1
|
Wimberly CE, Davis ES, Towry L, Walsh KM, Johnston EE. Psychosocial burden after the death of a child from cancer: Results of a bereaved parent survey. DEATH STUDIES 2024:1-9. [PMID: 38958178 DOI: 10.1080/07481187.2024.2371074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Parents experience lasting psychological distress after a child's death from cancer. Limited evidence exists regarding difficult life events, duration of psychosocial impacts, and associated risk factors among bereaved parents. Alex's Lemonade Stand Foundation surveyed self-selected, bereaved parents regarding difficult life events and psychosocial wellbeing (life satisfaction, unanswered questions, and missing the care team) through a public, cross-sectional survey. 176 bereaved parents (89% mothers) participated a median of 7 y after their child's death. The most difficult events were family vacations (80%), their child's birthday (80%), and anniversary of their child's death (76%). Only the latter did not improve with time. Greater life satisfaction was associated with male sex (ARR = 1.2, 95% CI:1.1-1.4) and being married/partnered (ARR = 1.2, 95% CI = 1.0-1.3). Having unanswered questions and missing the child's team were associated with annual income <$50,000 (ARR = 1.2, 95% CI:1.1-1.2; ARR = 1.2, 95% CI:1.0-1.3, respectively). Pediatric oncology programs need robust bereavement programs that include prolonged contact with families.
Collapse
Affiliation(s)
- Courtney E Wimberly
- Department of Neurosurgery and Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA
| | - Elizabeth S Davis
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Surgery, Boston University School of Medicine, Boston, North Carolina, USA
| | - Lisa Towry
- Alex's Lemonade Stand Foundation, Bala Cynwyd, Pennsylvania, USA
| | - Kyle M Walsh
- Department of Neurosurgery and Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA
- Children's Health and Discovery Institute, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Emily E Johnston
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
2
|
Lehmann OV, Kalstad TG, Neimeyer RA. Experiences of Fathers in Norway Attending an Online Course on Therapeutic Writing After the Death of a Child. QUALITATIVE HEALTH RESEARCH 2024; 34:458-472. [PMID: 38038335 PMCID: PMC10996295 DOI: 10.1177/10497323231216099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
After the unexpected death of a child, bereaved parents require prompt access to helpful support systems. Online therapeutic writing courses can make such support accessible. Because few studies have included bereaved fathers as participants, we explored the experiences of fathers whose children died unexpectedly and who were part of an online course of therapeutic writing in Norway. We piloted two courses (group 1, six weeks, n = 9; group 2, 5 weeks, n = 5). We describe our methodological considerations for using poetic representations in qualitative health research and present four poetic representations based on fieldwork notes written by the principal investigator. Then, we triangulate and narratively analyze them together with two collective poems written by participants from each group; excerpts of the writings from two fathers, one per group; evaluation surveys (n = 4; n = 3); and, anonymous check-out journaling from the second group (n = 3). Resistance was a salient feature of our participants' grief, and writing enabled them to both be in contact with their emotional world and process difficult emotions as they looked for meaning despite the death of their children. Those who attended the most classes perceived the course as transformative, being part of an ongoing self-exploration, and a possibility to continue and strengthen the bond with their children. Our findings mirror the complexities of the grief experiences of fathers, giving account of their need to find a rhythm to dive into their emotional world, the importance of peer support, and the value of diversifying intervention techniques to meet individual needs and preferences.
