Patterns of grief in young children following the death of a sibling
Grief; Death; sibling bereavement
Abstract Specific grief behaviors observed in children ages 4-16 years in the 2 years after the death of a sibling are reported. Using the Child Behavior Checklist (CBCL), the parents of 90 boys and girls rated the occurrence of behavior problems in their children. Behavior problems identified in 50% or more of the children are reported both for the total sample and by age and sex groups. The behaviors commonly observed in the bereaved children predominanty fell into the Agression subscale of the standardized CBCL. It is suggested that bereaved children use aggressive behaviors instrumentally to gain parental attention, rather than as an instinctual expression of hostility and anger.
1995
McCown DE; Davies B
Death Studies
1995
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Journal Article
<a href="http://doi.org/10.1080/07481189508252712" target="_blank" rel="noreferrer">10.1080/07481189508252712</a>
Long-Term Outcomes of Adolescent Sibling Bereavement
bereavement; sibling bereavement
The experience of sibling bereavement is relatively unexamined in the literature; the long-term effects of such an experience have received even less attention. In this study, grounded theory techniques for the analysis of qualitative data were used to analyze a series of intensive, semistructured interviews with 12 adults who, in their early adolescence, lost a sibling. Long-term outcomes included psychological growth, a sense of feeling different, and withdrawal from peers. The study presents a theoretic scheme relating these outcomes. The sense of personal growth and maturity arouses feelings of being different from peers, and may result in an intolerance of the developmentally appropriate behaviors demonstrated by peers. Some siblings respond to these feelings by withdrawing from their peers at a time when peer relationships are critical to completing developmental tasks. For such siblings, feelings of sadness and loneliness become long-term.
1991-01
Davies B
Journal Of Adolescent Research
1991
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Journal Article
<a href="http://doi.org/10.1177/074355489161007" target="_blank" rel="noreferrer">10.1177/074355489161007</a>
Sibling bereavement: research-based guidelines for nurses. [Review] [27 refs]
IM; sibling bereavement; N
Despite the marked improvement in the treatment of childhood cancer in recent decades, there are children who die, leaving behind a legacy of grief for all who knew them, including their siblings. Nurses can play a significant role in facilitating healthy grieving for these surviving children. The results of several studies pertaining to sibling bereavement after the death of a child from cancer provide guidelines for clinicians. [References: 27]
1993-05
Davies B
Seminars In Oncology Nursing
1993
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Journal Article
Challenges in identifying children for palliative care
Child; Attitude to Death; Pilot Projects; quality of life; patient care team; Caregivers/psychology; Human; Palliative Care; Attitude of Health Personnel; Patient Selection
1996
Davies B; Steele R
Journal Of Palliative Care
1996
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Journal Article
A qualitative study of advice from bereaved parents and siblings.
IM; sibling bereavement
Despite a growing bereavement literature, relatively little is known about what families find helpful after a child's death and how best to assist them during the grieving process. In this qualitative study, the authors explored advice from 40 families (65 parents, 39 siblings) of children who died from cancer 6-19 months earlier. Content analysis emphasized the individual nature of grief and revealed advice that fit into three temporal categories: before the death, soon after, and long-term. Findings are discussed in the context of contemporary theory and provide insight into the development and timing of grief interventions.
