Online versus face‑to‑face metacognitive educational counseling program on anxiety and meta‑worry in women with a history of miscarriage: A randomized clinical trial

In the COVID‑19 outbreak, women with a history of miscarriage need more mental health. Anxiety and meta‑worry as consequences of miscarriage, besides concerns due to pregnancy during coronavirus, show the necessity of appropriate online and face‑to‑face educational counseling. This study aimed to evaluate the effectiveness of online metacognitive educational counseling versus face‑to‑face method on anxiety and meta‑worry in these women.

In this randomized clinical trial, 80 women with a history of miscarriage, anxiety, and meta‑worry referred to Imam Jafar Sadegh hospital (labor, women ward and women clinic), Meybod, Iran, were selected conveniently and randomly assigned into two groups (n = 20/each). The participants received 8‑session metacognitive educational counseling package online or face‑to‑face. Data were collected by Beck Anxiety Inventory, Wellz meta‑worry questionnaire at baseline, week eight, and follow up as primary outcomes and analyzed via SPSS software (Anova and Repeated measure statistic tests).

Anxiety in the 12th week (online group 13.75 ± 3.59 vs. face to face 18.25 ± 5.91, P = 0.04) was statistical significantly less than baseline (respectively 22.15 ± 5.67 vs. 22.35 ± 4.93, P = 0.56); with fewer anxiety scores in the online group. Meta‑worry in the 12th week (online group 11.90 ± 2.59 vs. face to face 15.70 ± 4.06, P = 0.03) was statistically significant compared to baseline (respectively 17.15 ± 2.70 vs. 18.50 ± 3.47, P = 0.36); with fewer meta‑worry scores in the online group. Belief about worry in 12th week (online group 66.50 ± 14.60 vs. face to face 78.45 ± 9.27, P = 0.01) was statistical significantly less than baseline (respectively 85.50 ± 8.87 vs. 86.05 ± 8.85, P = 0.96); with less score of belief about worry in the online group.

Online and face‑to‑face metacognitive educational counseling methods decreased anxiety, meta‑worry, and belief about worry in women with miscarriage. But online educational counseling was more effective. Distance online counseling in COVID‑19 can help the mental health of women with miscarriage.