Trauma-Informed Care and Posttraumatic Growth Among Bereaved Youth: A Pilot Study

Intergenerational coping: Examining how caregiver and child coping relate to resilience in bereaved children

The death of a loved one can have harmful effects on children's mental health, yet some bereaved children exhibit resilience. Various caregiver and child coping strategies, including active and avoidant coping, may affect the psychosocial functioning of bereaved children. The current study recruited 78 bereaved children aged 8-17 and one of their caregivers to explore: 1) how caregivers' coping strategies affect their child's coping strategies and resilience, and 2) associations between children's coping and their resilience. Results from the active coping mediation model revealed that children's active coping was significantly associated with their resilience, and caregivers' active coping was indirectly associated with children's resilience through children's active coping. The avoidant coping model was not significant. These preliminary findings highlight the importance of promoting active coping strategies among bereaved children and caregivers.

The Healing through Arts (HeARTS) program for children bereaved by cancer: Pilot study findings from Singapore

OBJECTIVES

The article aims to investigate the feasibility, acceptability, and initial efficacy of a short-term 3-day art therapy group for children who have experienced parental death to cancer.

METHODS

The study utilized a pretest-posttest design and included children (n = 20) aged 7-12 years. The feasibility of the intervention was measured by recruitment ability, study compliance, and intervention adherence, while acceptability was assessed using a child-reported satisfaction survey. Efficacy was examined using the child-reported Pediatric Quality of Life Inventory (PedsQL), while the emotional, social, and behavioral functioning of children was measured using the parent-reported Strengths and Difficulties Questionnaire. Paired sample t-tests were used for analyses.

RESULTS

The intervention was found to be feasible (80% recruitment rate and 100% session adherence). Acceptability was high, and all participants were satisfied and found the intervention to be helpful. While results did not reach statistical significance, improvements in psychosocial and physical quality of life were reported by all the children post-intervention and at the 3-month follow-up. Parent-reported a decrease in behavioral difficulties scores and an increase in prosocial behavior scores at post-intervention and at the 3-month follow-up.

SIGNIFICANCE OF RESULTS

The 3-day art therapy group intervention was shown to be feasible to conduct and acceptable to the recipients. The intervention shows promise in improving post-death adjustment and quality of life outcomes of children bereaved by parental death due to cancer that were maintained after 3 months. The use of art therapy groups to ameliorate difficulties associated with parental loss and to assist children in coping day-to-day difficulties should be further investigated.

Evaluation of a New Online Program for Children Bereaved by Suicide: The Views of Children, Parents, and Facilitators

OBJECTIVE

Experiencing the suicide of a parent or a sibling is one of the most disruptive and stressful events in the life of a child or adolescent. Yet, little is known about the effectiveness of support offered to children and adolescents bereaved by suicide. This study aimed to evaluate participant and facilitator's perceived helpfulness of the new online Let's Talk Suicide program, piloted in 2021.

METHOD

Thematic Analysis of qualitative interviews with 4 children, 7 parents, and 3 facilitators (N = 14).

RESULTS

The analysis identified four themes focused on suicide bereavement specific support, the online environment experiences, expectations and perceived outcomes of the program, and parents' involvement in the program.

CONCLUSIONS

The young participants, parents, and facilitators were very positive about the program. They felt that it supported the children in their grief after suicide, helped to normalize their experiences, offered social support from peers and professionals, and enhanced their language and skills to express themselves and to deal with their emotions. Though longitudinal research is needed, the new program seems to address an existing gap in postvention services for children and adolescents bereaved by suicide. HIGHLIGHTSThe children felt supported in their grief as it enhanced their skills and language to express themselves.The program also acknowledged the parents and supported them in their parenting role.Future longitudinal studies may enhance the evidence of effectiveness of the program.

Posttraumatic Growth After Struggling With the Loss of a Parent in Young Adulthood

This study aims to examine posttraumatic growth and its associations with parental bereavement among adolescents and young adults. Fifty-five young adults who had lost a parent to cancer at least 2 months earlier and were about to attend a support group at a palliative care service were recruited. Data was collected through questionnaires before support group participation, about 5-8 months after the loss and at a 6-month follow-up, about 14-18 months after the loss. The result shows that the young adults experienced posttraumatic growth, mostly in the domains Personal strength and Appreciation of life. Posttraumatic growth was associated with bereavement outcomes, especially life satisfaction, a feeling of meaning in future life and psychological health. The result is of value for health care professionals as it adds information about the importance of supporting constructive rumination to enhance the possibility to positive psychological change after a parent's death.

Posttraumatic Growth Inventory-Expanded: Factor Structure, Test-Retest Reliability, and Validity in Trauma-Exposed and Bereaved Adults

Posttraumatic growth (PTG) is a positive psychological change experienced after trauma and it has gained global recognition in recent years. The present study aimed to validate a South Korean version of the Posttraumatic Growth Inventory-Expanded (K-PTGI-X) for use with trauma-exposed and bereaved samples. A national sample comprising South Korean adults was used for the analysis. As a result, the 4-factor bi-factor model was best supported in both the trauma and bereaved groups in terms of personal strength, new possibilities, spiritual-existential change, and being able to relate to others. Additionally, the K-PTGI-X showed satisfying reliability, concurrent validity, and discriminant validity. Lastly, regarding the group differences, women showed higher rates of PTG than men and the bereaved group exhibited higher spiritual and existential growth in the PTG than the trauma group. Given these results, implications for adaptation in various fields when assessing and encouraging PTG in practical settings are discussed.

The effect of nursing care based on human caring theory on posttraumatic growth in parentally bereaved adolescents: Action research

PROBLEM

The death of a parent is a traumatic experience for adolescents. Studies to ensure post-traumatic growth in adolescents are limited. The aim of this study to evaluate the effect of nursing care based on Watson's Theory of Human Caring on posttraumatic growth in parentally bereaved adolescents.