Thompson AL; Miller KS; Barrera M; Davies B; Foster TL; Gilmer MJ; Hogan N; Vannatta K; Gerhardt CA
Journal Of Social Work In End-of-life & Palliative Care
2011
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Journal Article
<a href="http://doi.org/10.1080/15524256.2011.593153" target="_blank" rel="noreferrer">10.1080/15524256.2011.593153</a>
Peer relationships of bereaved siblings and comparison classmates after a child's death from cancer
adolescent; Child; Female; Humans; Male; bereavement; Neoplasms; Interpersonal Relations; Siblings; Peer Group; social support; Age Factors; Sex Factors; Schools; Social Behavior; sibling bereavement
OBJECTIVES: To compare peer relationships among bereaved siblings and matched classmates, and to examine gender, grade level, and time since death as moderators. METHODS: Families were recruited from cancer registries at four hospitals 3-12 months after a child's death. Measures of social behavior and peer acceptance were completed by children in the classrooms of 105 bereaved siblings (ages 8-17 years). Teachers also reported on children's social behavior. Three classmates were matched for gender, race, and age to each bereaved sibling to form a comparison group (n = 311). RESULTS: Teachers reported bereaved siblings were more prosocial than comparison classmates. Peers perceived bereaved boys as more sensitive-isolated and victimized, while bereaved siblings in elementary grades were perceived by peers as less prosocial, more sensitive-isolated, less accepted, and as having fewer friends. Peers and teachers viewed bereaved siblings in middle/high school grades as higher on leadership-popularity. CONCLUSIONS: Bereaved siblings who were male and in elementary grades were more vulnerable to social difficulties, while those in middle/high school may exhibit some strengths. Ongoing research to inform the development of interventions for bereaved siblings is warranted.
Gerhardt CA; Fairclough DL; Grossenbacher JC; Barrera M; Gilmer MJ; Foster TL; Compas BE; Davies B; Hogan NS; Vannatta K
Journal Of Pediatric Psychology
2012
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Journal Article
<a href="http://doi.org/10.1093/jpepsy/jsr082" target="_blank" rel="noreferrer">10.1093/jpepsy/jsr082</a>
Changes in siblings after the death of a child from cancer.
adolescent; Child; Cross-Sectional Studies; Female; Humans; Male; bereavement; Death; Neoplasms; Adult; Parents; Middle Aged; Siblings; Qualitative Research; Time Factors; Nursing Methodology Research; Adaptation; Psychological; IM; sibling bereavement; N
IMPLICATIONS FOR PRACTICE: Our findings offer guidance to improve aftercare for bereaved siblings and their families. Additional research is needed to further delineate the needs of bereaved siblings and to develop strategies to promote adaptation to loss.
Foster TL; Gilmer MJ; Vannatta K; Barrera M; Davies B; Dietrich MS; Fairclough DL; Gerhardt CA
Cancer Nursing
2012
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Journal Article
<a href="http://doi.org/10.1097/NCC.0b013e3182365646" target="_blank" rel="noreferrer">10.1097/NCC.0b013e3182365646</a>
Pediatric Palliative Care
Davies B
Encyclopedia Of Death And The Human Experience
2009
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Book/Book Section
Bereavement
Palliative Care; Terminal Care; Terminally Ill; Longitudinal Studies; Children; Chronic disease
Davies B; Worder W; Orloff S; Gudsmundsdottir M; Toce S; Sumner L
Palliative Care For Infants, Children And Adolescents: A Practical Handbook
2004
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Book/Book Section
Fading away: The experience of transition for families with terminal illness
Family
Davies B; Reimer JC; Brown P; Martens N
1995
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Book/Book Section
Challenges of developing a children's hospice
Death; bereavement
Davies B; Eng B
Beyond The Innocence Of Childhood: Helping Children And Adolescents Cope With Death And Bereavement
1996
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Book/Book Section
The grief of siblings
Grief; Siblings
Davies B
Helping Bereaved Children : A Handbook For Practitioners
2002
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Book/Book Section
Supporting families in palliative care.
Davies B; Steele R
Oxford Textbook Of Palliative Nursing
2010
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Book/Book Section
Supporting families in palliative care.
Davies B
Ofxord Textbook Of Palliative Care Nursing
2005
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Book/Book Section
Grief and bereavement in pediatric palliative care
Davies B; Limbo R; Jin J
Oxford Textbook Of Palliative Nursing
2010
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Book/Book Section
After a child dies: Helping the siblings.
Child; Palliative Care; Terminal Care; Siblings; Longitudinal Studies
Davies B
Hospice Care For Children
1993
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Book/Book Section
Family functioning: Impact on siblings.
