Bereaved Families: A Qualitative Study of Therapeutic Intervention

  1. Moriconi, Valeria 2
  2. Cantero-García, María 123
  1. 1 Hospital Infantil Universitario Niño Jesus de Madrid
    info

    Hospital Infantil Universitario Niño Jesus de Madrid

    Madrid, España

    ROR https://ror.org/028brk668

  2. 2 Universidad Europea de Madrid
    info

    Universidad Europea de Madrid

    Madrid, España

    ROR https://ror.org/04dp46240

  3. 3 Universidad Internacional de Valencia
    info

    Universidad Internacional de Valencia

    Valencia, España

    ROR https://ror.org/00gjj5n39

Mostrar afiliaciones +
Revista:
Frontiers in Psychology

ISSN: 1664-1078

Año de publicación: 2022

Volumen: 13

Tipo: Artículo

DOI: 10.3389/FPSYG.2022.841904 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Frontiers in Psychology

Resumen

Background: A child’s death is the most stressful event and the most complex grief that families face. The process of psychological adaptation to the illness and death of a child is difficult due to a variety of emotional reactions. Parental grief had received the attention of researchers only in recent years when it became clear that this reality differs substantially from the general grief process.Objective: This work aims to highlight the needs of bereaved parents; increase the specificity and effectiveness of the therapeutic approach to prevent complications in the process of loss-making; and find the recurrent thematic nuclei in the development of bereavement present in a therapeutic group of parents who have lost their child to an onco-hematological disease.Method: Between 2011 and 2016, five therapeutic groups for the grief elaboration were made. The sample included a total of 50 parents of children who died from cancer between the ages of 0 and 21 years.Content analysis was carried out as a qualitative analysis method. The SAS® Text Miner software (SAS Institute Inc, 2004) was used to read, interpret, classify and integrate the data from numerous sources.Results: The development and consecutive interpretation of the 5 clusters have been carried out to analyze the related topics using the node “Topic Analysis” and requesting the subdivision into five topics. Four topics have been well defined. Clear topics are reducible to categories of emotional relief, tools, legacy, and unfinished business. The topic analysis provides interesting indications about the different interpretive journeys of the bereavement situation and offers ideas regarding the different types of social responses.Conclusions: After reviewing the existing bibliography, we have confirmed the lack of specific literature on the problem of grief in parents whose children have died from cancer. Much research has shown that parents who lose a child to cancer want support, and there are still few studies on the most effective interventions for this group.

