Perceptions of Inadequate Health Care and Feelings of Guilt in Parents after the Death of a Child to a Malignancy: A Population-Based Long-Term Follow-Up

Surkan, Pamela J.; Kreicbergs, Ulrika; Valdimarsdóttir, Unnur; Nyberg, Ullakarin; Onelöv, Erik; Dickman, Paul W.; Steineck, Gunnar

doi:10.1089/jpm.2006.9.317

Cited by 58 publications

(62 citation statements)

References 29 publications

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“…Furthermore, widows who considered that their husbands were exposed to less satisfactory care and treatment were two times more likely to react with guilt than widows that considered their husband's care being satisfactory. Our results are consistent with some of the findings of a previous investigation of feeling of guilt in relation to the provided health care among parents who lost a child to cancer [11]. That study indicates that feelings that their child had little or no access to pain relief, dietary advice, anxiety relief, or relief of other psychological symptoms increased the risk for subsequent guilt two-fold in the parents.…”

Section: Discussionsupporting

confidence: 91%

“…Indeed, in a previous study we found an increased risk of guilt in parents during the first year after having lost a child to cancer if the parents had a perception of inadequate health care [11]. Guilt was particularly evident among parents who were not confident that their child would receive immediate help at the hospital if needed, and among parents who perceived that the health care providers were not competent enough [11].…”

mentioning

confidence: 85%

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Guilt after the loss of a husband to cancer: Is there a relation with the health care provided?

et al. 2008

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 85%

Guilt after the loss of a husband to cancer: Is there a relation with the health care provided?

et al. 2008

Self Cite

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“…Cacciatore, Froen, and Killian (2013) reported that 24.6% of the bereaved mothers in their study blamed themselves for their baby's death; however, the study did not distinguish between characterological and behavioral self-blame. Percentages of bereaved parents who reported guilt were 14.1% (bereaved fathers; Surkan et al, 2006), 15.7% (bereaved mothers;Surkan et al, 2006), 42.5% (bereaved parents; Shanfield & Swain, 1984), 57% (bereaved parents; Miles & Demi, 1983), and 57% (bereaved fathers; Hughes & Page-Lieberman, 1989). Owing to differences in the operationalization of self-blame, guilt, and shame, these figures cannot be synthesized into a single estimate of prevalence.…”

Section: Study Findingsmentioning

confidence: 99%

A Systematic Review of the Peer-Reviewed Literature on Self-Blame, Guilt, and Shame

Duncan

Cacciatore

2015

Omega (Westport)

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This is the first systematic review of the evidence on the prevalence of self-blame, guilt, and shame in bereaved parents. A search of PsychINFO, MEDLINE, Embase, CINAHL, PubMed, and Science Direct resulted in 18 studies for the period 1975 to 2013 which the authors have appraised. Self-blame, guilt, and shame are common in bereaved parents, albeit to varying degrees, with differential relationships to sex, and diminishing over time. There is some evidence that guilt and shame predict more intense grief reactions and that self-blame predicts posttraumatic symptomology, anxiety, and depression in bereaved parents. Heterogeneity of the studies and numerous methodological concerns limit the synthesis and strength of the evidence and the generalizability of the findings. Self-blame, guilt, and shame are commonly experienced by bereaved parents. Awareness of these affective states may assist clinicians in the identification of bereaved parents who are at a higher risk of developing adverse psychological outcomes. Overall, self-blame, guilt, and shame have received very little attention in the bereavement research, leaving many unanswered questions. Implications for practice and recommendations for future research are discussed. Self-blame, guilt, and shame are common in bereavement and may hinder the healthy progression of mourning (Buckle & Fleming, 2011;Humphrey, 2009;Rando, 1986 , 1989). However, self-blame, guilt, and shame have received relatively little attention in parental bereavement research. Reviews of guilt and shame in bereavement are either not current or comprehensive, narrative in style and therefore more susceptible to researcher bias or focused on various types of bereavement rather than parental bereavement specifically (Buckle & Fleming, 2011;Humphrey, 2009;Rando, 1986). Miles and Demi (1986) have proposed the only current theory of guilt in bereaved parents. While clinicians acknowledge that self-blame, guilt, and shame often hinder the progression of normal grieving, there are currently no robust, empirically tested theories of self-blame, guilt, and shame in bereaved parents to guide either diagnoses or interventions. This is the first systematic review of the literature on self-blame, guilt, and shame in bereaved parents characterized by a specific research question, inclusion and exclusion criteria, an explicit search strategy, systematic data extraction procedure, coding and analysis of the studies, methodological appraisal, and a synthesis of the available evidence text. These characteristics reduce the likelihood of reviewer bias or selective citation and provide readers with the information necessary to appraise both the included studies and the systematic review itself (Mulrow, 1994;Pai et al., 2004).Defining Self-Blame, Guilt, and Shame Both guilt and shame are self-conscious emotions involving self-blame (Tangney & Salovey, 1999) and, because they are intimately related, they are more difficult to observe as separate phenomena (Blum, 2008;Kubany & Watson, 2003;Silfver, 2007). ...

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“…This naturally increases the chance of guilt being detected. Moreover, some guilt questions asked about the difficulties in dealing with guilt (McMenamy, Jordan, & Mitchell, 2008), whereas others asked about the frequency (Surkan et al, 2006). Thus, the prevalence of guilt bears different meanings in different studies, and it is difficult to make comparisons across them.…”

Section: The Prevalence Of Guiltmentioning

confidence: 99%

Guilt in Bereavement: A Review and Conceptual Framework

Stroebe

Chan

et al. 2013

Death Studies

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Thirty-four quantitative and 9 qualitative studies are reviewed to indicate current understanding of the nature and impact of guilt in bereavement. This overview suggests that guilt is especially prevalent among some vulnerable subgroups, and it is associated with maladaptive health outcomes. Being male, longer bereavement time, and good end-of life experience seem to be associated with less guilt feelings. However, definition ambiguity, measurement difficulties, and cultural insensitivity are evident in studies. Therefore, a multidimensional conceptualization of guilt and a structural model to guide future investigation of this phenomenon in the bereavement context is proposed.

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Perceptions of Inadequate Health Care and Feelings of Guilt in Parents after the Death of a Child to a Malignancy: A Population-Based Long-Term Follow-Up

Abstract: Bereaved parents' perceptions of inadequate health care were associated with subsequent feelings of guilt during the year following their child's death due to a malignancy.

Cited by 58 publications

References 29 publications

Guilt after the loss of a husband to cancer: Is there a relation with the health care provided?

Guilt after the loss of a husband to cancer: Is there a relation with the health care provided?

A Systematic Review of the Peer-Reviewed Literature on Self-Blame, Guilt, and Shame

Guilt in Bereavement: A Review and Conceptual Framework

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