No more the same: the lives of adolescents in Taiwan who have lost fathers

Parental death: a systematic review of support experiences and needs of children and parent survivors

BACKGROUND

Bereaved people need a supportive response from those around them. Knowing children's and surviving parents' needs following parental death is the first step to ensuring a supportive response. However, no systematic review has reported on this phenomenon.

AIM

To systematically identify and synthesise qualitative literature exploring support experiences of parentally bereaved children and surviving parents.

METHODS

Systematic review with thematic synthesis, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. MEDLINE, Embase, PsycINFO, CINAHL and the British Nursing Database were searched for relevant papers to September 2021. Included studies were appraised for quality and thematically synthesised using Thomas and Harden's thematic synthesis framework.

RESULTS

Fifteen qualitative studies from nine countries were included. There were four analytical themes from the children's perspectives (1) Openness of communication with children about death and dying, (2) Children's challenges of managing change, (3) Navigating emotions, and (4) Children's acceptability, access and engagement with support. There were three analytical themes from the parents' perspectives: (1) Adjusting as a parent, (2) Supporting their children, and (3) Parent's acceptability, access and engagement with support.

CONCLUSIONS

Following a parental death, open and honest communication and involvement in what is happening within the family will help children cope. Both children and parents suppress emotions and avoid conversations to protect each other and those around them. A taboo around death exists and constrains the support some families receive. Childhood bereavement is a public health issue, with a need for professionals and communities to better understand and respond to the needs of bereaved families.CRD42020166179.

Towards a model of loss navigation in adolescence

Researchers today consider childhood bereavement one of the most traumatic experiences that can befall a child. Nevertheless, most models of bereavement currently limit themselves to dealing with adult grief and primarily explores the internal processes associated with recovery. Based on a study which conducted focus groups with 39 Danish adolescents (aged 9-17), this article presents The Model of Loss Navigation in Adolescence. Centered on the three factors-Being Different, Being in Control, and Being in Grief-the model highlight the social conventions children have to navigate and how these influences both their day-to-day lives and their road to recovery.

Recovery experiences of Taiwanese women after terminating abusive relationships: a phenomenology study

This article describes the recovery experiences of women who had suffered intimate partner violence in Taiwan. A phenomenological study design using semi-structured interviews was used to obtain data from a purposive sample of eight women. Colaizzi's approach to narrative analysis was applied. Findings indicate that "reconstructing the self" emerged as the essence of the women's recovery experiences. Four themes were identified: Feeling shame, creating mastery, recognizing the imperfect self, and embodying the self by helping others. Understanding the recovery experience is an important step in effectively assisting women to recover from abusive relationships and to reconstruct their lives.

Recovery through reconnection: a cultural design for family bereavement in Taiwan

Using reanalyzed data from ethnographic research performed in Taiwan during the 1990s, the authors inspect Taiwanese cultural patterns as they affect adaptation to loss in the form of death. The data include participant observations and the narratives of 52 widows and 30 of their children. An analysis of interview transcripts suggests that the most common form of return to a harmony house among the participants was achieving a sense of reconnection with the deceased. According to the narratives, the Taiwanese concept of reconnection entails (a) maintaining the status quo, (b) restoring images of the deceased in family affairs, and (c) communicating with the dead. Each theme represents the efforts of bereaved families to retain a sense of wholeness (a central Chinese goal) and to preserve symbolic images of fathers and husbands. The authors suggest that reconnection is a culturally specific and accepted means of resolving grief among Taiwanese.

Interpretations of stillbirth

BACKGROUND

Continuity is a major concept in the father-son domain of the Han Chinese value system in Taiwan. Aspects of continuity may include structure, interactions and other facets of family; however, providing descendants is the keystone of women's reality in these families. In a culture in which death is seen as a taboo subject and the unborn child has not been recognized as a real baby, losing a long-expected child at the end of pregnancy becomes a great challenge to women who have experienced stillbirth.

AIM

The aim of this paper is to report a study exploring Taiwanese mothers' interpretations of stillbirth, and their unique sociocultural context.

METHOD

An interpretive ethnographic approach was used. Over a two and a half-year period, 20 women who had experienced such losses after at least 20 weeks of pregnancy were interviewed to find out how they interpreted their babies' deaths. Interview data were analysed thematically.

FINDINGS

The four major themes identified were: 'loss of control', 'broken dream', 'shattered self' and 'something wrong with me'. Interpretations of stillbirth among Taiwanese women indicate a strong sense of incompleteness and personal failure, triggering reactions in terms of not only maternal identity, but also female cultural roles. Many interviewees blamed themselves for the deaths of their unborn children, a viewpoint resulting in excessive guilt feelings.

CONCLUSION

Culturally bound taboos against talking about death, participating in death-related events, and expressing grief in public affect the adaptation and grieving processes of Taiwanese women who have had a stillbirth. Nurses should, therefore, make an effort to listen to the perspectives of such patients in order to assist them with coming to terms with their loss. As part of their education, nurses require information on cultural beliefs so that they can provide appropriate care to grieving mothers.