Referencias bibliográficas

  • Barbero, J., and Alameda, A. (2009). El duelo en padres del niño oncológico. Psicooncología 6, 485–498.
  • Currier, J. M., Holland, J. M., and Neimeyer, R. A. (2006). Sense-making, grief, and the experience of violent loss: toward a mediational model. Death Stud. 30, 403–428. doi: 10.1080/07481180600614351
  • Davies, R. (2004). New understandings of parental grief: literature review. J. Adv. Nurs. 46, 506–513. doi: 10.1111/j.1365-2648.2004.03024.x
  • Die-Trill, M. (2003). “El niño y el adolescente con cáncer,” in Psico-Oncología, ed. M. Die-Trill (Madrid: Ediciones Ades), 86–101.
  • Downe-Wamboldt, B. (1992). Content analysis: method, applications, and issues. Health Care Women Int. 13, 313–321. doi: 10.1080/07399339209516006
  • Eggly, S., Meert, K. L., Berger, J., Zimmerman, J., Anand, K. J., Newth, C. J., et al. (2011). A framework for conducting follow-up meetings with parents after a child’s death in the pediatric intensive care unit. Pediatr. Crit. Care Med. 12, 147–152. doi: 10.1097/PCC.0b013e3181e8b40c
  • Field, N. P., Gao, B., and Paderna, L. (2005). Continuing bonds in bereavement: an attachment theory based perspective. Death Stud. 29, 277–299. doi: 10.1080/07481180590923689
  • Field, N. P., Packman, W., Ronen, R., Pries, A., Davies, B., and Kramer, R. (2013). Type of continuing bonds expression and its comforting versus distressing nature: implications for adjustment among bereaved mothers. Death Stud. 37, 889–912. doi: 10.1080/07481187.2012.692458
  • Folkman, S. (2001). “Revised coping theory and the process of bereavement,” in Handbook of Bereavement Research: Consequences, Coping, and Care, eds M. S. Stroebe, R. O. Hansson, W. Stroebe, and H. Schut (Washington, DC: American Psychological Association), 563–584.
  • Gillies, J., and Neimeyer, R. A. (2006). Loss, grief, and the search for significance: toward a model of meaning reconstruction in bereavement. J. Constr. Psychol. 19, 31–65. doi: 10.1080/10720530500311182
  • Grassi, L., Sabato, S., Caruso, R., Tiberto, E., Padova, S., Ruffilli, F., et al. (2021). Reflecting on meaning in an existential-reorientation group psychotherapy approach for cancer patients: a qualitative thematic analysis. Palliat. Support. Care 19, 1–8. doi: 10.1017/S1478951521000936
  • Greenberg, L. S. (2012). Emotions, the great captains of our lives: their role in the process of change in psychotherapy. Am. Psychol. 67, 697–707. doi: 10.1037/a0029858
  • Grinberg, L. (1971). Culpa y Depresión. Buenos Aires: Paidós.
  • Heiney, S. P., Ruffin, J., and Goon-Johnson, K. (1995). The effects of a support group on selected psychosocial outcomes of bereaved parents whose child died from cancer. J. Pediatr. Oncol. Nurs. 12, 51–58. doi: 10.1177/104345429501200203
  • Holland, J. M., Klingspon, K. L., Lichtenthal, W. G., and Neimeyer, R. A. (2020). The Unfinished Business in Bereavement Scale (UBBS): development and psychometric evaluation. Death Stud. 44, 65–77. doi: 10.1080/07481187.2018.1521101
  • Horowitz, M. J., Bonanno, G. A., and Holen, A. (1993). Pathological grief: diagnosis and explanation. Psychosom. Med. 55, 260–273. doi: 10.1097/00006842-199305000-00004
  • Keesee, N., Currier, J., and Neimeyer, R. (2008). Predictors of grief following the death of one’s child: the contribution of finding meaning. J. Clin. Psychol. 64, 1145–1163. doi: 10.1002/jclp.20502
  • Klass, D. (1997). The deceased child in the psychic and social worlds of bereaved parents during the resolution of grief. Death Stud. 21, 147–176. doi: 10.1080/074811897202056
  • Klass, D., Silverman, P., and Nickman, S. (1996). Continuing Bonds: New Understandings of Grief. Washington DC: American Psychological Association Press.
  • Klingspon, K. L., Holland, J. M., Neimeyer, R. A., and Lichtenthal, W. G. (2015). Unfinished business in bereavement. Death Stud. 39, 387–398. doi: 10.1080/07481187.2015.1029143
  • Kochen, E. M., Jenken, F., Boelen, P. A., Deben, L., Fahner, J. C., van den Hoogen, A., et al. (2020). When a child dies: a systematic review of well-defined parent-focused bereavement interventions and their alignment with grief- and loss theories. BMC Palliat. Care 19:28. doi: 10.1186/s12904-020-0529-z
  • Lehman, D. R., Wortman, C. B., and Williams, A. F. (1987). Long-term effects of losing a spouse or child in a motor vehicle crash. J. Pers. Soc. Psychol. 52, 218–231. doi: 10.1037/0022-3514.52.1.218
  • Lichtenthal, W. G., and Breitbart, W. (2015). The central role of meaning in adjustment to the loss of a child to cancer: implications for the development of meaning-centered grief therapy. Curr. Opin. Support. Palliat. Care 9, 46–51. doi: 10.1097/SPC.0000000000000117
