Toward Optimal Emotional Care During the Experience of Miscarriage: An Integrative Review of the Perspectives of Women, Partners, and Health Care Providers.

INTRODUCTION: Miscarriage is frequently associated with significant emotional impact, causing psychological distress, trauma, and grief. Unfortunately, women and partners frequently report dissatisfaction with care around miscarriage, and health care providers report feeling ill-prepared and underequipped to provide emotional support. This integrative review synthesizes the individual perspectives of the woman experiencing the miscarriage, the partner, and the different health care provider roles involved in the care to better understand what future research is necessary to improve the experiences of bereaved parents and their health care providers. METHODS: Electronic databases were searched for studies that covered emotional care around miscarriage from the perspective of women, partners, or health care providers. The review included studies published in English between 2015 and 2022, using either quantitative or qualitative methods. Thematic analysis was carried out, and conclusions from these articles were integrated into themes and subthemes. RESULTS: A total of 60 studies met the inclusion criteria. Two main themes were identified for women: (1) a need for more information and (2) a need for acknowledgment of their loss. Two main themes were likewise identified for partners: (1) a need for more information and (2) a need for recognition. Three main themes were identified for health care providers: (1) a need for additional training, (2) components of quality care, and (3) perceived barriers to providing care. DISCUSSION: There is broad overlap in the needs identified by bereaved parents and their health care providers, as well as general agreement regarding the barriers to providing effective care. Five areas of future research priority were identified to understand how best to meet these needs: empirical evaluation of strategies to meet identified needs, investigation of setting-specific needs, integrated consideration of all relevant roles, investigation of the care needs of diverse groups, and an investigation of the predictors of emotional impact.

Behavioral and Emotional Functioning of Children and Adolescents at the End of Treatment for Acute Lymphoblastic Leukemia Compared to Healthy Peers.

This study describes the behavioral and emotional adjustment of 77 children and adolescents 3 months post-treatment for acute lymphoblastic leukemia (ALL), compared to 52 age and sex-matched healthy peers. Parents, teachers, and self-report ratings on the Behavioral Assessment System for Children, Second Edition (BASC-2) were utilized to measure psychological function. While overall mean scores were in the average range for both groups, parents and teachers rated patients higher on behavior symptoms, internalizing problems and adaptive skill difficulties. No significant differences between groups were observed on self-report, and inter-rater correlations were low to moderate. For the ALL group, maternal university completion was associated with elevations on parent report of behavioral problems, while no other factors predicted either parent or teacher report on other scales. Findings indicate that a subset of patients will require specialist psychosocial support to optimise their adjustment following treatment completion.

The rubber hand illusion in children: What are we measuring?

The rubber hand illusion (RHI) is a much-studied bodily illusion that has been used in a wide number of populations to investigate the plasticity of the mental body representation. In adult participants, the wide adoption of the illusion has led to a proliferation of experimental variations of the illusion, and with that, considerable apparent inconsistencies in both empirical results and conceptual interpretations. In turn, this makes it challenging to integrate empirical findings and to identify what those findings together can tell us about the representation of the body in the brain. More recently, scientists have started applying the illusion to populations of children, in order to better understand how body representations develop in both typically developing children and in clinical populations. With this field now starting to expand, we believe it is both urgent and important to prevent unintended methodological variability from hindering the consistency of the paediatric literature as it has the adult literature. With this aim in mind, we review the 12 currently available paediatric RHI studies, and summarise their key methodological choices and conceptual definitions. We highlight a number of important discrepancies, particularly where seemingly equivalent analysis choices might significantly affect the interpretation of results, and make recommendations for future studies. We hope this will allow this important and emerging field to benefit from the synergy that results from multiple studies using convergent and consistent empirical methods.