Grief and ruminative thought after perinatal loss among Turkish women: one-year cohort study

Abstract BACKGROUND: Among women who have suffered loss of pregnancy, the level of grief decreases gradually. Age, mental health status and childlessness are the factors known to mostly affect women's levels of grief. OBJECTIVES: To assess the levels of grief among women who experienced perinatal loss and the changes in their ruminative thought styles over the first year after their loss. DESIGN AND SETTING: One-year follow-up study carried out in a university hospital in Turkey. METHODS: The study population included 70 women who experienced loss of pregnancy in the hospital. The sample size was calculated using G*Power V3.1. Data were collected at 48 hours, at the third month, at the sixth month and at one year after pregnancy loss, between June 2018 and June 2019. A personal information form, the Perinatal Grief Scale and the Ruminative Thought Style Questionnaire were used for data collection. RESULTS: The women's highest levels of grief and ruminative thought style were in the first 48 hours. Their tendency towards grief and ruminative thought styles decreased over the repeated measurements during the follow-up. Women aged 20-29 years had the highest levels of grief at the third month after perinatal loss. CONCLUSIONS: Nursing assessments regarding grief and ruminative thought style over the first 48 hours after perinatal loss should be integrated into nursing care for these women. Grief follow-up programs for these women can be developed through nursing research.

The Structural Analysis of Variables Related to Posttraumatic Growth among Psychiatric Nurses

PURPOSE: The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.METHODS: Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.RESULTS: The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.CONCLUSION: A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses' hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.

A Structural Equation Model of Factors Influencing Posttraumatic Growth of Earthquake Victims

PURPOSE: The purpose of this study is to construct and test a structural equation model of posttraumatic growth (PTG) of earthquake victims based on Tedeschi and Calhoun's model (2004). METHODS: Data were collected from 195 earthquake victims living in K. City. The exogenous variables include distress perception, resilience, and social support, and the endogenous variables include intrusive rumination, deliberate rumination, and posttraumatic growth. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. RESULTS: The modified model showed a good fitness to the data. Moreover, 6 of the 9 paths of the final model were statistically significant, which include PTG affected by deliberate rumination (β=.58, p<.001), resilience (γ=.18, p=.001), and distress perception (γ=.20, p=.002). These predictors explain 51.8% of variance in posttraumatic growth. CONCLUSION: Based on the results of this study, it is necessary to develop and disseminate preventive intervention programs to increase the resilience of earthquake-prone communities. In addition, after exposure to a community-scale traumatic event such as earthquake, we should provide social supports to alleviate distress perception and transition from intrusive rumination to deliberate rumination so that we can seek new meaning from the earthquake and facilitate posttraumatic growth.