Acute Illnesses, Use of Health Services, and Changes in Medication Among Parents After Infant or Child Death

Brooten, Dorothy; Youngblut, JoAnne M.; Roche, Rosa M.; Caicedo, Carmen; Del-Moral, Teresa; Cantwell, G. Patricia; Totapally, Balagangadhar

doi:10.4037/ajcc2019572

Cited by 5 publications

(6 citation statements)

References 29 publications

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“…post-traumatic stress, insomnia, substance abuse, and physical morbidity (2)(3)(4)(5)(6). Complicated grief, a persistent and impairing form of grief, has been suggested to occur in as many as 60% of bereaved parents 6 months after their child's death in a PICU and persist in 40% at 18 months (7,8).…”

mentioning

confidence: 99%

Therapeutic Alliance Between Bereaved Parents and Physicians in the PICU

Suttle

Hall

Pollack

et al. 2020

Pediatric Critical Care Medicine

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Therapeutic alliance is the collaborative bond that develops between patients/families and healthcare providers. Our objective is to determine the extent of therapeutic alliance bereaved parents perceive to have occurred with their child's physicians during their child's PICU stay, and associated factors. DESIGN:Multicenter observational study. SETTING: Eight children's hospitals affiliated with the Collaborative Pediatric Critical Care Research Network.PATIENTS: Parents greater than or equal to 18 years old whose child died in a PICU (including cardiac ICU). INTERVENTIONS:Bereaved parents completed the Human Connection Scale, a 16-item measure of therapeutic alliance, 6 months after their child's death. Human Connection Scale scores range from 16 to 64 with higher scores indicating greater alliance. Parents provided sociodemographic data, and medical records were reviewed for the child's clinical characteristics. MEASUREMENTS AND MAIN RESULTS:Two-hundred and thirty-three parents of 157 deceased children responded to the Human Connection Scale with greater than or equal to 80% item completion. Among parents, 146 (62.7%) were female, 155 (66.5%) were White and 46 (19.7%) were Black, 175 (75.1%) were married, and 209 (89.7%) had at least a high-school education. Among children, median age at the time of death was 5.9 years (interquartile range, 0.64-13.9 yr) and 114 (72.6%) died after limitation or withdrawal of life support. Mean Human Connection Scale score was 51.4 ± 11.1 for all parents, 52.6 ± 9.0 for White parents, and 47.0 ± 13.7 for Black parents. In multivariable modeling predicting Human Connection Scale scores, race was the only parent or child characteristic in the final model. Human Connection Scale scores were significantly different (-4.56; 95% CI, -8.53 to -0.6; p = 0.025) between the Black and White parents with items about trust, care, and honest communication showing the greatest mean difference. CONCLUSIONS: Among parents bereaved in the PICU, therapeutic alliance with physicians is moderately high. Future research should identify strategies to strengthen therapeutic alliance with Black parents and examine the role of alliance on bereaved parents' health outcomes.

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confidence: 99%

Therapeutic Alliance Between Bereaved Parents and Physicians in the PICU

Suttle

Hall

Pollack

et al. 2020

Pediatric Critical Care Medicine

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“…Some negative health behaviors, such as smoking and drinking alcohol, may increase in a minority of parents, though possibly not permanently. Early assessment of parental health can lead to early intervention and health outcome improvement (Dias et al, 2018;Brooten et al, 2018). The development of a national registry of bereaved parents' health status would facilitate future longitudinal research in this area.…”

Section: Limitationsmentioning

confidence: 99%

“…Existing literature has examined various parental outcomes, including parental hospitalization rates following the death of a child (Brooten et al, 2018;Li et al, 2005), psychological disorders including depression and various anxiety disorders (Christiansen et al, 2013;Dyregrov & Matthiesen, 1987), and disease conditions including myocardial infarction as well as cancer incidences 2003). found an increased risk for myocardial infarction in parents who lost a child with significantly higher rates among mothers compared with fathers in the 1st year following the death (Li et al, 2005).…”

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confidence: 99%

“…Studies on health outcomes of bereaved American parents are limited, conflicting and have only examined short-term health outcomes (Dias et al, 2018). Parent reports of acute illnesses, hospitalizations, and medication changes were highest for the first 6 months following the death of a child (Brooten et al, 2018). Birenbaum et al (1996) compared the health status of bereaved parents with that of nonbereaved adults and found no difference in health status between the two groups.…”

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confidence: 99%

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Bereaved parents’ health outcomes following the death of their child.

