{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:06:29Z","timestamp":1790273189498,"version":"4.1.0"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012400","name":"Sigma Theta Tau International","doi-asserted-by":"publisher","award":["Small Grant"],"award-info":[{"award-number":["Small Grant"]}],"id":[{"id":"10.13039\/100012400","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012400","name":"Sigma Theta Tau International","doi-asserted-by":"publisher","award":["Beta Nu Chapter Research Grant"],"award-info":[{"award-number":["Beta Nu Chapter Research Grant"]}],"id":[{"id":"10.13039\/100012400","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>This paper aims to understand the patient experiences of women who suffered a miscarriage during the COVID-19 pandemic and examine the relationships of patient experience with miscarriage management, psychological distress, and COVID-19-related stressors. A convergent parallel mixed-methods design combined cross-sectional survey data and qualitative descriptive interviews. Seventy-one women in North Carolina who experienced a miscarriage during the COVID-19 stay-at-home mandates were assessed on patient experience, miscarriage management, perceived stress, anxiety, depression, posttraumatic stress, and COVID-19\u2013related stressors. In-depth interviews were conducted with a subsample of 18 participants. Quantitative and qualitative findings of the subsample were integrated using a joint display to examine the level of convergence. Approximately half of participants reported poor patient experiences (52%), and half reported good patient experiences (48%). COVID-19\u2013related stressors, including inability to have a support person present and access to care disruptions, did not differ significantly between groups. Participants reporting poor patient experiences had significantly higher levels of perceived stress, anxiety, and depressive symptoms (p\u2009&lt;\u2009.05). Among those receiving medical and\/or surgical management, good patient experiences were associated with lower psychological distress; this pattern was not observed among participants undergoing expectant management. Qualitative findings identified four categories shaping miscarriage care: Access to Care, Healthcare Provider Interactions, Healthcare Support Staff Interactions, and Healthcare System Interactions. Data integration demonstrated strong convergence for all four subcategories of the Healthcare Provider Interactions category; moderate convergence for access to care; and weak convergence for healthcare support staff interactions and healthcare system interactions. Findings underscore the central role of provider and nursing interpersonal care in shaping patient experiences and psychological well-being following miscarriage, even amid COVID-19-related system disruptions. Results highlight the need for structured follow-up, emotionally supportive care, and attention to organizational policies to improve miscarriage care during public health crises.<\/jats:p>","DOI":"10.1371\/journal.pone.0359158","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:25:36Z","timestamp":1790270736000},"page":"e0359158","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating grief and healthcare: Mixed-methods study on patient experiences of miscarriage during COVID-19"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9545-9484","authenticated-orcid":true,"given":"Madeline","family":"Fernandez-Pineda","sequence":"first","affiliation":[{"name":"College of Nursing, East Carolina University","place":["Greenville, North Carolina, United States of America"],"department":["Department of Nursing Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Swift","sequence":"additional","affiliation":[{"name":"College of Nursing, East Carolina University","place":["Greenville, North Carolina, United States of America"],"department":["Department of Advanced Nursing Practice and Education"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0952-6311","authenticated-orcid":true,"given":"Christyn","family":"Dolbier","sequence":"additional","affiliation":[{"name":"Thomas Harriot College of Arts and Sciences, East Carolina University","place":["Greenville, North Carolina, United States of America"],"department":["Department of Psychology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin","family":"Swanson","sequence":"additional","affiliation":[{"name":"College of Nursing, East Carolina University","place":["Greenville, North Carolina, United States of America"],"department":["Department of Nursing Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne Rose","family":"Choufani","sequence":"additional","affiliation":[{"name":"College of Nursing, East Carolina University","place":["Greenville, North Carolina, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3866-7970","authenticated-orcid":true,"given":"Kaitlin","family":"Guard Banasiewicz","sequence":"additional","affiliation":[{"name":"College of Nursing, East Carolina University","place":["Greenville, North Carolina, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"pone.0359158.ref001","article-title":"Early pregnancy loss (spontaneous abortion)","volume-title":"StatPearls","author":"C Alves","year":"2026"},{"issue":"4","key":"pone.0359158.ref002","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2019.10.102","article-title":"Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: A multicenter, prospective, cohort study","volume":"222","author":"J Farren","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"10285","key":"pone.0359158.ref003","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1016\/S0140-6736(21)00682-6","article-title":"Miscarriage matters: The epidemiological, physical, psychological, and economic costs of early pregnancy loss","volume":"397","author":"S Quenby","year":"2021","journal-title":"Lancet"},{"issue":"1","key":"pone.0359158.ref004","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1186\/s12884-024-06610-z","article-title":"Compounding stress: A mixed-methods study on the psychological experience of miscarriage amid the COVID-19 pandemic","volume":"24","author":"M Fernandez-Pineda","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0359158.ref005","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1111\/jocn.12781","article-title":"Women\u2019s experiences of early miscarriage: Implications for nursing care","volume":"24","author":"EJ Radford","year":"2015","journal-title":"J Clin Nurs"},{"issue":"2","key":"pone.0359158.ref006","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.wombi.2018.06.006","article-title":"\u201cThe loss was traumatic\u2026 some healthcare providers added to that\u201d: Women\u2019s experiences of miscarriage","volume":"32","author":"C Bellhouse","year":"2019","journal-title":"Women Birth"},{"key":"pone.0359158.ref007","unstructured":"Agency for Healthcare Research and Quality. 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