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Bereaved mothers and fathers: Grief and psychological health 1 to 5 years after losing a child to cancer
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.ORCID iD: 0000-0002-4142-5967
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Bereaved parents often experience severe suffering and are at elevated risk for developing grief complications such as prolonged grief and other negative psychological health outcomes. The general aim of this thesis was to investigate symptoms of prolonged grief, depression, posttraumatic stress, anxiety, rumination, and sleep disturbance in parents who had lost a child to cancer 1 to5 years earlier. Attention was also given to the potential impact on the parents’grief of their experiences during the child’s illness, and finally to the parents’ views on their coping with grief. Methods: A cross-sectional design for data collection was used for all four studies in this thesis. Both quantitative and qualitative methods were used for data analysis, to provide various and complementing perspectives on bereaved parents’ grief and their psychological health. Results:Bereaved parents’ symptom levels of prolonged grief and psychological symptoms were found to be elevated and neither time- nor gender-dependent across the first five years after the loss. We also found that some of the parents’experiences during their child’s illness were associated with their grief and psychological symptoms. These factors differed for mothers and fathers. Mothers valued trustful relations with health care professionals, while fathers reported better psychological health when they had received support in practical matters. Findings also showed that parents found certain factors facilitated or complicated their coping with grief. Unsurprisingly, social support promoted positive coping with grief, while a less familiar factor – going back to work – could make coping with grief harder. Clinical implications: The findings provide knowledge which can improve the care for children, through development of support to their parents in pediatric oncology contexts and in bereavement.

Place, publisher, year, edition, pages
Stockholm: Ersta Sköndal Bräcke University College , 2020. , p. 80
Series
Avhandlingsserie inom området Människan i välfärdssamhället, ISSN 2003-3699 ; 3
Keywords [en]
Bereavement, grief, pediatric oncology, parents, psychological health
National Category
Nursing
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
URN: urn:nbn:se:esh:diva-8006Libris ID: htvzwxn8fdbz1pqkISBN: 978-91-985808-3-9 (print)OAI: oai:DiVA.org:esh-8006DiVA, id: diva2:1415221
Opponent
Supervisors
Available from: 2020-03-27 Created: 2020-03-17 Last updated: 2020-05-26Bibliographically approved
List of papers
1. Psychometric properties of the Prolonged Grief Disorder-13 (PG-13) in bereaved Swedish parents.
Open this publication in new window or tab >>Psychometric properties of the Prolonged Grief Disorder-13 (PG-13) in bereaved Swedish parents.
2018 (English)In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 267, p. 560-565, article id S0165-1781(18)30138-0Article in journal (Refereed) Published
Abstract [en]

This study aimed to validate the Swedish version of the Prolonged Grief Disorder-13 tool (PG-13) by examining its psychometric properties, including factor structure, discriminant and concurrent validity. The PG-13 was assessed in a sample of Swedish parents who had lost a child to cancer 1-5 years previously. The sample included 225 parents (133 mothers and 92 fathers) with a mean age of 46.02 years (SD = 8.15) and 16.0% met the criteria for Prolonged Grief Disorder (PGD). A principal component analysis was performed, and the results supported a one-factor structure of the PG-13. The PG-13 was shown to have high internal consistency and intelligible associations with concurrent psychological symptoms and grief rumination as well as with known risk factors for PGD. These results indicate satisfactory psychometric properties of the instrument, thus supporting the use of the PG-13 as a valid measure of PGD.

Keywords
Bereavement, Parents, Pediatric oncology, Principal component analysis, Prolonged Grief Disorder, Validation
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-6995 (URN)10.1016/j.psychres.2018.06.004 (DOI)29982112 (PubMedID)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2020-03-17Bibliographically approved
2. Bereaved mothers' and fathers' prolonged grief and psychological health 1 to 5 years after loss-A nationwide study.
Open this publication in new window or tab >>Bereaved mothers' and fathers' prolonged grief and psychological health 1 to 5 years after loss-A nationwide study.
2019 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, no 7, p. 1530-1536Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To assess differences in prolonged grief, depression, posttraumatic stress, and sleep disturbances in bereaved parents across years since loss (1-5 years) and by gender and to assess potential interactive effects of time since loss and gender on bereavement outcomes.

METHODS: This study examined symptom levels of prolonged grief disorder, depression, posttraumatic stress, and insomnia in bereaved parents. A sample, including 133 mothers and 92 fathers who had lost a child to cancer 1 to 5 years previously, subdivided to five subsamples, one for each year since loss. Analysis of variance (ANOVA) was used to assess differences in symptom levels, related to years since loss, and gender.

RESULTS: Regardless of how many years had passed since the loss, symptom levels of prolonged grief, depression, posttraumatic stress symptoms, and insomnia were elevated in all subsamples. Mothers showed higher symptom levels of prolonged grief, depression, and posttraumatic stress than fathers. However, no significant interaction effects were found between years since loss and gender on any of the symptom levels.

CONCLUSIONS: Cancer-bereaved mothers and fathers are vulnerable to prolonged grief and psychological symptoms up to 5 years after the death of their child. Findings highlight that bereaved parents may need long-term support, and the results deserve further attention in research and clinical care.

Keywords
PGD, childhood cancer, depression, fathers, insomnia, mothers, pediatric oncology, posttraumatic stress, prolonged grief
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-7665 (URN)10.1002/pon.5112 (DOI)31108000 (PubMedID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2020-03-17Bibliographically approved
3. Factors During a Child's Illness Are Associated With Levels of Prolonged Grief Symptoms in Bereaved Mothers and Fathers
Open this publication in new window or tab >>Factors During a Child's Illness Are Associated With Levels of Prolonged Grief Symptoms in Bereaved Mothers and Fathers
2020 (English)In: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 38, no 2, p. 137-144Article in journal (Refereed) Published
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-7982 (URN)10.1200/JCO.19.01493 (DOI)31725342 (PubMedID)
Available from: 2020-02-06 Created: 2020-02-06 Last updated: 2020-04-15Bibliographically approved
4. Parents’ views on what facilitated or complicated their grief after losing a child to cancer
Open this publication in new window or tab >>Parents’ views on what facilitated or complicated their grief after losing a child to cancer
2020 (English)In: Article in journal (Refereed) Submitted
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-8005 (URN)
Available from: 2020-03-16 Created: 2020-03-16 Last updated: 2020-04-15Bibliographically approved

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