The effects of a support group on selected psychosocial outcomes of bereaved parents whose child died from cancer

The Development of a Bereavement Support Group Curriculum for Bereaved Parents of Young Adult Children: Bridging the Gap

Purpose: There is limited research addressing the bereavement needs of parents whose young adult (YA) children have died from cancer. Research within oncology about the impact of child loss has tended to focus on parents of pediatric aged children. We adapted a general bereavement support group curriculum used with adults to address the unique needs of bereaved parents of YAs. Methods: Using a quality improvement framework, 25 bereaved parents of YA children participated in one of three 6-session bereavement support group programs during 2020 and 2021. Due to the coronavirus disease 2019 (COVID-19) pandemic, the programs were offered virtually. The participants provided feedback and completed an evaluation. Results: Nineteen mothers and six fathers participated with 20 (80%) completing the evaluation. The median time since the death of their child was 6 months. The participants evaluated the program highly, reporting that they felt less isolated (4.25/5 on a 5-point Likert scale); that their concerns were similar to others (4.45/5); and the discussion topics were relevant (4.20/5). Other topics that were identified included the impact on the family of losing a YA child, and how other relationships change. Forty-five percent of participants expressed a preference for a hybrid delivery model, incorporating in-person and virtual sessions. The majority also wished to continue meeting monthly, given they had little contact with other bereaved parents of YAs. Conclusion: The general bereavement support group curriculum was readily adapted for use with bereaved parents of YA children who died from cancer. A hybrid delivery model was the preferred method for future groups.

Bereaved Families: A Qualitative Study of Therapeutic Intervention

Background

A child's death is the most stressful event and the most complex grief that families face. The process of psychological adaptation to the illness and death of a child is difficult due to a variety of emotional reactions. Parental grief had received the attention of researchers only in recent years when it became clear that this reality differs substantially from the general grief process.

Objective

This work aims to highlight the needs of bereaved parents; increase the specificity and effectiveness of the therapeutic approach to prevent complications in the process of loss-making; and find the recurrent thematic nuclei in the development of bereavement present in a therapeutic group of parents who have lost their child to an onco-hematological disease.

Method

Between 2011 and 2016, five therapeutic groups for the grief elaboration were made. The sample included a total of 50 parents of children who died from cancer between the ages of 0 and 21 years.Content analysis was carried out as a qualitative analysis method. The SAS^® Text Miner software (SAS Institute Inc, 2004) was used to read, interpret, classify and integrate the data from numerous sources.

Results

The development and consecutive interpretation of the 5 clusters have been carried out to analyze the related topics using the node "Topic Analysis" and requesting the subdivision into five topics. Four topics have been well defined. Clear topics are reducible to categories of emotional relief, tools, legacy, and unfinished business. The topic analysis provides interesting indications about the different interpretive journeys of the bereavement situation and offers ideas regarding the different types of social responses.

Conclusions

After reviewing the existing bibliography, we have confirmed the lack of specific literature on the problem of grief in parents whose children have died from cancer. Much research has shown that parents who lose a child to cancer want support, and there are still few studies on the most effective interventions for this group.

A Systematic Literature Review of the Current State of Knowledge Related to Interventions for Bereaved Parents

Aims:

The purpose of this systematic literature review is to describe the interventions for bereaved parents, evaluate intervention effectiveness through study methodology rigor, replicability, and theoretical foundations.

Methods:

We searched MEDLINE via PubMed (1966-2018), CINAHL (1937-present), PsycINFO (1887-present), and Embase (1947-present) using various search words and MeSH terms related to the study purpose. A blinded screening of title/abstract was performed, with conflicting inclusion decisions resolved through group discussions. Matrices for remaining articles were created and discussed among the team. The levels of evidence of the 9 records were rated from very low to high based on the Grading of Recommendations Assessment, Development, and Evaluation guidelines.

Results:

Our initial pool included 1025 articles. After the screening of titles/abstracts, 63 articles were retained for full-text reviews. Evaluated based on the inclusion/exclusion criteria, 9 records met the review criteria. Of the 9 records, 1 was graded as very low, 3 low, and 5 low to moderate. The interventions for bereaved parents varied from using single-model interventions such as expressive arts therapy and telephone support to multimodal interventions that combined resources (ie, peer support, resource packets, and health-care support). Only 1 study explicitly illustrated how its bereavement intervention was designed based on the proposed theoretical model.

Conclusions:

This review highlights the need for individualized, well-tested, and effective bereavement care interventions to support bereaved parents. In summary, the state of the science on interventions for bereaved parents is poor and much work needs to be done to effectively address the needs of bereaved parents, including both their physical and emotional health needs.

Assistance to Parents who have Lost their Child with Cancer

Aims and background

To assess the psychological needs of parents after the death of their child from cancer.

Methods

The study comprises a preliminary retrospective phase to identify parents who spontaneously contacted the medical staff, followed by a prospective phase in which families were contacted by telephone and were invited to a meeting.

Results

The retrospective study demonstrated that more than 50% of the families spontaneously sought contact with the department. In the prospective study, 17 families were contacted and the majority of them subsequently decided to come to the department for a talk.

Conclusions

Our experience shows that parents have a strong need to have further contact with the team that took care of their children for months. In the process of coping with bereavement, anxiety and depression are common and not necessarily pathological, though there may be psychopathological reactions that can interfere with the parents’ quality of life.

