Comparison of mothers and grandmothers physical and mental health and functioning within 6 months after child NICU/PICU death

Abstract

BackgroundLosing a child is devastating for parents and grandparents. Family and friends generally focus on comforting and supporting the bereaved parents, unintentionally ignoring the bereaved grandparents. Grandmothers and grandfathers often struggle with wanting to help their adult children (deceased child’s parents) without usurping the parents’ responsibilities and decisions regarding the deceased child. Research on mothers’ and grandmothers’ health at about the same time after the same child’s death in the neonatal or pediatric intensive care unit is lacking. The aim of this study was to compare mothers and grandmothers on physical health, mental health, and functioning in the first 1–6 months after the same child’s death in a neonatal or pediatric intensive care unit.MethodsThis cross-sectional secondary analysis compared 32 mothers with 32 grandmothers of the same 32 deceased children (newborn-6 years). Grandmothers were recruited through these 32 mothers. Most grandmothers and mothers were Hispanic (25%, 34%) or Black (44%, 41%), respectively. Mothers and grandmothers separately completed questions about their Physical Health, Mental Health [depression (Beck Depression Inventory), Post-Traumatic Stress Disorder (PTSD, Impact of Events-R), grief (Hogan Grief Reaction Checklist)], and Functioning (social support [MSPSS] and Employment) since the child’s/grandchild’s death. Paired t-tests and Chi Square tests were used to compare grandmothers with mothers of the same deceased infant/child on their private and separate responses to study measures.ResultsMothers had significantly more acute illnesses than grandmothers. More mothers (63%) than grandmothers (37%) were categorized as clinically depressed. More mothers (69%) than grandmothers (44%) had clinical PTSD. Mothers reported significantly higher levels of despair and detachment than grandmothers. Only 4 mothers and 2 grandmothers were in therapy at the time of interview. Grandmothers and mothers rated their ability to concentrate on their work and their level of social support similarly.ConclusionsMothers had more acute illnesses, more severe depression, and a higher level of grief than grandmothers. However, few received therapy despite their high levels of depressive and PTSD symptoms.

The Association between Therapeutic Alliance and Parental Health Outcomes following a Child's Death in the Pediatric Intensive Care Unit

“…38 Depression is commonly reported among parents experiencing child loss. [9][10][11][12] In our study, mothers had greater symptoms of depression than fathers consistent with prior research on parental bereavement 9,10 and higher prevalence of major depressive episodes in women compared with men in the general U.S. population. 38 Greater symptoms of depression were also seen in parents of children that died at an older age.…”

“…[16][17][18][19] Similar to prior work, bereaved parents in our study experienced substantial adverse mental health symptoms including symptoms of complicated grief, depression, and post-traumatic stress. 6,7,[9][10][11][12] Parents with stronger therapeutic alliances with PICU physi-cians demonstrated less symptoms of complicated grief during bereavement; however, therapeutic alliance was not significantly associated with lesser symptoms of depression, post-traumatic stress, or better overall health.…”

“…8 Many parents experience symptoms of major depression or post-traumatic stress disorder (PTSD) after their child's death. [9][10][11][12] Although some overlap in symptoms exists, depression and PTSD differ from complicated grief in several ways. Predominant symptoms of depression include a reduced ability to feel pleasure and persistent feelings of worthlessness whereas predominant symptoms of complicated grief are yearning and sadness over the loss while selfesteem is often maintained.…”

Impact of Perinatal Death on the Social and Family Context of the Parents

“…Perinatal death and grief not only affect the nuclear family but also the extended family and the parents' social environment [70]. Grandparents' expectations and hopes for the arrival of a new grandchild are jeopardized, which could have consequences that need to be addressed and understood [71,72]. Grandparents and close family members play a crucial role in social support and communication with parents [73].…”

Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design

“…Parents face psychological distress in perinatal and neonatal death with an increased risk of post-traumatic stress disorder, depression, and anxiety. Reports have identified the relationship between perinatal death and the devastating impact on parents, including stress and mental health issues lasting for at least 6 months after the death of their infant (44,45). During our parent consultation round to discuss our study protocol, parents indicated that they did not want a 6 months follow-up survey.…”