Early Bereavement Psychosocial Outcomes in Parents of Children Who Died of Cancer With a Focus on Social Functioning

Abstract

PURPOSE: The early grief experience of parents of children who died of cancer remains understudied. Understanding psychosocial symptomology and functioning of parents early in their bereavement is essential to developing supportive interventions aimed at offsetting poor mental and physical outcomes. METHODS: Parents of children from two centers who died of cancer 6 to 24 months before were mailed a survey that included validated tools and additional Likert scale-based questions. We used correlation and univariate and multiple regression analyses to assess the associations between psychosocial and grief outcomes and parental social functioning. RESULTS: One hundred twenty-five parents representing 88 children completed the survey. Most respondents identified as female (63%), White (84%), and non-Hispanic (91%). The mean time since child's death was 14.7 (range, 8-26) months. Bereaved parents' mean score for social functioning was only slightly below normative values, and most parents indicated post-traumatic growth and adaptive coping. Parents had high symptom levels for depression, anxiety, post-traumatic stress, and prolonged grief, with those identifying as female having significantly higher symptom scores. Using multivariate analysis, parental scores for resilience and continuing bonds were associated with higher social functioning scores and parental scores for depressive symptoms and prolonged grief were associated with lower social functioning scores. CONCLUSION: Although bereaved parents exhibit resilience and positive coping, they also show high levels of psychosocial distress in the first 2 years after their child's death, which may reflect the typical parental bereavement experience. Screening for low parental social functioning may identify parents who would benefit from additional support early in bereavement.

Mixed‐methods analysis of decisional regret in parents following a child's death from cancer

“…Mothers’ RR for decisional regret was 10‐fold compared to fathers. This intensified maternal response is consistent with other outcomes, such as prolonged grief, impaired social functioning, post‐traumatic stress disorder, depression, anxiety, and other adverse sequelae 13,26,30,31 . However, a recent review demonstrates that fathers are less forthcoming when sharing grief experiences, 24 which may also explain observed differences in mothers’ and fathers’ risk of regret.…”

“…This intensified maternal response is consistent with other outcomes, such as prolonged grief, impaired social functioning, post-traumatic stress disorder, depression, anxiety, and other adverse sequelae. 13,26,30,31 However, a recent review demonstrates that fathers are less forthcoming when sharing grief experiences, 24 which may also explain observed differences in mothers' and fathers' risk of regret. Parent-perceived child suffering is also common among bereaved parents 18,32,33 and is associated with adverse grief outcomes.…”

“…We generated descriptive statistics for all quantitative variables. Decisional regret is uniquely experienced by different parents of the same child, and differences in grief outcomes by parental gender are well‐established, 24,25–27 including in this cohort, 13 so we assumed no interdependence in outcomes within dyads. This is consistent with historical and contemporary studies of bereaved parents 25–27 .…”

“…The data for this analysis come from a larger study examining the early parental bereavement experience following a child's death from cancer; additional methodological details and primary findings are published. 13,14 IRB approval was obtained at Dana-Farber Cancer Institute (DFCI) and St. Jude Children's Research Hospital (SJCRH).…”

Experiences of Pediatric Palliative Care Among Bereaved Parents Who Lost a Child With Leukemia in South Korea

“…4 In addition, previous studies have shown that bereaved parents experience high rates of emotional and psychological pain, emphasizing the importance of providing continued bereavement services in palliative care. Snaman et al 5 found high rates of depression, anxiety, and posttraumatic stress among bereaved parents, especially among mothers who had been the primary caregivers for their children. Suttle et al 6 observed that although the pain, depression, and posttraumatic stress of bereaved parents eased over 13 months after a child's death, a high level of symptoms persisted.…”