Grief and coping of parents whose child has a constant life-threatening disability,hypoplastic left heart syndrome with reference to the Dual-Process Model

This paper reports on a study that examined the grief and coping of 29 parents whose child has hypoplastic left heart syndrome using the Dual Process Model. The study employed a secondary thematic analysis of interviews at key times of treatment and recovery for the child. After the diagnosis, parents experienced intense loss (LO), but focused upon restoration-orientated tasks (RO) to support their child. Over time, most parents employed a healthy oscillation between LO coping and RO coping, with waves of grief and with some grieving suppressed. There are some specific grief and coping and gender patterns employed by parents.     

Interactive grief and coping in the marital dyad

Experiencing the death of one's child has been described as one of the most traumatic events that can occur in adult life. This qualitative study examined the grief resolution process of 27 marital couples after the fetal or infant death of their child. Interactive dynamics in the couples' relationship and ways in which they coped with the effects of the death on themselves individually and as a part of a dyadic system were of central importance. The central focus of this article is on the dyadic context, in which marital partners attempt to meet relational responsibilities as well as their own needs. The pressures of being in a system in which both partners are coping with strong and frequently unfamiliar thoughts and emotions are described. Those factors that lead to conflict and stress during this time are discussed as well as other factors that minimize conflict and reduce stress. Finally, implications of these findings for those working with bereaved parents are presented.     

Interactive grief and coping in the marital dyad

Abstract

Experiencing the death of one's child has been described as one of the most traumatic events that can occur in adult life. This qualitative study examined the grief resolution process of 27 marital couples after the fetal or infant death of their child. Interactive dynamics in the couples' relationship and ways in which they coped with the effects of the death on themselves individually and as a part of a dyadic system were of central importance. The central focus of this article is on the dyadic context, in which marital partners attempt to meet relational responsibilities as well as their own needs. The pressures of being in a system in which both partners are coping with strong and frequently unfamiliar thoughts and emotions are described. Those factors that lead to conflict and stress during this time are discussed as well as other factors that minimize conflict and reduce stress. Finally, implications of these findings for those working with bereaved parents are presented.     

The aging of grief in Israel: a perspective of bereaved parents

This article focuses on long - term grief of older bereaved parents within the context of the Israeli society. The themes that emerged in a group discussion with 29 elderly bereaved parents whose sons were killed during military service support previous findings that the passage of time has no diminishing effect on parents' grief or on relinquishing attachment to the deceased. Aging appears to increase internalized involvement with the long - lost child, fears of fading memories, and the need to eternalize the deceased. In reviewing the past, parents reevaluate their coping with the loss and their relationship with the surviving children. The strong attachment seems to continue in external and inner representations of the lost child. In Israel, this preoccupation is enhanced due to society's attitude to dead soldiers, creating thereby an interface between society and bereaved families. The authors conclude that grief is a central theme in aging parents, and the term "aging of grief" is suggested to describe the course that grief and its many aspects may take with the passage of time.     

Experiences of African American Parents Following Perinatal or Pediatric Death: A Literature Review

A child's death is one of life's most difficult experiences. Little is known about the unique factors that influence the grief experience for bereaved African American parents. Through an integrative review of 10 publications, the authors describe the grief responses, outcomes, and implications for African American parents who experience the death of a child. Four themes emerged: (a) emotional response to loss; (b) factors that added to the burden of loss; (c) coping strategies; and (d) health consequences of grief. Healthcare providers, administrators, and policymakers should be sensitive to the unique needs of African American parents following a child's death.     

Psychological and religious coping strategies of mothers bereaved by the sudden death of a child

The authors examined the associations of 3 types of psychological coping (task-based, emotion-based, avoidance), 2 types of religious coping (positive, negative), and their interactions with grief of 57 mothers bereaved by the sudden death of a child. Results indicated that mothers who use emotion-based coping report significantly higher levels of grief, whereas mothers who use avoidance coping report lower levels of grief. The interaction of task coping and positive religious coping was also associated with lower self-reported grief. The findings support the differential utility of various coping styles on mothers' grief reactions to the sudden death of a child.     

Psychological and Religious Coping Strategies of Mothers Bereaved by the Sudden Death of a Child

ABSTRACT

The authors examined the associations of 3 types of psychological coping (task-based, emotion-based, avoidance), 2 types of religious coping (positive, negative), and their interactions with grief of 57 mothers bereaved by the sudden death of a child. Results indicated that mothers who use emotion-based coping report significantly higher levels of grief, whereas mothers who use avoidance coping report lower levels of grief. The interaction of task coping and positive religious coping was also associated with lower self-reported grief. The findings support the differential utility of various coping styles on mothers’ grief reactions to the sudden death of a child.     