  • Lichtenthal, W. G., Catarozoli, C., Masterson, M., Slivjak, E., Schofield, E., Roberts, K. E., et al. (2019). An open trial of meaning-centered grief therapy: rationale and preliminary evaluation. Palliat. Support. Care 17, 2–12. doi: 10.1017/S1478951518000925
  • Ljungman, L., Hovén, E., Ljungman, G., Cernvall, M., and von Essen, L. (2015). Does time heal all wounds? A longitudinal study of the development of posttraumatic stress symptoms in parents of survivors of childhood cancer and bereaved parents. Psychooncology 24, 1792–1798. doi: 10.1002/pon.3856
  • Meert, K. L., Eggly, S., Pollack, M., Anand, K. J., Zimmerman, J., Carcillo, J., et al. (2007). Parents’ perspectives regarding a physician–parent conference after their child’s death in the pediatric intensive care unit. J. Pediatr. 151, 50–55. doi: 10.1016/j.jpeds.2007.01.050
  • Meyer, E., Ritholz, M., Burns, J., and Truog, R. (2006). Improving the quality of end-of-life care in the pediatric intensive care unit: parents’ priorities and recommendations improving the quality of end-of-life care in the pediatric intensive care unit: parents’ priorities and recommendations. Pediatrics 117, 649–657. doi: 10.1542/peds.2005-0144
  • Moriconi, V., and Cantero-García, M. (2022). Focus Group una Herramienta Eficaz para la Elaboración del Duelo en Familias con Hijos Oncológicos. (in press).
  • Morris, S., Fletcher, K., and Goldstein, R. (2019). The grief of parents after the death of a young child. J. Clin. Psychol. Med. Settings 26, 321–338. doi: 10.1007/s10880-018-9590-7
  • Neimeyer, R. A., Baldwin, S. A., and Gillies, J. (2006). Continuing bonds and reconstructing meaning: mitigating complications in bereavement. Death Stud. 30, 715–738. doi: 10.1080/07481180600848322
  • O’Connor, K., and Barrera, M. (2014). Changes in parental self-identity following the death of a child to cancer. Death Stud. 38, 404–411. doi: 10.1080/07481187.2013.801376
  • Rando, T. (1998). “Parental adjustment to the loss of a child,” in Children and Death, eds D. Papadatou and C. Papadatos (Washington DC: Hemisphere Publishing Corp.), 233–253.
  • Richardson, M., Cobham, V., Murray, J., and McDermott, B. (2011). Parents’ grief in the context of adult child mental illness: a qualitative review. Clin. Child Fam. Psychol. Rev. 14, 28–43. doi: 10.1007/s10567-010-0075-y
  • SAS Institute Inc (2004). Getting Started with SAS® 9.1 Text Miner. Cary, NC: SAS Institute Inc.
  • Schaefer, M. R., Wagoner, S. T., Young, M. E., Madan-Swain, A., Barnett, M., and Gray, W. N. (2020). Healing the hearts of bereaved parents: impact of legacy artwork on grief in pediatric oncology. J. Pain Symptom Manage. 60, 790–800. doi: 10.1016/j.jpainsymman.2020.04.018
  • Schiff, D. (1997). The Bereaved Parent. New York, NY: Crown Publishers.
  • Steinhauser, K. E., Voils, C. I., Bosworth, H., and Tulsky, J. A. (2015). What constitutes quality of family experience at the end of life? Perspectives from family members of patients who died in the hospital. Palliat. Support. Care 13, 945–952. doi: 10.1017/S1478951514000807
  • Stroebe, M., Abakoumkin, G., Stroebe, W., and Schut, H. (2012). Continuing bonds in adjustment to bereavement: impact of abrupt versus gradual separation. Pers. Relationsh. 19, 255–266. doi: 10.1111/j.1475-6811.2011.01352.x
  • Talbot, K. (2002). What Forever Means After the Death of a Child. London: Brunner Routledge.
  • Tan, J., Docherty, S., Barfield, R., and Brandon, D. (2012). Addressing parental bereavement support needs at the end of life for infants with complex chronic conditions. J. Palliat. Med. 15, 579–584. doi: 10.1089/jpm.2011.0357
  • Tizón, J., and Sforza, M. (2008). Días de Duelo. Barcelona: Alba editorial.
  • Wiener, L., Tager, J. M., Mack, J., Battles, H., Bedoya, S. Z., and Gerhardt, C. A. (2019). Helping parents prepare for their child’s end of life: a retrospective survey of cancer-bereaved parents. Pediatr. Blood Cancer 67:e27993. doi: 10.1002/pbc.27993
  • Zhang, Y., and Jia, X. (2018). A qualitative study on the grief of people who lose their only child: from the perspective of familism culture. Front. Psychol. 9:869. doi: 10.3389/fpsyg.2018.00869
  • Zheng, Y., Lawson, T. R., and Anderson Head, B. (2017). “Our only child has died”—a study of bereaved older Chinese parents. Omega 74, 410–425. doi: 10.1177/0030222815612285
  • Zhou, N., Wen, J., Stelzer, E. M., Killikelly, C., Yu, W., Xu, X., et al. (2020). Prevalence and associated factors of prolonged grief disorder in Chinese parents bereaved by losing their only child. Psychiatry Res. 284:112766. doi: 10.1016/j.psychres.2020.112766
  • Zhou, N., Yu, W., Huang, H., Shi, G., Luo, H., Song, C., et al. (2018). Latent profiles of physical and psychological outcomes of bereaved parents in China who lost their only child. Eur. J. Psychotraumatol. 9:1544026. doi: 10.1080/20008198.2018.1544026