Association and mediation of in-hospital support and posttraumatic stress following stillbirth Open Access
Badgley, Allison (2017)
Abstract
About 1 in 200 pregnancies in the United States end in stillbirth, resulting in substantial psychological morbidity in bereaved mothers and their families. Factors occurring during and immediately after a traumatic event have the biggest impact on the later development of posttraumatic stress (PTS) symptoms, highlighting the importance of support received in the hospital after a stillbirth. This was a cross-sectional investigation of the relationship and possible mediators between reported support received from hospital staff and PTS symptoms. Data were used from the SCRN-OASIS follow-up maternal interviews from a sample of women (n=254) who had a stillbirth 6 months to 3 years prior. PTS symptoms were measured using the Impact of Events Scale (IES). Feeling blamed by others for the loss of the baby was found to significantly influence the relationship between staff support and PTS, with support received in hospital decreasing PTS symptoms more in women who felt blamed by others. Among women aged 25-34, reported in-hospital support was associated with a -8.22 (95% CI: -15.9, -0.5) reduction in IES scores for women who did not feel blamed and a -18.8 (95% CI: -31.7, -5.9) reduction in women who felt blamed. The association was not significant among women aged under 25 and was only significant for women 35 or older who felt blamed for their loss. While support received from hospital staff was not associated with lower PTS symptoms among all ages, it was significantly related to a reduction of PTS symptoms in women aged 25-34 and in women who felt blamed by others for the stillbirth. These findings indicate that receiving support in the hospital from nurses and other staff is especially effective among certain populations of bereaved mothers and can contribute to a reduction in PTS symptoms.
Table of Contents
Table of Contents
Background…………………………………………………..………….………..1
Methods………………………………………………………………...………….12
Results…………………………………………………………….…….………….20
Discussion……………………………………………………….…….……….….24
References……………………………………………………….…….………….29
Tables……………..…………………………………………….……….……..….34
Figures……………..…………………………………………….……….….….…43
Appendix……………..……………………………………….……………...……46
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