Complicated grief and associated risk factors among parents following a child's death in the pediatric intensive care unit.

Children's Hospital of Michigan, 3901 Beaubien Blvd., Detroit, MI 48201, USA.
JAMA Pediatrics (Impact Factor: 5.73). 11/2010; 164(11):1045-51. DOI: 10.1001/archpediatrics.2010.187
Source: PubMed


To investigate the extent of complicated grief symptoms and associated risk factors among parents whose child died in a pediatric intensive care unit.
Cross-sectional survey conducted by mail and telephone.
Seven children's hospitals affiliated with the Collaborative Pediatric Critical Care Research Network from January 1, 2006, to June 30, 2008.
Two hundred sixty-one parents from 872 families whose child died in a pediatric intensive care unit 6 months earlier.
Assessment of potential risk factors, including demographic and clinical variables, and parent psychosocial characteristics, such as attachment style, caregiving style, grief avoidance, and social support.
Parent report of complicated grief symptoms using the Inventory of Complicated Grief. Total scale range is from 0 to 76; scores of 30 or higher suggest complicated grief.
Mean (SD) Inventory of Complicated Grief scores among parents were 33.7 (14.1). Fifty-nine percent of parents (95% confidence interval, 53%-65%) had scores of 30 or higher. Variables independently associated with higher symptom scores in multivariable analysis included being the biological mother or female guardian, trauma as the cause of death, greater attachment-related anxiety and attachment-related avoidance, and greater grief avoidance.
Parents who responded to our survey experienced a high level of complicated grief symptoms 6 months after their child's death in the pediatric intensive care unit. However, our estimate of the extent of complicated grief symptoms may be biased because of a high number of nonresponders. Better understanding of complicated grief and its risk factors among parents will allow those most vulnerable to receive professional bereavement support.

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    • "Bereaved parents often experience serious mental and physical health effects, including depression and anxiety (Kreicbergs, Valdimarsdottir, Onelov, Henter, & Steineck, 2004; McCarthy et al., 2010), complicated grief (Meert et al., 2010) and even death (Li, Precht, Mortensen, & Olsen, 2003). Over 80% of deaths among hospitalized children occur following admission to an intensive care unit (Angus et al., 2004). "
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    ABSTRACT: Parent-physician bereavement meetings may benefit parents by facilitating sense making, which is associated with healthy adjustment after a traumatic event. Prior research suggests a reciprocal relationship between sense making and positive emotions. We analyzed parents’ use of emotion words during bereavement meetings to better understand parents’ emotional reactions during the meeting and how their emotional reactions related to their appraisals of the meeting. Parents’ use of positive emotion words increased, suggesting the meetings help parents make sense of the death. Parents’ use of positive emotion words was negatively related to their own and/or their spouse’s appraisals of the meeting, suggesting that parents who have a positive emotional experience during the meeting may also have a short-term negative reaction. Language analysis can be an effective tool to understand individuals’ ongoing emotions and meaning making processes during interventions to reduce adverse consequences of a traumatic event, such as a child’s death.
    Journal of Language and Social Psychology 09/2014; 34(2). DOI:10.1177/0261927X14555549 · 1.04 Impact Factor
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    ABSTRACT: To describe a framework to assist pediatric intensive care unit physicians in conducting follow-up meetings with parents after their child's death. Many childhood deaths occur in pediatric intensive care units. Parents of children who die in pediatric intensive care units often desire a follow-up meeting with the physician(s) who cared for their child. Prior research conducted by the Collaborative Pediatric Critical Care Research Network on the experiences and perspectives of bereaved parents and pediatric intensive care unit physicians regarding the desirability, content, and conditions of follow-up meetings. The framework includes suggestions for inviting families to follow-up meetings (i.e., developing an institutional system, invitation timing, and format); preparing for the meeting (i.e., assessing family preferences; determining location, attendees, and discussion topics; reviewing medical and psychosocial history); structure of the meeting (i.e., opening, closing, and developing a meeting agenda); communicating effectively during the meeting; and follow-up for both parents and physicians. This framework is based on the experience and perspectives of bereaved parents and pediatric intensive care unit physicians. Future research should be conducted to determine the extent to which physician-parent follow-up meetings provide a benefit to parents, families, physicians, and other healthcare providers participating in these encounters.
    Pediatric Critical Care Medicine 01/2010; 12(2). DOI:10.1097/PCC.0b013e3181e8b40c · 2.34 Impact Factor
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