"Our Only Child Has Died"-A Study of Bereaved Older Chinese Parents

Long and complicated grief is a relevant factor contributing to the deterioration of the older adults' later life quality. In China, the unintentional consequence of the one-child policy has emerged. There, the group of older adults who lost their only child is called shiduers. The current study compared 42 older adults who lost their only child to 33 older adults who have a child, in term of their physical and mental health, and social support. The results confirmed the general deteriorating trend in those aspects of the bereaved Chinese parents' life after their only child's death. The results also revealed the impairments on the shiduers' physical, mental, and social aspects were significant, compared to the clinical diagnosis cutoff points used in Western countries. Unique policy and cultural characteristics are the main factors contributing to the severe impairment of shiduers. Results have implications for policy advocacy and practice intervention in specific cultural environments.

When Grief Turns Into Love

A child’s death caused by cancer generates a deep impact on his/her parents, who can be affected by serious health problems due to an impairment of their lifestyle. Notwithstanding their suffering, some parents manage to overcome it and discover a new meaning for their lives. The goal of this phenomenological study is to understand the lived experiences that help parents to revive after the death of their child due to cancer. The participants were fathers and mothers who believe that they have elaborated their mourning. Their lived experiences were collected in interviews they had previously agreed to give. The question that steered the interview was: “What is the experience you went through that helped you to revive after your child died due to cancer?” Data were analyzed using Streubert’s method. Analyzing the interviews of the participants, 3 interweaved essences were detected: transition from surviving to reviving themselves; ascribing a sense and meaning to the life, agony, and death of a child; and helping other parents through one’s own experience.

Participant evaluation of teleconference support for African American women with breast cancer

BACKGROUND

African American women with breast cancer face obstacles such as transportation and family obligations when attending standard support groups. Teleconference support circumvents barriers such as transportation to participation, but few evaluations have been reported about teleconference support.

OBJECTIVE

The purpose of this article was to describe the format of a teleconference group and to provide a descriptive account of the participants' feedback about a teleconference group intervention.

METHODS

A descriptive design was used. Participants completed the Overall Support Group Evaluation tool at the end of the 10th group session.

RESULTS

Teleconference group participants' feedback indicated that they perceived they had gained knowledge about breast cancer and coping. The participants expressed that the group helped them to reach out and ask for support and improved family and work relationships. Also, participants rated the group highly for the presence of therapeutic factors. On a scale of 1 to 4, with 4 being the highest, mean scores ranged from 3.97 to 3.56.

CONCLUSIONS

The participants gave high ratings of satisfaction in terms of knowledge gained, leadership style, and benefits. The participants perceived that the group increased their knowledge about cancer, improved family connections, and increased their ability to deal with their cancer.

IMPLICATIONS FOR PRACTICE

Using teleconferencing technology to deliver a support group to African American breast cancer patients is a beneficial method to reach a disadvantaged population that may be unable to attend face-to-face groups.

Grandparent's health and functioning after a grandchild's death

Approximately 160,000 grandparents experience the death of a grandchild each year; this represents a permanent, irrevocable loss for the grandparent, resulting in physical and emotional responses. Grandparents who lose a grandchild experience increased alcohol and drug use, thoughts of suicide, and pain for their adult child who is also grieving. Supportive resources available to grieving grandparents, the effects of the grandchild's death on the grandparent-parent relationship, and the influence of race and ethnicity on grandparent grieving are discussed. Despite approximately 40,000 child and infant deaths each year, knowledge about grandparent health and functioning after the death of a grandchild is limited.

Bereavement care interventions: a systematic review

BACKGROUND: Despite abundant bereavement care options, consensus is lacking regarding optimal care for bereaved persons. METHODS: We conducted a systematic review, searching MEDLINE, PsychINFO, CINAHL, EBMR, and other databases using the terms (bereaved or bereavement) and (grief) combined with (intervention or support or counselling or therapy) and (controlled or trial or design). We also searched citations in published reports for additional pertinent studies. Eligible studies had to evaluate whether the treatment of bereaved individuals reduced bereavement-related symptoms. Data from the studies was abstracted independently by two reviewers. RESULTS: 74 eligible studies evaluated diverse treatments designed to ameliorate a variety of outcomes associated with bereavement. Among studies utilizing a structured therapeutic relationship, eight featured pharmacotherapy (4 included an untreated control group), 39 featured support groups or counselling (23 included a control group), and 25 studies featured cognitive-behavioural, psychodynamic, psychoanalytical, or interpersonal therapies (17 included a control group). Seven studies employed systems-oriented interventions (all had control groups). Other than efficacy for pharmacological treatment of bereavement-related depression, we could identify no consistent pattern of treatment benefit among the other forms of interventions. CONCLUSIONS: Due to a paucity of reports on controlled clinical trails, no rigorous evidence-based recommendation regarding the treatment of bereaved persons is currently possible except for the pharmacologic treatment of depression. We postulate the following five factors as impeding scientific progress regarding bereavement care interventions: 1) excessive theoretical heterogeneity, 2) stultifying between-study variation, 3) inadequate reporting of intervention procedures, 4) few published replication studies, and 5) methodological flaws of study design.