Collapse
Affiliation(s)
- Olga V. Lehmann
- Department of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Trine Giving Kalstad
- The Norwegian SIDS and Stillbirth Association, Oslo, Norway
- Department of Crisis Psychology, University of Bergen, Bergen, Norway
| | - Robert A. Neimeyer
- Department of Psychology, University of Memphis, Memphis, TN, USA
- Portland Institute for Loss and Transition, Portland, USA
| |
Collapse
|
3
|
Fisher RS, Dattilo TM, DeLone AM, Basile NL, Kenney AE, Hill KN, Chang HF, Gerhardt CA, Mullins LL. The study of psychosocial outcomes of parents bereaved by pediatric illness: a scoping review of methodology and sample composition. J Pediatr Psychol 2024; 49:207-223. [PMID: 38423530 DOI: 10.1093/jpepsy/jsae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE Parents of children who died of a medical condition experience a range of psychosocial outcomes. The current scoping review aims to summarize the outcomes assessed, methodology, and sample characteristics of recent psychosocial research conducted with this population. METHODS Included studies were limited to peer-reviewed, psychosocial outcomes research published between August 2011 and August 2022, written in English, and including caregiver study participants of children who died of a medical condition. Data sources were scholarly journal articles from 9 electronic databases, including Scopus, Web of Science, Academic Search Primer, ProQuest Research Library, PubMed, Embase, PsycINFO, Psychology & Behavioral Sciences Collection, and Health Source: Nursing/Academic Edition. The Mixed Methods Appraisal Tool-2018 evaluated methodological quality. RESULTS The study sample included 106 studies, most of which were either qualitative (60%) or quantitative (29%). Mixed-methods studies (8%) and randomized clinical trials (2%) were also identified. Study quality was variable, but most studies met all quality criteria (73%). Studies primarily represented cancer populations (58%), White participants (71%), and mothers (66%). Risk-based psychosocial outcomes (e.g., grief) were more commonly assessed than resilience-based outcomes. CONCLUSIONS The current scoping review revealed that recent research assessing the psychosocial outcomes of bereaved parents is limited in the representation of diverse populations, primarily qualitative, of broadly strong methodological quality, and oriented to psychosocial risk. To enhance the state of the science and inform evidence-based psychosocial services, future research should consider varied methodologies to comprehensively assess processes of risk and resilience with demographically and medically diverse populations.
Collapse
Affiliation(s)
- Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Ansley E Kenney
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Kylie N Hill
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Hui-Fen Chang
- William E. Brock Memorial Library, Oklahoma State University, Stillwater, OK, United States
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| |
Collapse
|
4
|
Denhup C. "Trying to Find North": Fathers Voice the Nature of Their Bereavement. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241238383. [PMID: 38445575 DOI: 10.1177/00302228241238383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Fathers' lived experience of bereavement is not well understood. This article presents findings from a Heidegerrian phenomenological study, which aimed to describe fathers' bereavement. Fathers' bereavement is a life-long journey along which a father navigates through devastating and traumatic loss with great strength; has profound grief that mirrors the profound love he has for his child; chooses to live life with intention and engages in meaningful activities that create purpose aimed at honoring his child, continuing his child's legacy, and using his own suffering for the good of others; is anchored by a continuing bond of love that fuels an ongoing relationship with his child; and needs a supportive community to sustain him as he travels down the healing road where it is possible to find faith, hope, and love while being forever transformed by loss. Findings amplify fathers' voice so nurses gain a deeper understanding of their experience.
Collapse
Affiliation(s)
- Christine Denhup
- The Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT, USA
| |
Collapse
|
5
|
Shin S, Ahn S, Joung J, Kim S. Parents' lived experiences of losing adolescent children in the Korean Ferry Sewol disaster: Lessons through a qualitative meta-synthesis. DEATH STUDIES 2023; 48:584-599. [PMID: 37672392 DOI: 10.1080/07481187.2023.2253764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
This study meta-synthesized qualitative studies on the parents' experiences of losing their adolescent children due to the human-made disaster, Ferry Sewol disaster in Korea, 2014. Five Korean and five international electronic databases were searched. Twenty-one studies were selected and critically appraised. Thematic analysis was employed. Four themes (with 10 subthemes) were derived: screaming in excruciating pain at the unbelievable deaths of children, family love evolving amidst pain and deepening into higher value, relationships collapsed and reformed while experiencing various social perspectives, and transitioning from a life of holding on to a life of progress. Bereaved parents experience psychological, physical, social pain for a long time, but gradually tried not to waste their children's death, forming new values and life goals. There is pressing need to devise sustained recovery strategies that account for distinct characteristics and needs of affected population groups.
