PDF(Pubmed)
Abstract：
BACKGROUND: Experiencing a miscarriage can have profound psychological implications, and the added strain of the COVID-19 pandemic may have compounded these effects. This study aimed to explore the psychological experiences, assess the levels of psychological distress (depression, anxiety, and post-traumatic stress disorder), and examine the relationships of personal significance of miscarriage and perceived stress with psychological distress of women in North Carolina who suffered a miscarriage of a desired pregnancy between March 30, 2020, and February 24, 2021, of the COVID-19 pandemic, at 14 to 31 months after the loss.
METHODS: We conducted a cross-sectional mixed-methods study using a convergent parallel design. A total of 71 participants from North Carolina completed the online survey and 18 completed in-depth interviews. The survey assessed demographics, mental health and reproductive history, personal significance of miscarriage, perceived stress, anxiety, depression, and PTSD. Interview questions asked about the psychological experience of the miscarriage and how the COVID-19 pandemic affected them and their experience.
RESULTS: Findings indicated moderate to severe levels of depression, anxiety, and PTSD, which persisted 14 to 31 months post-miscarriage. After conducting hierarchical binary logistic regressions, we found that perceived stress and prior trauma increased the odds of depression, perceived stress increased the odds of anxiety, and personal significance and prior trauma increased the odds of PTSD symptoms 14-31 months post-miscarriage. Notably, a subsequent successful childbirth emerged as a protective factor against depression, anxiety, and PTSD. Qualitative findings depicted emotions such as profound isolation, guilt, and grief. Women noted that additional pandemic-specific stressors exacerbated their distress. The categories identified via conventional content analysis fell under five broader thematic groups: mental health disorders, negative emotions/feelings, positive emotions/feelings, thoughts, and other experiences.
CONCLUSIONS: Miscarriage during the COVID-19 pandemic intensified and added complexity to the psychological distress experienced by affected women. The study underscores the need for comprehensive mental health screenings, specialized support for vulnerable groups, and the necessity of trauma-informed care. Providers are strongly encouraged to adopt a multifaceted, individualized approach to patient care that is cognizant of the unique stressors introduced by the pandemic.
METHODS: We conducted a cross-sectional mixed-methods study using a convergent parallel design. A total of 71 participants from North Carolina completed the online survey and 18 completed in-depth interviews. The survey assessed demographics, mental health and reproductive history, personal significance of miscarriage, perceived stress, anxiety, depression, and PTSD. Interview questions asked about the psychological experience of the miscarriage and how the COVID-19 pandemic affected them and their experience.
RESULTS: Findings indicated moderate to severe levels of depression, anxiety, and PTSD, which persisted 14 to 31 months post-miscarriage. After conducting hierarchical binary logistic regressions, we found that perceived stress and prior trauma increased the odds of depression, perceived stress increased the odds of anxiety, and personal significance and prior trauma increased the odds of PTSD symptoms 14-31 months post-miscarriage. Notably, a subsequent successful childbirth emerged as a protective factor against depression, anxiety, and PTSD. Qualitative findings depicted emotions such as profound isolation, guilt, and grief. Women noted that additional pandemic-specific stressors exacerbated their distress. The categories identified via conventional content analysis fell under five broader thematic groups: mental health disorders, negative emotions/feelings, positive emotions/feelings, thoughts, and other experiences.
CONCLUSIONS: Miscarriage during the COVID-19 pandemic intensified and added complexity to the psychological distress experienced by affected women. The study underscores the need for comprehensive mental health screenings, specialized support for vulnerable groups, and the necessity of trauma-informed care. Providers are strongly encouraged to adopt a multifaceted, individualized approach to patient care that is cognizant of the unique stressors introduced by the pandemic.
摘要：
背景：经历流产可能会产生深刻的心理影响，而COVID-19大流行的新增毒株可能加剧了这些影响。本研究旨在探索心理体验，评估心理困扰的水平(抑郁症，焦虑,和创伤后应激障碍)，并检查了在2020年3月30日至2021年2月24日期间遭受预期妊娠流产的北卡罗来纳州妇女的心理困扰与流产和感知压力的个人重要性之间的关系，在损失后的14到31个月。
方法：我们使用收敛并行设计进行了横截面混合方法研究。来自北卡罗来纳州的71名参与者完成了在线调查，18人完成了深度访谈。调查评估了人口统计，心理健康和生殖史，流产的个人意义，感知压力，焦虑,抑郁症,PTSD面试问题询问了流产的心理经历，以及COVID-19大流行如何影响他们和他们的经历。
结果：研究结果表明中度至重度抑郁，焦虑,和PTSD,流产后持续14至31个月。在进行分层二元逻辑回归后，我们发现感知的压力和先前的创伤增加了抑郁的几率，感知到的压力增加了焦虑的几率，个人意义和既往创伤增加了流产后14-31个月PTSD症状的几率。值得注意的是,随后的成功分娩成为对抗抑郁症的保护因素，焦虑,PTSD定性的发现描绘了情感，如深刻的孤立，内疚，内疚和悲伤。妇女指出，针对流行病的额外压力源加剧了她们的痛苦。通过常规内容分析确定的类别属于五个更广泛的主题组：精神健康障碍，负面情绪/感受，积极的情绪/感觉，思想,和其他经验。
结论：COVID-19大流行期间的流产加剧，并增加了受影响妇女经历的心理困扰的复杂性。这项研究强调了全面心理健康筛查的必要性，对弱势群体的专门支持，以及创伤知情护理的必要性。强烈鼓励供应商采用多方面的，认识到大流行带来的独特压力源的个性化患者护理方法。
方法：我们使用收敛并行设计进行了横截面混合方法研究。来自北卡罗来纳州的71名参与者完成了在线调查，18人完成了深度访谈。调查评估了人口统计，心理健康和生殖史，流产的个人意义，感知压力，焦虑,抑郁症,PTSD面试问题询问了流产的心理经历，以及COVID-19大流行如何影响他们和他们的经历。
结果：研究结果表明中度至重度抑郁，焦虑,和PTSD,流产后持续14至31个月。在进行分层二元逻辑回归后，我们发现感知的压力和先前的创伤增加了抑郁的几率，感知到的压力增加了焦虑的几率，个人意义和既往创伤增加了流产后14-31个月PTSD症状的几率。值得注意的是,随后的成功分娩成为对抗抑郁症的保护因素，焦虑,PTSD定性的发现描绘了情感，如深刻的孤立，内疚，内疚和悲伤。妇女指出，针对流行病的额外压力源加剧了她们的痛苦。通过常规内容分析确定的类别属于五个更广泛的主题组：精神健康障碍，负面情绪/感受，积极的情绪/感觉，思想,和其他经验。
结论：COVID-19大流行期间的流产加剧，并增加了受影响妇女经历的心理困扰的复杂性。这项研究强调了全面心理健康筛查的必要性，对弱势群体的专门支持，以及创伤知情护理的必要性。强烈鼓励供应商采用多方面的，认识到大流行带来的独特压力源的个性化患者护理方法。
