The experience of parental death concomitant with parental divorce occurs for 46% of Danish children and 50% of American children who lose a parent to death. This experience of loss and double bereavement compounds increased risk of mental health problems. The aim of this study was to explore nursing interventions for double bereaved children that promoted their well-being. A phenomenological–hermeneutic approach was used to conduct 20 interviews with nurses in family cancer care. Ricoeur’s theoretical framework was followed with naïve reading, structural analysis, and critical interpretation, resulting in the formulation of a new model of nursing care for these children: the Divorced Family–Focused Care Model. Four themes were apparent: (a) collection of information about family structure, (b) assessment of support needs, (c) initiation of well-being support, and (d) coordination and follow-up focused on the child’s well-being. The new intervention model has implications for health care education and implementation of health care policies.

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Aims and objectives To explore how children and young adults from divorced families experience double bereavement when they lose a divorced parent with cancer and how the double bereavement influences their mental health consequences and need of support. Background Children and young people who are confronted with the cancer and death of a parent is a highly stressful life event, which is associated with an increased risk of mental health problems, especially when children experience divorced parental cancer and death. Design Participant observations and interviews with a phenomenological‐hermeneutic approach and COREQ standards for reporting qualitative research. Methods We conducted 340 hr of participant observations within nine different support groups totalling 27 children and young adults from divorced families and included 28 interviews with participants and relatives. Analyses are based on Ricoeur's theory of interpretation: naïve reading, structural analysis, interpretation and discussion. Results The experiences with double bereavement identified three main themes: 1. navigating through multiple transitions and disruptions within two family worlds; 2. consequences for mental health including stress overload and disruptions to well‐being; and 3. need for accessible support derived from close relationships and professionals within and in‐between family worlds. Conclusion Children and young adult's double bereavement includes multiple transitions and disruptions often related to stress overload and mental health problems. Support from close relationships and professionals is experienced as helpful in the prevention and mitigation of mental health problems. Relevance to clinical practice There is a need for targeted accessible support availability to children, young adults and their families when a divorced parent is dying of cancer in clinical practice. Our findings suggest that specific health policies for health professionals should be developed to target improved support for these families.

The aim of this review was to identify research on children and adolescents who experience double bereavement, i.e. the experience of loss through parental divorce followed by either parental death or critical illness with imminent death. This knowledge may identify evidence to underpin knowledge and practice for nurses and other health professionals, so they can intervene with these children and adolescents more efficaciously. An integrative systematic review was conducted using PubMed, CINAHL and PsycINFO. The results show four major themes: Complexity in their experiences of double bereavement; challenges in both custodial and non-custodial parental death; risk of mental health problems, and the need of support and interventions.

Aims and objective To investigate how participating in the early recognition method treatment strategy affect illness insight and management, in patients with schizophrenia or bipolar disorder in community mental healthcare. Background The current practice in mental healthcare focus on shared decision‐making and self‐managing capacity, but poor insight is a predictor of poor adherence and dropout. Engagement in illness management and recovery predict the treatment response. Design Semi‐structured interviews with a phenomenological‐hermeneutic approach. Methods We conducted 36 semi‐structured interviews with 26 patients. The interviews were conducted before and after participating in the intervention using the early recognition method strategy. The analysis was based on Ricoeur's theory of interpretation: Naive reading, structural analysis, interpretation and discussion. The COREQ checklist was used as reporting guideline. Results The experience of participating in treatment as usual and early recognition method revealed two main themes. The first theme ‘patient care’ describes how dialogue and collaboration increase awareness of the illness and how to gain control. The second theme ‘insight and experience’ describes how illness affects personality and self‐image, and how insight entails control and self‐confidence. Conclusion Managing life with severe mental illness is complex and challenging. However, the experience of guidance, support and collaboration between patient and nurse are essential to improve these circumstances. Relevance to clinical practice A systematic approach to the patient' symptoms, as in the early recognition method strategy, enhances knowledge of the individual patient' symptoms, both for nurse and patient. A knowledge that is significant for meeting individual treatment needs. Therefore, applying this strategy is likely to enhance collaboration and improve treatment outcome.

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