Bereaved Parents’ Health Status During the First 6 Months After Their Child’s Death

Abstract

Purpose:

To examine bereaved parents’ physical, mental, and social health during the first 6 months after their child’s (<12 years) death from a life-threatening illness.

Background and Significance:

Bereaved parents have higher mortality and morbidity rates when compared to nonbereaved parents. Acute illnesses, hospitalizations, and medication changes are highest in the first 6 months. An understanding of bereaved parents’ health risk indicators can help inform development of health promotion and disease prevention measures.

Methods and Analysis:

A prospective descriptive study examined 8 parent dyads. Parents completed health surveys (Patient-Reported Outcomes Measurement Information System–global, social, and sleep; Brief Symptom Inventory [BSI] 18), which are used to assess parents’ health at 3 and 6 months after their child’s death. Demographic data included a medical history, hospital or emergency department visits, and smoking and alcohol intake. Descriptive statistics were used to compare parents’ scores to US general population scores.

Findings:

Mothers’ and fathers’ physical, mental, and sleep health scores were typically within 1 to 2 standard deviations of the population norms. However, their social health scores were as low as 3 standard deviations and all parents’ scores were below population norms. Four (25%) of the 16 parents had new diagnosis during the first 6 months. Based on the BSI-18, 3 parents had their scores above population cutoffs, which warranted a need for further clinical evaluation.

Conclusions:

Health data highlight the “at-risk” health status of bereaved parents. Further validation of these data is required to support the development of health promotion and disease prevention programs.

Keywords

parental bereavement bereaved parents health status health outcomes pediatric bereavement care bereavement programs child’s death palliative and end-of-life

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References

Kochanek

Murphy

Tejada-Vera

. Deaths: final data for 2014. Natl Vital Stat Rep. 2016;65(4):1–122.

Rostila

Saarela

Kawachi

. The forgotten griever: a nationwide follow-up study of mortality subsequent to the death of a sibling. Am J Epidemiol. 2012;176(4):338–346.

Van Ommeren

Levav

. Mortality in parents after death of a child. Lancet. 2003;361(9370):1747; author reply 1748.

Werthmann

Smits

. Parental mortality rates in a western country after the death of a child: assessment of the role of the child’s sex. Gend Med. 2010;7(1):39–46.

Harper

O’Connor

O’Carroll

. Increased mortality in parents bereaved in the first year of their child’s life. BMJ Support Palliat Care. 2011;1(3):306–309.

Levav

Friedlander

Kark

Peritz

. An epidemiologic study of mortality among bereaved parents. N Engl J Med. 1988;319(8):457–461.

Barry

Kasl

Prigerson

. Psychiatric disorders among bereaved persons: the role of perceived circumstances of death and preparedness for death. Am J Geriatr Psychiatry. 2002;10(4):447–457.

Lannen

Wolfe

Prigerson

Onelov

Kreicbergs

. Unresolved grief in a national sample of bereaved parents: impaired mental and physical health 4 to 9 years later. J Clin Oncol. 2008;26(36):5870–5876.

Stroebe

Schut

Stroebe

. Health outcomes of bereavement. Lancet. 2007;370(9603):1960–1973.

10.

Hansen

Mortensen

Olsen

. Myocardial infarction in parents who lost a child: a nationwide prospective cohort study in Denmark. Circulation. 2002;106(13):1634–1639.

11.

Kreicbergs

Valdimarsdóttir

Onelöv

UVE

Henter

Steineck

. Anxiety and depression in parents 4-9 years after the loss of a child owing to a malignancy: a population-based follow-up. Psychol Med. 2004;34(8):1431–1441.

12.

Johansen

Hansen

Olsen

. Cancer incidence in parents who lost a child: a nationwide study in Denmark. Cancer. 2002;95(10):2237–2242.

13.

Youngblut

Brooten

Cantwell

del Moral

Totapally

. Parent health and functioning 13 months after infant or child NICU/PICU death. Pediatrics. 2013;132(5):e1295–1301.

14.

Murphy

Johnson

Fan

Lohan

. Bereaved parents’ outcomes 4 to 60 months after their children’s deaths by accident, suicide, or homicide: a comparative study demonstrating differences. Death Stud. 2003;27(1):39–61.

15.

Rogers

Floyd

Seltzer

Greenberg

Hong

. Long-term effects of the death of a child on parents’ adjustment in midlife. J Fam Psychol. 2008;22(2):203–211.

16.

Chan

Wang

. Symptoms of posttraumatic stress disorder and depression among bereaved and non-bereaved survivors following the 2008 Sichuan earthquake. J Anxiety Disord. 2012;26(6):673–679.

17.

Johnsen

Olsen

. Stroke in parents who lost a child: a nationwide follow-up study in Denmark. Neuroepidemiology. 2003;22(3):211–216.

18.

Johansen

Olsen

. Cancer survival in parents who lost a child: a nationwide study in Denmark. Br J Cancer. 2003;88(11):1698–1701.