Collapse
Affiliation(s)
- Soyoung Shin
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Suyoun Ahn
- Department of Nursing, Seoyeong University, Paju, South Korea
| | - Jaewon Joung
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
| | - Sungjae Kim
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
| |
Collapse
|
6
|
Bezerra MAR, Rocha RC, Rocha KNDS, Moura DFS, Christoffel MM, Souza IEDO, Rocha SSD. Death of children by domestic accidents: unveiling the maternal experience. Rev Bras Enferm 2022; 75:e20210435. [DOI: 10.1590/0034-7167-2021-0435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/15/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to unveil the meanings of mothers whose children died as a result of domestic accidents in childhood. Methods: a qualitative research, in the light of Heideggerian phenomenology, with ten mothers whose children died from domestic accidents. It was carried out in a municipality of the Northeast Region of Brazil through phenomenological interviews between May and June 2017. The existential analytic was constituted by the comprehensive moments of the Heideggerian method. Results: the meanings unveiled pointed out that, to understand the sudden death of her child, the mother oscillates between feeling guilty, pointing and denying guilt. She reports emptiness, permanent pain, non-acceptance of her child’s death, and the desire to keep him in her life. In this journey, the fear that brings limitations to her life and that of her other children is revealed. Final Considerations: it was revealed that the death of the child in infancy compromises the integrality of being a mother, indicating the need for systematic and continuous care for the adequate management of the emotional and social effects.
Collapse
|
7
|
McNeil MJ, Baker JN, Snyder I, Rosenberg AR, Kaye EC. Grief and Bereavement in Fathers After the Death of a Child: A Systematic Review. Pediatrics 2021; 147:peds.2020-040386. [PMID: 33648950 DOI: 10.1542/peds.2020-040386] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The death of a child is devastating, and complicated grief adversely impacts parental physical and psychosocial well-being. Most research currently is centered on bereaved mothers, and the experiences of fathers remains underexplored. OBJECTIVE We systematically reviewed the literature to characterize the grief and bereavement experiences of fathers after the death of a child. DATA SOURCES We searched Medline, PsycInfo, Embase, and Cumulative Index to Nursing and Allied Health Literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. STUDY SELECTION Inclusion criteria encompassed English language articles published between 2007 and 2019 that evaluated the grief and bereavement experiences of fathers after the death of their child. We excluded studies describing paternal bereavement after the death of a child aged older than 21 years, stillbirth, miscarriage, or studies that did not specify age of death. DATA EXTRACTION Extracted domains included study design, demographics, findings, and quality assessment. RESULTS We screened 1848 deduplicated titles and abstracts and 139 full articles, yielding 21 articles for inclusion in this analysis. Fathers often avoided discussing their grief with others, returned to work earlier, and used goal-oriented tasks as coping strategies. Intense grief reactions and posttraumatic psychological sequelae diminished over time in mothers yet persisted in fathers. LIMITATIONS Included studies were primarily descriptive in nature, without ability to ascertain causality. Limited paternal data exists in the literature compared with maternal data. CONCLUSIONS Despite evolving gender roles, many fathers navigate loss through stoicism, self-isolation, and hard work. For some fathers, these coping mechanisms may be inadequate for navigating grief.
Collapse
Affiliation(s)
- Michael J McNeil
- Division of Quality and Life and Palliative Care, Department of Oncology St. Jude Children's Research Hospital, Memphis, Tennessee;
| | - Justin N Baker
- Division of Quality and Life and Palliative Care, Department of Oncology St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ian Snyder
- University of Tennessee Health Science Center, Memphis, Tennessee
| | - Abby R Rosenberg
- Palliative Care and Resilience Laboratory, Seattle Children's Research Institute, Seattle, Washington; and.,Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
| | - Erica C Kaye
- Division of Quality and Life and Palliative Care, Department of Oncology St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
8
|
Santos MRD, Wiegand DLM, Sá NND, Misko MD, Szylit R. From hospitalization to grief: meanings parents assign to their relationships with pediatric oncology professional. Rev Esc Enferm USP 2019; 53:e03521. [PMID: 31618316 DOI: 10.1590/s1980-220x2018049603521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 04/11/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To understand the meanings assigned by bereaved parents to their relationships with healthcare professionals during the end-of-life hospitalization of their child. METHOD Qualitative-interpretative study based on hermeneutics. Data were collected from interviews with parents who were grieving the death of a child with cancer in the hospital and participant observation in an oncology ward. Deductive thematic analysis for data interpretation ensued. RESULTS The experience of parents is the sum of all relationships during treatment. Therefore, meanings form a tangle of interrelated senses built not only in the interaction with these professionals, but also with the child and with grief itself. In relationships with professionals, meanings related to the memories of the child, negative emotions and regret were identified. CONCLUSION The experiences and meanings of grief are shaped by the social processes and interactions experienced by the family in the hospital. The relationship with the professionals represents part of the support in coping with the grief after the child's death in the hospital, due to the perpetuity of the love shown for the child as a possible legacy in the legitimacy of the experienced interactions.