Chronic sorrow: a parental response

It is important to recognize that parents of disabled, premature, or chronically ill children may never fully resolve the grief associated with their child's special condition. Nurses need to identify the emotional responses of parents and assist them in coping with their special needs and concerns, thus helping to prevent major adjustment or psychological problems of both the child and parents.     

Effects of a program of intervention on parental distress following infant death

A longitudinal study of 144 parents (65 fathers, 79 mothers) was conducted to evaluate the effectiveness of a program of intervention in relieving the psychological distress of parents a ected by infant death. Participants were assessed in terms of their psychiatric disturbance, depression, anxiety, physical symptoms, dyadic adjustment, and coping strategies. The experimental group (n=84) was offered an intervention program comprising the use of specially designed resources and contact with a trained grief worker. A control group (n=60) was given routine community care. Parental reactions were assessed at four to six weeks postloss (prior to the implementation of the intervention program), at six months postloss, and at 15 months postloss. A series of multivariate analyses of variance revealed that the intervention was effective in reducing the distress of parents, particularly those assessed prior to the intervention as being at high-risk of developing mourning difficulties. Effects of the intervention were noted in terms of parents overall psychiatric disturbance, marital quality, and paternal coping strategies.     

Supporting families of technology-dependent patients hospitalized in a pediatric intensive care unit

Having a child hospitalized in the PICU is a stressful event and may be even worse for parents when their child is technology dependent. These parents are often experts at knowing their child, are used to being strong caregivers and advocates for their child, and may experience long-term sorrow or grief over their child's lifespan. Although there is little research about effective PICU nursing interventions for this parent group, several suggestions can be inferred. Armed with this knowledge, the PICU nurse can be instrumental in helping these parents decrease their stress and improve coping skills not only for dealing with the child's PICU stay but also for improving their experiences at home.     

EFFECTS OF A PROGRAM OF INTERVENTION ON PARENTAL DISTRESS FOLLOWING INFANT DEATH

A longitudinal study of 144 parents (65 fathers, 79 mothers) was conducted to evaluate the effectiveness of a program of intervention in relieving the psychological distress of parents a ected by infant death. Participants were assessed in terms of their psychiatric disturbance, depression, anxiety, physical symptoms, dyadic adjustment, and coping strategies. The experimental group (n=84) was offered an intervention program comprising the use of specially designed resources and contact with a trained grief worker. A control group (n=60) was given routine community care. Parental reactions were assessed at four to six weeks postloss (prior to the implementation of the intervention program), at six months postloss, and at 15 months postloss. A series of multivariate analyses of variance revealed that the intervention was effective in reducing the distress of parents, particularly those assessed prior to the intervention as being at high-risk of developing mourning difficulties. Effects of the intervention were noted in terms of parents overall psychiatric disturbance, marital quality, and paternal coping strategies.     

Paternal and maternal coping with the death of a child

Parents' coping strategies in dealing with a child's death and gender differences in coping were studied. Twenty-five married couples who lost their child were interviewed and given an instrument to ascertain their coping strategies. Five major coping strategies used by parents were: seeking the release of tension, avoiding painful thoughts and feelings, using a cognitive framework to understand and deal with the experience of loss, helping others, and relying on religious beliefs. Parents found it necessary not only to release their emotional tension, but also to prevent themselves from becoming preoccupied with their trauma by keeping busy and avoiding reminders. Parents also attempted to overcome their grief by gaining an understanding of their experience through reading and by focusing their thoughts on the positive. Helping others directed parents' attention away from their grief while contributing to a belief that something worthwhile had resulted from their child's death. Religious faith gave parents strength and helped them maintain hope. Other strategies included seeking support through groups, seeking relief from pain, investing themselves in a new object of love, seeking professional help, staying alone, and visiting the cemetery. Several statistically significant gender differences in coping were identified. Mothers were found to cry, read, and write on loss and grief, help others, and stay alone to a greater degree than fathers. Reading and writing were coping strategies used primarily by mothers.     

Death of adolescents: parental grief and coping strategies

The death of an adolescent is a particularly complex issue. The process of grieving and coping can be complicated by the tension that may have existed in the parent/child relationship because of the conflict in terms of personal ideology at this stage in the adolescent's development. As a result, parents of adolescent children who die have the potential to experience abnormal grief reactions. Parental coping strategies vary according to the mode of death and outlook adopted by the parents, although some studies suggest parents bereaved of adolescent children do not exhibit marked difference in grieving or coping in comparison to other groups of parents. Healthcare professionals must recognize the specific and special needs of this parent group, and provide appropriate support to minimize the risk of harmful sequelae that may occur as a result of inappropriate and insensitive care.     

