An Online Self-help Intervention for Coping With the Loss of a Partner: Randomised Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 80
- Locations
- 2
- Primary Endpoint
- Grief: Texas Revised Inventory of Grief - German Version
Study Overview
Brief Summary
When someone has lost his or her partner, feelings of grief are normal and usually diminish over time. However, for some people, strong feelings of grief persist. For coping with grief, it is important to learn to accept the loss, experience the pain of grief, adjust to an environment without the deceased person, and withdraw emotional energy and focus it on other relationships. Loss-oriented tasks, such as grief work, and restoration-oriented tasks, such as attending to life changes, engaging in new activities and finding new roles and identities, are both essential.
The program is designed to be completed in 10 weeks and recommends that mourners complete one module or topic a week. To examine the benefits of SOLENA, this study will compare the answers of mourners that completed the intervention with the mourners of the control group, which will wait to complete the intervention. The group that completed the intervention is divided in two sub-groups. One group of mourners will complete the intervention in a fixed order, while the other will complete it in a self-tailored order according to their own needs at each moment. Specifically, the study examines how well the self-help program reduces grief, depression symptoms, and loneliness and examines whether the topics of the study modules are presented in a given order or whether participants can work on the topics according to their current needs makes a difference. Ultimately, it is expected that the self-tailored version leads to more benefits than completing SOLENA's modules in a fixed order.
Detailed Description
BACKGROUND AND RATIONALE
The death of a spouse is a frequent and very stressful critical life event in later life. The loss of a partner involves the adaptation of daily routines which can be even more challenging when social, physical, and financial resources decline in later life. Grief and psychological distress after the loss of a spouse are normative reactions. For most people, grief intensity weakens to a manageable degree within several weeks or months. However, some individuals are less able to cope with bereavement and show symptoms of disturbed or prolonged grief or adaptation problems.
To support coping with the loss of a significant person, the Task model identifies four tasks of mourning, namely accepting the reality of the loss, experiencing the pain of grief, adjusting to an environment without the deceased person, and withdrawing emotional energy and reinvesting it in another relationship. Moreover, the dual-process model of coping with bereavement posits that a dynamic coping process oscillating between loss-oriented tasks such as grief work and restoration-oriented tasks such as attending to life changes is essential for adjustment.
Based in these two models, Brodbeck and colleagues developed LIVIA, a text-based self-help online program to support the loss of the spouse, which has proved its efficacy for mourning older adults from a general population. LIVIA is rooted in cognitive behavioural therapy, including the most relevant treatment elements to support the mourning process: exposure, cognitive reappraisal, integration, and restoration as well as self-care and social reengagement treatment components.
LIVIA confirmed that the intervention is also efficacious for milder grief symptoms. Compared to the control group, the intervention resulted in significant reductions in grief (d = 0.81), depression (d = 0.59), psychopathological distress (d = 0.39) (primary outcomes), embitterment (d = 0.37), loneliness (d = 0.37) and an increase in life satisfaction (d = -0.41) (secondary outcomes). These gains were maintained over three months. Improvements were similar among participants with low, medium, or high levels of grief at baseline. Therefore, LIVIA provides a promising basis for the development of a more sophisticated and attractive intervention with a more inclusive target group, e.g., mourners of all ages who lost their spouse within the previous six months, while still seeking help for coping with the loss.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Experience of spousal bereavement
- •Seeking help for coping with grief or the psychosocial adaptation to a life without the partner
- •Having access to an internet connection and adequate equipment
- •Mastery of the German language
- •An informed consent by the participant.
Exclusion Criteria
- •Loss less than one month ago
- •Acute suicidality
- •Inability to follow the procedures of the study, e.g., due to comprehension problems, visual impairment, lack of sufficient motor skills or severe psychological or somatic disorders which require immediate treatment which impedes the continuous work on the self-help programme.
Outcomes
Primary Outcomes
Grief: Texas Revised Inventory of Grief - German Version
Time Frame: At week 10 (post-intervention)
Grief is assessed with the Texas Revised Inventory of Grief - German Version. The TRIG is a widely used measure to assess the severity of grief. The TRIG German version is a 16-item measure to assess the severity of grief from 1 = completely true to 5 = completely false. The scale ranges from 1 to 80, higher values indicate higher levels of grief.
Secondary Outcomes
- Depression symptoms measured by The Patient Health Questionnaire (PHQ-9) German version.(At week 10 (post-intervention))
- Perceived loneliness measured by the Jong Gierveld Loneliness Scale(At week 10 (post-intervention))
Investigators
Jeannette Brodbeck
Professor
University of Applied Sciences and Arts Northwestern Switzerland