Walk with Me (WWM) for Perinatal Grief

项目摘要 在怀孕期间和产后早期失去孩子会造成巨大的心理痛苦。 对许多女性和她们的伴侣来说，并可能导致长期的心理损伤和障碍，如 如创伤后应激、长期悲伤和自杀。在美国，大约有24000名婴儿 每年都有死产，超过14,000名婴儿在出生后30天内死亡。约15%的父母会 经历过流产的女性中，超过30%的人接受了诊断 创伤后应激障碍的标准。目前，有效和可获得的治疗方法有限。 减轻创伤和强烈悲痛的影响，这些都是围产期丢失的常见原因。先前的研究发现 在线认知行为疗法(CBT)将有效减少围产期悲伤和创伤后应激 精神障碍症状。然而，需要提供认知重新评估以外的支持的计划 提供具体的战略，以减少痛苦并增加对后续工作的依恋 怀孕包括正念练习和纳入与父母合作的指导原则 有过围产期丢失的经历。运用悲伤的指导原则并灌输实用的策略来减少 对失去亲人的父母的痛苦，如促进伴侣订婚和悲痛仪式的例子 对这一人群的认知行为疗法的重要补充。此外，失去亲人 父母可能会遇到来自健康护理专业人员(HCP)的破坏性沟通，这些专业人员缺乏足够的 训练。目前还没有现成的工具可以将HCP培训与对失去亲人的父母的直接支持结合在一起。 这个第一阶段项目的目标是创建一个移动应用程序的原型，它展示了 减少围产期损失后父母痛苦(创伤应激和悲伤强度)的有效性。我们 我将通过实现我们的三个具体目标来实现这一目标：具体目标1：使用迭代形成法 开发进程，以开发培训和模块，以利用 认知行为疗法与围产期亲子合作指导原则 损失。具体目标2：开发具有应用程序核心组件的原型。具体地说，HCP 为失去亲人的父母提供培训和四个主要模块，包括两个关于悲伤正常化的模块，一个关于正念的模块 帮助应对创伤和痛苦症状，并使用CBT策略管理负面情绪 思想。具体目标3：评估Walk With Me By的可接受性、可用性和有效性 对HCP和失去亲人的父母进行混合方法计划评估，以优化成功的 《与我同行》的用途。

Project Summary The loss of a child during pregnancy and the early postpartum period causes significant psychological distress for many women and their partners and may lead to long-lasting psychological impairment and disorder such as posttraumatic stress, prolonged grief, and suicide. Approximately 24,000 babies in the United States are stillborn each year and over 14,000 infants die within the first 30 days of life. About 15% of parents will experience a miscarriage and more than 30% of women who experience a miscarriage meet the diagnostic criteria for posttraumatic stress disorder. Currently, there are limited efficacious and accessible treatments to attenuate the effects of trauma and intense grief that are common to perinatal loss. Prior research has found online cognitive behavioral therapy (CBT) to be effective for reducing perinatal grief and post-traumatic stress disorder symptoms. However, there is a need for programs that provide support beyond cognitive reappraisal to offer concrete strategies to reduce distress and increase availability for attachment to subsequent pregnancies including mindfulness practice and the inclusion of guiding principles for working with parents who have experienced perinatal loss. Using guiding principles of grief and infusing practical strategies to reduce distress for bereaved parents such as facilitating partner engagement and examples of grief rituals are be important additions to components of cognitive behavioral therapy for this population. Additionally, bereaved parents may experience damaging communication from health care professionals (HCPs) who lack sufficient training. There are no readily available tools that blend HCP training with direct support for bereaved parents. The goal of this phase I project is to create a prototype of a mobile application that demonstrates promise of effectiveness for reducing parent distress (traumatic stress and intensity of grief) following a perinatal loss. We will accomplish this goal by accomplishing our three specific aims: Specific Aim 1: Use an iterative formative development process to develop training and modules for grief processing and healing activities leveraging cognitive behavioral therapy and guiding principles for working with parents who have experienced perinatal loss. Specific Aim 2: Develop prototype featuring core components of the application. Specifically, HCP training and four key modules for bereaved parents including two on normalization of grief, one on mindfulness to facilitate coping with trauma and distress symptoms and one using CBT strategies to manage negative thoughts. Specific Aim 3: Evaluate the acceptability, usability, and effectiveness of Walk with Me by conducting a mixed-methods program evaluation with HCPs and bereaved parents to optimize the successful use of Walk with Me.