Resilience and Coping Strategy after Abortion due to Fetal Malformation: A Web-Based Randomized Controlled Intervention
Authors: Zarei Maryam , Kheirkhah Masoomeh , Azadi Nemam Ali , Saberi Mahdi , Esmaeeli Nazanin 
Published: November 2020

Abstract
Background: Today, due to the development of advanced fetal screening techniques, termination for fetal abnormalities has increased, and has caused significant grief for women which can lead to long-term mental disorders. Self-help intervention with web guide may help provide appropriate education and counseling to women. Therefore, this study was conducted to determine the effect of social network education on resilience and coping strategies of women abortion due to fetal malformation.Methods: This clinical trial studied two groups of 100 qualified pregnant women with abnormal fetuses who referred to Tehran Forensic Medicine Center. Randomly assigned into a randomized blocks list as two intervention group and routine group. Sampling was done by random allocation method by Excel software and blinding in the statistical analysis stage and was done as single-blind. The intervention in the experimental group was done as education through mobile social software (Soroush) and for 6 weeks and three times a week. The control group received routine care and after the second test, the content of the network education was also given to them. Resilience and coping strategies were evaluated before, immediately and three months after the intervention using the Persian version of Connor-Davidson Resilience Scale (CD-RISC-2003) and coping strategies (COPE-1989), respectively. Analysis of variance with repeated measures of ANOVA was used for statistical analysis.Results: The mean resilience score in both control and test groups increased significantly (P<0.001) which can indicate the effect of time, but the study of the effect of group over time indicated that in the resilience variable there was a significant difference between the two groups (P<0.001). The simultaneous effect and group on the resilience variable was significant (p<0.001) and the mean variation of resilience score in the intervention group was significantly higher than the control group (p<0.001). The mean score of problem-focused coping strategies in the experimental group increased significantly during 12 weeks (p<0.001) but no significant difference was observed in the control group (p=0.218). Regarding the emotion-focused strategy, a significant decrease was observed in the experimental group (p<0.001) but in the control group there was a significant increase (P=0.001). There was a significant decrease in the avoidance strategy in the experimental group (p<0.001); there was no significant changes in the control group (p=0.066) and the simultaneous effect of group and time in all coping strategies was significant (P<0.001).Conclusion: Social network education leads to enhanced resilience and greater use of problem-focused coping strategies in women after abortion due to fetal malformation and is effective on improving women’s health by reducing emotion-focused and avoidance-focused coping strategies. Low cost and fast access to virtual mobile networks allow women to access educational content after abortion due to fetal malformation.Registration in clinical trial: it is registered in the Thai Clinical Trial Registry (TCTR) under the number TCTR20200519001.CONSORT : This study follows the CONSORT guidelines.