Browsing by Author "Fredenburg, Michaelene"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    “There's no time limit on grief:” Women's perspectives on a novel reproductive grief screening tool
    (Elsevier, 2023-12-04) Bute, Jennifer J.; Brann, Maria; Buskmiller, Cara; Fredenburg, Michaelene; Communication Studies, School of Liberal Arts
    Objective: Women who have experienced reproductive loss (i.e., miscarriage, stillbirth, abortion) evaluated the usefulness of a novel screening tool, Reproductive Grief Screen (RGS), to identify patients struggling with ongoing, complicated grief. Methods: This mixed-methods study involved U.S. women who had experienced reproductive loss. Online data collection resulted in 27 interviews and 282 surveys completed. Perceptions of and preferences about RGS were thematically analyzed. Chi square analyses assessed relationships between demographics and tool preferences. Results: RGS validated women's experiences with grief after reproductive loss. Women noted their providers may be unaware of their loss(es). Participants requested periodic screening using RGS beginning shortly after a loss (or during new patient intake) and occurring regularly (e.g., annually). Overall, women preferred completing RGS online before an appointment, though preferences varied by demographics (i.e., age, time since loss). Participants want providers to compassionately discuss RGS results with them and offer appropriate resources. Conclusion: The RGS can help identify largely ignored grief after reproductive loss. Innovation: Findings from group and individual interviews and a survey of women who have coped with reproductive loss suggest that use of a brief RGS tool could reshape clinical practice to aid women who might be facing complicated grief. Moreover, women expressed clear preferences for how to implement use of the RGS in clinical contexts.
  • Thumbnail Image
    Item
    Validation of a Brief Measure for Complicated Grief Specific to Reproductive Loss
    (Springer Nature, 2023-04-20) Buskmiller, Cara; Grauerholz, Kathryn R.; Bute, Jennifer; Brann, Maria; Fredenburg, Michaelene; Refuerzo, Jerrie S.; Communication Studies, School of Liberal Arts
    Objective: Complicated grief reactions follow some pregnancy outcomes, like miscarriage, stillbirth, neonatal death, infant death, selective reduction, or termination of pregnancy. Stigma can delay treatment and worsen outcomes. Screening tools such as the Edinburgh Postnatal Depression Scale detect complicated grief poorly, and specific tools for prolonged or complicated grief after a reproductive loss are cumbersome. In this study, a five-item questionnaire to detect complicated grief after reproductive loss of any type was designed and preliminary validated. Methods: A questionnaire patterned after the extensively validated Brief Grief Questionnaire (BGQ) was created by a group of physicians and lay advocates to employ non-traumatic but specific language related to grief after miscarriage, stillbirth, neonatal death, infant death, selective reduction, or termination of pregnancy. One hundred and forty women at a large academic center were recruited in person and via social media to validate the questionnaire with well-studied instruments for anxiety (7-item Panic Disorder Severity Scale, PDSS), trauma (22-item Impact of Events Scale), and reproductive grief and depressive symptoms (33-item Perinatal Grief Scale [PGS]). Results: The response rate was 74.9%. Of the 140 participants, 18 (12.8%) experienced their loss during high-risk pregnancies, and 65 (46.4%) were recruited via social media. Seventy-one (51%) respondents had a score > 4, a positive screen for the BGQ. On average, women experienced their loss 2 years prior to participation (IQR 1-5 years). Cronbach's alpha was 0.77 (95% CI: 0.69-0.83). The goodness of fit indices of the model met Fornell and Larker criteria (RMSEA = 0.167, CFI = 0.89, SRMR = 0.06). The AVE was 0.42 and the CR 0.78. Conclusions: This investigator-created screening tool is internally consistent and meets preliminary criteria for discriminant validity. This tool can be refined prior to testing for sensitivity and specificity in screening for complicated grief after a reproductive loss.