time 1) and how they feel currently as adults about their previous adolescent perinatal death (T2; Time 2). Data were collected at both T1 and T2. The Perinatal Grief Intensity Scale is accompanied by an appropriately weighted Excel scoring sheet which was utilised to analyse the data at both T1 and T2.
As adolescents, participants perceived similar high and medium grief intensity when compared by type of loss (miscarriage, n = 6; abortion, n = 6). However, more women who had an abortion (n = 5) experienced low grief intensity compared with participants who had a miscarriage (n = 2). As adults, participants continued to perceive similar high and medium grief intensity when compared by type of loss (miscarriage, n = 6; abortion, n = 5). In addition, women who had an abortion continued to experience more low grief intensity (n = 6) compared with participants who had a miscarriage (n = 2). Approximately one quarter of adult female respondents, 26 % (n = 5) exhibited increased grief intensity as measured by the scores over time. Thirty seven percent (n = 7) exhibited no change in scores, and 37 % (n = 7) exhibited decreased scores over time in response to adolescent miscarriage or abortion.
Support for the adoption of the Perinatal Grief Intensity Scale to identify women in need of follow-up for grief intensity after an adolescent miscarried or terminated pregnancy is evident. The results of this study have demonstrated that grief can resurge or appear in adult females as they respond to events across the lifespan, including further reproductive experiences. Therefore there is a compulsion for health care professionals to identify women at risk of intensive grief responses due to previous contributory events.
Healthcare providers should screen adult women who have experienced a previous adolescent miscarriage or termination for adverse mental health issues in adulthood.
本研究旨在调查女性对青少年围产期死亡后悲伤强度影响的终生回忆认知。
19名成年女性，她们在青少年时期经历过流产或堕胎。该研究涉及回忆3至28年前发生的相关经历。
使用一份包含55个条目的在线调查问卷来收集对青少年流产和堕胎经历的回忆认知。围产期悲伤强度量表嵌入在这份调查问卷中。参与者被要求回忆她们在青少年时期（T1；时间1）对围产期损失的反应，以及她们成年后对之前青少年围产期死亡的感受（T2；时间2）。在T1和T2两个时间点收集数据。围产期悲伤强度量表附有一份经过适当加权的Excel计分表，用于分析T1和T2两个时间点的数据。
青少年时期，按损失类型（流产，n = 6；堕胎，n = 6）比较，参与者感知到的悲伤强度有高有中且相似。然而，与经历流产的参与者（n = 2）相比，更多经历堕胎的女性（n = 5）悲伤强度较低。成年后，按损失类型（流产，n = 6；堕胎，n = 5）比较，参与者继续感知到相似的高悲伤强度和中悲伤强度。此外，与经历流产的参与者（n = 2）相比，经历堕胎的女性继续有更多悲伤强度较低的情况（n = 6）。约四分之一的成年女性受访者，即26%（n = 5）随着时间推移，分数显示悲伤强度增加。37%（n = 7）的分数没有变化，37%（n = 7）随着时间推移，因青少年时期的流产或堕胎，分数显示悲伤强度下降。
显然支持采用围产期悲伤强度量表来识别青少年流产或终止妊娠后悲伤强度需要后续跟进的女性。本研究结果表明，悲伤可能在成年女性对一生中各种事件（包括进一步的生殖经历）做出反应时再次出现或显现。因此，医护人员有必要识别因先前相关事件而有强烈悲伤反应风险的女性。
医疗保健提供者应对曾在青少年时期经历流产或终止妊娠的成年女性进行筛查，以排查其成年期的不良心理健康问题。
