Bereavement outcomes for parents who lose a child to cancer: Are place of death and sex of parent associated with differences in psychological functioning?

Abstract

Despite increasing cure rates, cancer is a leading cause of non-accidental death in childhood. Models of psychosocial care in pediatric cancer may therefore need to address bereavement planning for a 'minority group' of parents (approximately 25%) for whom cure of their child is not possible. This study addresses a gap in knowledge concerning long-term bereavement and psychological outcomes for parents, as a function of the sex of the parent and the place of the child's death: home versus hospital. Fifty Australian parents (25 father-mother dyads), whose child had died at least 1 year prior to study participation, independently completed measures of psychological functioning (depression, anxiety and stress), family functioning, and pathological grieving (separation distress, and traumatic distress). The results showed some support for a hypothesized interaction between place of death and sex of parent. Fathers reported significantly higher levels of depression, anxiety and stress when the child died in hospital rather than at home. By way of contrast, differences for mothers as function of place of death were not reflected in psychological outcomes but were more closely tied to symptoms of pathological grieving. The findings are discussed with respect to the needs for services for surviving adult family members, especially for fathers who may have an enhanced psychological vulnerability after the death of a child in hospital rather than at home.

Fathers of Children With Cancer: A Descriptive Synthesis of the Literature

“…Younger age of fathers and less time from diagnosis were linked to higher ambiguity and high emotionality. Goodenough, Drew, Higgens, and Trethewie (2004) also described higher psychological distress in fathers of younger children.…”

Prevalence and Predictors of Parental Grief and Depression after the Death of a Child from Cancer

“…[6][7][8] However, researchers have identified that a subset of parents continue to experience severe and escalating psychological and physical problems. [9][10][11][12] Preliminary data suggest that these parents may be experiencing symptoms that constitute prolonged grief disorder (PGD). PGD, also known as complicated grief, is defined as a persistent elevated level of grief for more than 6 months after the loss of a loved one, beyond that which is considered adaptive, due to problematic adjustment to the loss.…”

Parents' Thoughts and Perceptions on Hearing that Their Child Has Incurable Cancer

“…10,11,15 Parental decision making about end-of-life care is associated not only with the QOL of the child, but also with the grief and depression that parents go through after the child's death. [16][17][18] It is important for health care professionals to support parents, help them come to terms with their child's condition, and aid in making end-of-life decisions; this is important so that parents can still have a sense of parenthood after the child's death. We conducted research to clarify parents' thoughts and perceptions regarding their child's diagnosis with incurable cancer and to understand the changes that occur during the end-of-life decision-making process.…”