19.

Laursen

Precht

Olsen

Mortensen

. Hospitalization for mental illness among parents after the death of a child. N Engl J Med. 2005;352(12):1190–1196.

20.

Hendrickson

. Morbidity, mortality, and parental grief: a review of the literature on the relationship between the death of a child and the subsequent health of parents. Palliat Support Care. 2009;7(1):109–119.

21.

Rostila

Saarela

Kawachi

. Mortality in parents following the death of a child: a nationwide follow-up study from Sweden. J Epidemiol Community Health. 2011;66(10):927–933.

22.

Levav

Kohn

Iscovich

Abramson

Tsai

Vigdorovich

. Cancer incidence and survival following bereavement. Am J Public Health. 2000;90(10):1601–1607.

23.

Birenbaum

Stewart

Phillips

. Health status of bereaved parents. Nurs Res. 1996;45(2):105–109.

24.

Murphy

Shevlin

Elklit

. Psychological consequences of pregnancy loss and infant death in a sample of bereaved parents. J Loss Trauma. 2014;19(1):56–69.

25.

Dias

Docherty

Brandon

. Parental bereavement: looking beyond grief. Death Stud. 2017;41(5):318–327.

26.

Hawthorne

Youngblut

Brooten

. Parent spirituality, grief, and mental health at 1 and 3 months after their infant’s/child’s death in an intensive care unit. J Pediatr Nurs. 2016;31(1):73–80.

27.

Kovarsky

. Loneliness and disturbed grief: a comparison of parents who lost a child to suicide or accidental death. Arch Psychiatr Nurs. 1989;3(2):86–96.

28.

Wijngaards-de Meij

Stroebe

Schut

. Couples at risk following the death of their child: predictors of grief versus depression. J Consult Clin Psychol. 2005;73(4):617–623.

29.

Lang

Fleiszer

Duhamel

Sword

Gilbert

Corsini-Munt

. Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief. Omega (Westport). 2011;63(2):183–196.

30.

Rand

Kellner

Revak-Lutz

Massey

. Parental behavior after perinatal death: twelve years of observations. J Psychosom Obstet Gynaecol. 1998;19(1):44–48.

31.

Buysse

Moul

. Development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments. Sleep. 2010;33(6):781–792.

32.

Castel

Williams

Bosworth

. Content validity in the promis social health domain: a qualitative analysis of focus group data. Quality of Life Research?: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 2008;17(5):737–749. http://doi.org/10.1007/s11136-008-9352-3.

33.

Asner-Self

Schreiber

Marotta

. A cross-cultural analysis of the brief symptom inventory-18. Cultural Diversity and Ethnic Minority Psychology. 2006;12(2):367–375. https://dx-doi-org.web.bisu.edu.cn/10.1037/1099-9809.12.2.367.

34.

Galdón

MJ1

Durá

Andreu

. Psychometric properties of the brief symptom inventory-18 in a spanish breast cancer sample. J Psychosom Res. 2008;65(6):533–9. doi: 10.1016/j.jpsychores.2008.05.009. Epub 2008 Oct 28.

35.

Merport

Recklitis

Does the brief symptom inventory-18 case rule apply in adult survivors of childhood cancer? Comparison with the symptom checklist-90. J Pediatr Psychol. 2012;37(6):650–9. doi: 10.1093/jpepsy/jss050. Epub 2012 Mar 26.

36.

Meachen

SJ1

Hanks

Millis

. The reliability and validity of the brief symptom inventory-18 in persons with traumatic brain injury. Arch Phys Med Rehabil. 2008;89(5):958–65. doi: 10.1016/j.apmr.2007.12.028.

37.

Gilmer

Foster

Vannatta

. Changes in parents after the death of a child from cancer. J Pain Symptom Manage. 2012;44(4):572–582.

38.

Miles

. Emotional symptoms and physical health in bereaved parents. Nurs Res. 1985;34(2):76–81.

39.

Song

Floyd

Seltzer

Greenberg

Hong

. Long-term effects of child death on parents’ health-related quality of life: a dyadic analysis. Fam Relat. 2010;59(3):269–282.

40.

Butler

Hall

Copnell

. Ethical and practical realities of using letters for recruitment in bereavement research. Res Nurs Health. 2017;40(4):372–377.

41.

Gaab

Altruism in families facing the death of a child: how do they do it?

J Paediatr Child Health. 2012;48(12):1056–1057.

42.

van der Geest

Darlington

Streng

Michiels

Pieters

van den Heuvel-Eibrink

. Parents’ experiences of pediatric palliative care and the impact on long-term parental grief. J Pain Symptom Manage. 2014;47(6):1043–1053.

43.

Feudtner

Womer

Augustin

. Pediatric palliative care programs in children’s hospitals: a cross-sectional national survey. Pediatrics. 2013;132(6):1063–1071.