Dias¹,

Friebert²,

Donelan³

et al. 2021

Clinical Practice in Pediatric Psychology

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The death of one's child may negatively affect parental health. Existing models exploring parental bereavement do not provide sufficient frameworks to understand the complexities of health outcomes. The purpose of this study was to examine the health status of bereaved parents. Method: Cross-sectional retrospective study of bereaved parents whose children died at this hospital between 2002 and 2019. A study-specific demographic questionnaire, the National Institutes of Health Roadmap Patient-Reported Outcomes Measurement Information System (PROMIS) initiative. Depressive symptoms were assessed using the PROMIS v1.0 Emotional Distress-Depression-Short Form 8a (Pilkonis et al., 2011). PROMIS measures (depressive symptoms, anxiety, applied cognitive functioning, physical functioning, sleep disturbance), and a measure of posttraumatic growth were mailed and included a link to self-enter data via Research Electronic Data Capture (REDCap, n.d.) or return paper copies. Results: One hundred fifty surveys were returned (22% response rate). Mean participant age was 41.6 years (SD = 10.3 years; 83% female). Participants' health history responses show greater prevalence of depressive symptoms, anxiety, and sleep disorders after their child's death. The largest difference on PROMIS measures was poorer physical function in the bereaved cohort than in the general population. There were no differences in PROMIS scores based on participant gender or on the presence of surviving siblings. Among those reporting smoking or alcohol consumption, qualitative data suggest that although some might increase use, such use might decrease over time. Conclusions: Bereaved parents manifest poorer psychological and cognitive functioning, and their physical functioning was substantially poorer than the general population mean. Bereaved parents may benefit from proactive guidance normalizing potential challenges to health status and behavior, including appropriate psychoeducational resources.

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“…Few studies have evaluated changes in bereaved parents' mental health symptoms over time. [9][10][11][12][13] Available data suggest that mental health symptoms decline during the first year after a child's death for many parents but not all. Our objective was to (1) describe the change in complicated grief, depression, and post-traumatic stress symptoms among bereaved parents between 6 and 13 months after their child's death in a PICU, and (2) identify factors associated with parents' mental health symptoms at 13 months.…”

Section: Introductionmentioning

confidence: 99%

Complicated Grief, Depression and Post-Traumatic Stress Symptoms Among Bereaved Parents following their Child’s Death in the Pediatric Intensive Care Unit: A Follow-Up Study

Suttle

Hall

Pollack

et al. 2021

Am J Hosp Palliat Care

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Background: Parents often suffer reduced mental health after their child’s death; however, the trajectory and risk factors are not well described. Objective: Describe the change in complicated grief, depression, and post-traumatic stress symptoms among parents between 6 and 13 months after their child’s death in a pediatric intensive care unit (PICU), and factors associated with 13-month symptoms. Methods: Parents whose children died in 1 of 8 PICUs affiliated with the Collaborative Pediatric Critical Care Research Network completed surveys 6 and 13 months after their child’s death. Surveys included the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire-8 (PHQ-8) for depression, and the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT). Parents provided sociodemographics. Charts were reviewed for child characteristics. Results: One-hundred and fifty seven parents of 104 deceased children completed surveys at both time points. Mental health symptoms declined over time (mean (SD)): ICG (33.8 (15.4) vs. 30.5 (15.2), p < 0.001), PHQ-8 (9.0 (6.4) vs. 7.3 (5.8), p < 0.001), and SPRINT (14.1 (8.3) vs. 12.0 (8.2), p < 0.001). After controlling for 6-month scores, higher 13-month ICG was independently associated with sudden unexpected death; higher PHQ-8 with Black race, insecure attachment style, and sudden unexpected death; and higher SPRINT with having a high school level of education (compared to college degree or higher). Conclusion: Mental health symptoms improve among parents during the first 13 months after their child’s death; however, symptoms persist for many. Black parents and those whose children die suddenly may be high risk for poor adjustment during bereavement.

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Acute Illnesses, Use of Health Services, and Changes in Medication Among Parents After Infant or Child Death

Cited by 5 publications

References 29 publications

Therapeutic Alliance Between Bereaved Parents and Physicians in the PICU

Therapeutic Alliance Between Bereaved Parents and Physicians in the PICU

Bereaved parents’ health outcomes following the death of their child.

Complicated Grief, Depression and Post-Traumatic Stress Symptoms Among Bereaved Parents following their Child’s Death in the Pediatric Intensive Care Unit: A Follow-Up Study

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