One out of every five pregnancies end in miscarriage, yet so little is known about the prospective effects of miscarriage on women's lives. Still less is known about how to care for women who grieve this loss. The overall purpose of this proposed project is to examine the effects of a caring based intervention program on the health of women in the first year subsequent to their experience of miscarriage. The intervention consists of one-to-one nurse conducted counseling sessions in the first three months after loss. The intervention is based on the Models of the human Experience of Miscarriage and Caring. This five year project consist of three interrelated studies.
The specific aims of each study are: Study I: Describe from a phenomenological perspective how women describe success in the childbearing role and how women perceive themselves in their childbearing role, Study II: 1. Conduct a randomized experimental study of the effects of a caring based intervention program on women's emotional, physical, and reproductive health; coping strategies utilized; and perceptions of support and caring in the first year subsequent to the experience of miscarriage; and 2. Examine the relationships among the client, process, and outcome variables in order to identify who benefits most from the intervention and how the process (i.e., caring) related to the outcomes: Study III: 1. Conduct a descriptive phenomenological study of the nurse-client transactions (Study II intervention) in order to identify the mechanisms through which the caring modalities are expressed; and 2. Develop a strategy for monitoring the levels of caring in the counseling intervention. Study I involves the sequence of: phenomenological analysis to define categories, content analysis to define items, and factor analysis as one component of the development of a scale to identify how women perceive themselves in their childbearing role. The main test of treatment effects in Study II will be a repeated measures analysis of variance. Study III involves a phenomenological analysis of the audiotaped and transcribed Study II interventions. Ultimately a scale will be developed to rate audiotapes of the Study II intervention for levels of caring. Finally, the association between client, process, and outcome variables will be evaluated through multivariate regression techniques.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29NR001899-05
Application #
3476321
Study Section
Nursing Research Study Section (NURS)
Project Start
1988-05-15
Project End
1994-04-30
Budget Start
1992-05-01
Budget End
1994-04-30
Support Year
5
Fiscal Year
1992
Total Cost
Indirect Cost
Name
University of Washington
Department
Type
Schools of Nursing
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Swanson, Kristen M; Karmali, Zahra A; Powell, Suzanne H et al. (2003) Miscarriage effects on couples' interpersonal and sexual relationships during the first year after loss: women's perceptions. Psychosom Med 65:902-10
Swanson, K M (1999) Effects of caring, measurement, and time on miscarriage impact and women's well-being. Nurs Res 48:288-98
Swanson, K M (1999) Research-based practice with women who have had miscarriages. Image J Nurs Sch 31:339-45
Swanson, K M (1993) Nursing as informed caring for the well-being of others. Image J Nurs Sch 25:352-7