METHODS

This study was participatory action research. The study was carried out with four participants through online interviews. In the study, pre- and post-action data were obtained through individual interviews and scales. During the action process, nursing care based on the Theory of Human Caring was provided to the participants individually tracked through the Omaha System. Pre and post-action qualitative data were analyzed using the descriptive analysis method. In quantitative data, scale total and sub-scores were documented.

FINDINGS

During the action, it was determined via Omaha System coding that the participants mostly experienced grief and mental health problems. In the pre-action, the participants stated that they experienced various difficulties regarding grief. In the post-action, the participants stated that the meaning of parental loss,its effects on life, and their ability to cope with loss changed and they experienced positive changes. In addition, when the scale scores of the participants' pre- and post-action were compared, it was found that the Mourning Scale scores decreased, and the Post-traumatic Growth Inventory scores increased.

CONCLUSIONS

The result of this study demonstrate that nursing care based on Theory of Human Caring reduces the grief symptoms and contributes to post-traumatic growth in parentally bereaved adolescents.

Growing in Suffering: The Curvilinear Relationship Between Prolonged Grief and Post-traumatic Growth of Recently Bereaved Individual During the COVID-19 Pandemic

The outbreak of the COVID-19 pandemic brought new challenges to mourning and growth of bereaved. The purpose is to explore the relationship between the prolonged grief (PG) symptoms and the post-traumatic growth (PTG) of recently bereaved people during the COVID-19 period, and the mediating role of meaning making. 305 participants were recruited to complete the Posttraumatic Growth Inventory, Inventory of Complicated Grief, and Integration of Stressful Life Experiences Scale. Hierarchical multiple regression analyses and Medcurve in SPSS were adapted to test the hypotheses. The results revealed that there was a curvilinear relationship between PG and PTG and meaning making had a completely mediating effect on this relationship. Different intervention goals - whether alleviating distress or cultivating growth - should be set up according to the level of grief for recently bereaved individuals during COVID-19. More attention should be paid to the role of meaning making in the future clinical practice.

Posttraumatic Growth Experiences of Adolescents With Parental Loss: A Phenomenological Study

This study examines the post-traumatic growth of adolescents who have lost their parents about their experiences. Eight adolescents whose parents had died participated in the study conducted in the phenomenological design. The data were collected with three-step semi-structured interviews and analyzed using the phenomenological analysis technique performed in five stages. The findings were grouped into three main themes as "reactions to loss," "readjustment," and "post-traumatic growth," and nine subthemes under each, and these sub-themes were categorized into forty-five codes.

How Do We Move Forward With Trauma-Informed Care?

Trauma is not limited to adverse childhood events or abuse, but also a host of situations of loss, chronic stressors, and now the COVID-19 pandemic. Interprofessional teams must be able to recognize and treat trauma on the frontlines and behind the scenes. Understanding, assessing, and educating staff and patients on trauma, its physical and mental effects, and using trauma-informed approaches in practices throughout the health care system is vital for nursing and the multidisciplinary team. We provide an overview of trauma and its effects and how to help patients at all levels of recovery moving forward.

Bereavement care interventions for children under the age of 18 following the death of a sibling: a systematic review

BACKGROUND

Childhood bereavement after sibling death is common, but often unrecognized. The psychosomatic and socioeconomic outcomes of bereaved children can be compromised if appropriate care is unavailable during the formative years leading into adulthood.

AIM

This review aims to describe the methods, structures and procedures of bereavement care for children and adolescents after the loss of a sibling, and the impact on the families benefiting from these interventions.

DESIGN

A systematic review without restriction on study design was conducted.

DATA SOURCES

Four databases (MEDLINE, PsycINFO, EMBASE, Cochrane Library) were searched for articles published from 2000 to 2019. The search was conducted according to PRISMA guidelines and the protocol is registered on PROSPERO under number CRD42019124675. Articles were assessed against eligibility criteria by both authors, and quality was appraised using CASP checklists and NHMRC grading guidelines.

RESULTS

Twenty-three studies met inclusion criteria. Bereavement care was most often accessed by children ages 6-18 who lost a sibling to cancer 6-12 months prior. The interventions were typically group sessions or weekend camps, run predominantly by unpaid staff from a variety of backgrounds. Some staff members received priori specific training. Grief education is taught through mediated discussion and bereavement-centered activities balanced with playful and relaxed activities. Several services have effectuated evaluations of their interventions, and preliminary results show a positive effect for families.

CONCLUSION

Existing literature most likely gives an incomplete picture of appropriate childhood bereavement care, and many interventions possibly remain unpublished or published in other non-scientific sources. An effective response to childhood grief would involve collaboration between medical resources and community services, reinforced through the development of outreach and training programs.

Does Post-Traumatic Growth Follow Parental Death in Adulthood? An Empirical Investigation

This study looked at the loss of a parent in adulthood and whether this was followed by post-traumatic growth? Participants, 100 bereaved adults, from Pakistan and England, lost parents in the last 10 years. They completed three questionnaires. The study hypotheses were, first, that participants whose bereavement occurred more than five years ago would show significantly higher levels of post-traumatic growth. Second, participants with higher levels of post-traumatic growth would experience significantly higher grief scores. Thirdly, participants with higher levels of post-traumatic growth would show significantly higher levels of coping skills. Two hypotheses were rejected, only one received partial support. Yet, levels of post-traumatic growth were high in this sample. Post-traumatic growth does not follow every bereavement. The authors provide autoethnographic material to challenge this. Circumstances surrounding bereavement during the Covid-19 pandemic, are more likely to lead to increases in complicated grief reactions, rather than post-traumatic growth.