Collapse
Affiliation(s)
- Maiara Rodrigues Dos Santos
- Universidade Univeritas/UNG , Guarulhos , SP , Brasil .,Universidade de São Paulo , Escola de Enfermagem , São Paulo , SP , Brasil
| | | | | | - Maira Deguer Misko
- Universidade Estadual de Campinas , Faculdade de Enfermagem , Campinas , SP , Brasil
| | - Regina Szylit
- Universidade de São Paulo , Escola de Enfermagem , São Paulo , SP , Brasil
| |
Collapse
|
9
|
Bekkering HJ, Woodgate RL. The Parental Experience of Unexpectedly Losing a Child in the Pediatric Emergency Department. OMEGA-JOURNAL OF DEATH AND DYING 2019; 84:28-50. [PMID: 31547765 DOI: 10.1177/0030222819876477] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Child loss is the most traumatic loss a parent can experience, increasing their risk of negative outcomes such as complicated grief. Unexpected loss in the unfamiliar environment of the Emergency Department (ED) significantly increases this risk. Despite this knowledge, research on child loss in the context of the ED is scarce. An interpretive description qualitative research study was performed with eight parents (five mothers and three fathers) to examine their experience of unexpectedly losing a child in the pediatric ED. Data collection included interviews, demographic questionnaires, and field notes. Data were analyzed using a constant comparative method and revealed four main themes: "grief as waves," "being the good parent," "coping through the waves of grief," and "the new normal." Improving understanding around child loss and implementing stronger support for parents, through communication, advocacy, and physical presence while in the ED, could greatly reduce parents' risk of negative outcomes.
Collapse
Affiliation(s)
- Holly J Bekkering
- Health Sciences Center - Variety Children's Heart Center, Winnipeg, Manitoba, Canada
| | - Roberta L Woodgate
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
10
|
Wang E, Hu H, Shi Z, Liu H, Zhang C, Jiang H, Xia L, Li S, He Y. Gender Differences in Mental Health of Bereaved Parents in an Only-Child Society: Evidence From China. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:525-544. [DOI: 10.1177/0030222819853934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined gender differences in mental health of bereaved parents related to the gender of deceased only child in China, an only-child society with traditional culture of son preference, using data drawn from the China Family Planning Survey on Vulnerable Households in 2017. The findings indicated that parents with deceased only child suffered from more negative mental health symptoms than nonbereaved parents. For only-child-death families, there were no statistically significant gender differences in mental health of parents, and the gender of the deceased only child was basically unrelated to maternal/paternal mental health. Due to the implementation of one-child policy in China, both sons and daughters are highly prized and equally relied on by aging parents owing to the irreplaceability of the only child, which might moderate the effects of traditional culture of son preference on bereaved parental mental health.
Collapse
Affiliation(s)
- Enjian Wang
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, P.R. China
| | - Hongwei Hu
- School of Public Administration and Policy, Renmin University of China, Beijing, P.R. China
| | - Zhenzhen Shi
- School of Public Administration and Policy, Renmin University of China, Beijing, P.R. China
| | - Hongting Liu
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, P.R. China
| | - Chu Zhang
- School of Public Administration and Policy, Renmin University of China, Beijing, P.R. China
| | - Haixia Jiang
- Institute of Population Research, Peking University, Beijing, P.R. China
| | - Lu Xia
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, P.R. China
| | - Sisi Li
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, P.R. China
| | - Yongjia He
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, P.R. China
| |
Collapse
|