Miscarriage is the unintended loss of pregnancy less than 20 weeks gestation. Healthcare professionals shy away from the topic and often do not view the psychological effects of perinatal loss as significant (DiMarco, 2002; Laurent, 1991).  Little is known about the best approach nurses can take with these women and a cost effective intervention has not been evaluated in this underserved population. This triangulated study evaluates the effectiveness of journaling to improve the emotional outcome of women post spontaneous abortion (SAB) and threatened miscarriage (TAB), examines perceptions and experiences following SAB, and assesses patient satisfaction of the nursing care received during treatment in the emergency department (ED).   

Method:

Subjects were identified using a convenience sample of ED patients and were randomized into one of 2 groups: Group 1, the control and Group 2, journaled for a period of 6 weeks.  At the end of 6 weeks all subjects were measured for grief (Perinatal Bereavement Grief Score), anxiety, and depression (Hospital Anxiety and Depression Scale (HADS)) and patient satisfaction (Laschinger) with the nursing care they received.  

Results:

Preliminary results indicate that these women appreciate recognition and understanding about their experience.  However, subject mortality is an issue with this study.  Of 22 subjects to date the response rate is 22%.  Using HADS the respondents have reported mild-moderate anxiety (M=10.25) and normal depression scores (M=7.5).  Mean patient satisfaction scores for nursing care fell in the “very good “ category.  

Conclusions: Women have anxiety post SAB.  Patients appreciate the care they receive in the ED and nurses can make a difference with these women.  Journaling may be an option for TAB and SAB survivors to ventilate their feelings.  With education nurses can address this taboo subject with the patient and other significant family members.