The impact of supportive counselling on women's psychological wellbeing after miscarriage - a randomised controlled trial

流产 医学 一般健康问卷 随机对照试验 贝克抑郁量表 苦恼 心理困扰 萧条(经济学) 物理疗法 产科 怀孕 精神科 心理健康 临床心理学 焦虑 外科 生物 遗传学 宏观经济学 经济
作者
Grace Kong,Tony K.H. Chung,Ingrid Hung Lok
出处
期刊:Bjog: An International Journal Of Obstetrics And Gynaecology [Wiley]
卷期号:121 (10): 1253-1262 被引量:23
标识
DOI:10.1111/1471-0528.12908
摘要

To assess the effectiveness of supportive counselling after miscarriage.Randomised controlled trial.University hospital.Two hundred and eighty women with miscarriage.Women were randomised to receive supportive counselling from a nurse (at diagnosis and 2 weeks later) or routine care. Psychological wellbeing was measured with the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI).Primary outcome measured the proportion of women suffering psychological distress (GHQ-12 score ≥4) at 3 months after miscarriage. Secondary outcomes were GHQ-12 and BDI scores at 6 weeks, 3 and 6 months.There was no difference in the proportion of women suffering psychological distress at 3 months after miscarriage (17.1% in counselling group versus 24.4% in control group; 95% CI -0.034 to 0.177; P = 0.19). However, for the subgroup of women (n = 152) with high baseline GHQ-12 scores, the median GHQ-12 score in the counselling group was significantly lower than the control group at 6 weeks (median score 3 versus 4.5 in counselling and control groups; P = 0.04) and 3 months (median score 1 versus 2.5 in counselling and control groups; P = 0.03). Similarly, for women with high baseline BDI scores (BDI > 12), the proportion for women continuing to score high was significantly lower in the counselling group 6 weeks after miscarriage (33.3 versus 61.1% in counselling group and control group; P = 0.03).Although the results of current study do not justify routine counselling of all women following miscarriage, a supportive counselling programme for selected women with high levels of psychological distress is promising and merits further investigation.
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