Chronic sorrow and coping in families of children with epilepsy.

Epilepsy, a common problem in child neurology, affects the entire family. There is a potential for such psychosocial consequences as parental chronic sorrow and alterations in coping. In this study, 67 parents completed brief questionnaires about their sorrow and coping styles. Results demonstrated chronic sorrow as measured by the Adapted Burke Questionnaire (10.45 +/- 7.9). Interestingly, the total score was not significantly different between parents of children with refractory and nonrefractory epilepsy or parents of children with comorbid or without comorbid conditions. Selection of the individual item disbelief, however, was significantly increased in parents of children with nonrefractory epilepsy, and selection of the item anger was significantly increased in parents of children with comorbid conditions. Parental coping styles were similar to those reported in the normative data for the instrument used, the Coping Health Inventory for Parents (CHIP). The correlation between chronic sorrow and coping was significant between the grief component of sorrow and Coping Pattern II of the CHIP. Implications for practice include earlier identification of parental feelings of sorrow and coping styles, which may contribute to a positive outcome.     

Paternal and maternal coping with the death of a child

Abstract

Parents' coping strategies in dealing with a child's death and gender differences in coping were studied. Twenty-five married couples who lost their child were interviewed and given an instrument to ascertain their coping strategies. Five major coping strategies used by parents were: seeking the release of tension, avoiding painful thoughts and feelings, using a cognitive framework to understand and deal with the experience of loss, helping others, and relying on religious beliefs. Parents found it necessary not only to release their emotional tension, but also to prevent themselves from becoming preoccupied with their trauma by keeping busy and avoiding reminders. Parents also attempted to overcome their grief by gaining an understanding of their experience through reading and by focusing their thoughts on the positive. Helping others directed parents' attention away from their grief while contributing to a belief that something worthwhile had resulted from their child's death. Religious faith gave parents strength and helped them maintain hope. Other strategies included seeking support through groups, seeking relief from pain, investing themselves in a new object of love, seeking professional help, staying alone, and visiting the cemetery. Several statistically significant gender differences in coping were identified. Mothers were found to cry, read, and write on loss and grief, help others, and stay alone to a greater degree than fathers. Reading and writing were coping strategies used primarily by mothers.     

Chronic grief: experiences of working parents of children with chronic illness

Parents of children with chronic illness experience multiple stressors associated with their numerous roles. For parents who are working full time and caring for a child with chronic illness, the stressors related to managing work and caring responsibilities are magnified. Although the impact of caring for a child with chronic illness has been widely investigated, the literature reveals a paucity of research on the experiences of parents who are also in full time employment. This paper shares qualitative findings of a study involving interviews of twelve parents who were working full time while caring for a child with chronic illness. Data was collected through in-depth semi structured interviews and thematic analysis was then used to develop and categorise themes. Two intertwined themes are reported: (1) grief and (2) dealing with professionals. In this study, parents revealed the chronic grief they experienced in relation to their child's condition, which often recurred at various stages of the child's illness. The child's initial diagnosis was found to be the most stressful part of the grieving process, with most feeling their voices as parents were not being heard or valued by health professionals at this time. This affected parents' confidence in the health care system and triggered the re-emergence of grief, aggravating an already stressful situation. The findings illustrate that the grief experienced by these parents can be exacerbated by their dealings with health professionals. Implications for various health professionals are drawn from the findings in order to highlight avenues where guidance and support can be provided to these parents.     

Young Children's Grief: Parents' Understanding and Coping

The grief experiences of young children and the interactional dynamics between parents and children leading to healthy grieving remain comparatively underresearched. This article reports a qualitative evaluation of a Norwegian Bereavement Support Program where 8 parents described their young child's grief reactions and coping and how these intersected with their own grief. Successful parental coping with their child's grief involves understanding the child's genuine concerns following the death and an intricately holistic balance between shielding and including, between informing and frightening, and between creating a new life while cherishing the old.     

Loneliness and disturbed grief: a comparison of parents who lost a child to suicide or accidental death

Grief reactions of two types of sudden untimely deaths were compared: the loss of a child by accidental death and the loss of a child by suicidal death. Three hypotheses were tested. The degree of disturbed grief and the degree of loneliness in parents who lost a child to suicidal death were compared to those reactions in parents who lost a child to accidental death. The relationship between the degree of disturbed grief and the degree of loneliness was assessed. For suicide survivors, grief and loneliness tended to rise over time, whereas grief and loneliness decreased over time for accidental death survivors. The findings from this study indicate that the loss of a child from an accidental death places a parent at high risk for disturbed grief and loneliness, and at even higher risk when the loss is a result of suicidal death.