The experience of parental death concomitant with parental divorce occurs for 46% of Danish children and 50% of American children who lose a parent to death. This experience of loss and double bereavement compounds increased risk of mental health problems. The aim of this study was to explore nursing interventions for double bereaved children that promoted their well-being. A phenomenological–hermeneutic approach was used to conduct 20 interviews with nurses in family cancer care. Ricoeur’s theoretical framework was followed with naïve reading, structural analysis, and critical interpretation, resulting in the formulation of a new model of nursing care for these children: the Divorced Family–Focused Care Model. Four themes were apparent: (a) collection of information about family structure, (b) assessment of support needs, (c) initiation of well-being support, and (d) coordination and follow-up focused on the child’s well-being. The new intervention model has implications for health care education and implementation of health care policies.
Aims and objectives
To explore how children and young adults from divorced families experience double bereavement when they lose a divorced parent with cancer and how the double bereavement influences their mental health consequences and need of support.
Background
Children and young people who are confronted with the cancer and death of a parent is a highly stressful life event, which is associated with an increased risk of mental health problems, especially when children experience divorced parental cancer and death.
Design
Participant observations and interviews with a phenomenological‐hermeneutic approach and COREQ standards for reporting qualitative research.
Methods
We conducted 340 hr of participant observations within nine different support groups totalling 27 children and young adults from divorced families and included 28 interviews with participants and relatives. Analyses are based on Ricoeur's theory of interpretation: naïve reading, structural analysis, interpretation and discussion.
Results
The experiences with double bereavement identified three main themes: 1. navigating through multiple transitions and disruptions within two family worlds; 2. consequences for mental health including stress overload and disruptions to well‐being; and 3. need for accessible support derived from close relationships and professionals within and in‐between family worlds.
Conclusion
Children and young adult's double bereavement includes multiple transitions and disruptions often related to stress overload and mental health problems. Support from close relationships and professionals is experienced as helpful in the prevention and mitigation of mental health problems.
Relevance to clinical practice
There is a need for targeted accessible support availability to children, young adults and their families when a divorced parent is dying of cancer in clinical practice. Our findings suggest that specific health policies for health professionals should be developed to target improved support for these families.
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