Longitudinal Studies; Attitude to death -- In infancy & childhood; Bereavement -- in infancy & childhood; Bereavement in children; Brothers and sisters -- Death -- Psychological aspects; Children and death; Grief in children; Sibling Relations -- in infancy & childhood
Davies B
Shadows In The Sun: The Experiences Of Sibling Bereavement In Childhood.
1999
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Book/Book Section
End of life in pediatric oncology: how clinical practice leads to research
Biomedical Research; Evidence-based Medicine; Oncology Nursing/td [trends]; Pediatrics/td [trends]; Child; Humans; Research Design
In pediatric oncology nursing, and across practice disciplines in general, clinical research serves as the cornerstone for improving patient care. Historically, advances made in the care and cure of childhood cancer have stemmed directly from clinical research. The developments of new research questions are varied in their origin--some questions are based on previous work that leads logically to the next question, some are based on a clinical problem that requires more immediate attention, and then there are those that arise from an individual clinical experience. This last category provides clinicians with a poignant reason to search for answers on how to provide the most optimal care for all future patients. As the number of advanced practice nurses in pediatric oncology increases, there is the likelihood of an increased pursuit of clinical research. This article describes how one clinician's experience with dying children resulted in the pursuit of answers to clinical research questions. By reflecting on clinical practice and incorporating our practice in the development of research questions, we can improve the quality of care provided to all children with cancer. Copyright 2002 by Association of Pediatric Oncology Nurses
Pritchard M; Davies B
Journal Of Pediatric Oncology Nursing
2002
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<a href="http://doi.org/10.1053/jpon.2002.127226" target="_blank" rel="noreferrer noopener">10.1053/jpon.2002.127226</a>
Paediatric palliative care research in Canada: Development and progress of a new emerging team
Paediatric palliative care is a field distinct from adult palliative care, although there are many overlaps in language, approach and philosophy. Several features, however, distinguish paediatric palliative care. The illnesses that affect children are different from those that are most predominant in the adult population. In addition, the role and involvement of the family, while always important in palliative care generally, is heightened in paediatric palliative care. In this new and growing interdisciplinary specialty, paediatric palliative care professionals recognize that children exist within a family system, with individual members making up the components (1). These distinguishing characteristics mean that we cannot simply translate general or adult palliative care research to the paediatric arena. Canada has been a leader in the development of clinical paediatric palliative care, with programs in the major Canadian geographical centres, as well as North America’s first free-standing children’s hospice, Canuck Place Children’s Hospice (Vancouver, British Columbia). At the same time, there is widespread acknowledgement that not enough research has been undertaken within paediatric palliative care to provide an adequate evidence base for practice. To increase research capacity in Canada, in 2004, the Canadian Institutes of Health Research funded a research program entitled ‘Transitions in Pediatric Palliative and End-of-Life Care’ through a New Emerging Team grant.
Straatman L; Cadell S; Davies B; Siden H; Steele R
Paediatrics & Child Health
2008
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<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603510/" target="_blank" rel="noreferrer">PMC2603510</a>
Families' transition to a Canadian paediatric hospice. Part one: planning a pilot study
Canada; Child; Health Planning; Health Services Needs and Demand; Hospices/organization & administration; Humans; Palliative Care; Pediatrics; Pilot Projects
This article describes the rationale for planning and conducting a qualitative pilot study about families' transition to a Canadian paediatric hospice. Discussion includes: background information and a literature review pertinent to the study; debate around the term 'hospice' versus 'palliative care'; the different and unique needs of children requiring a palliative approach compared with adult hospice patients; and information about planning and beginning the study, including the rationale for a pilot, details about the study site, recruitment and procedures, and data collection and analysis. The results from the pilot study, as well as implications for practice and research are reported in part two.
Steele R; Derman S; Cadell S; Davies B; Siden H; Straatman L
International Journal Of Palliative Nursing
2008
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<a href="https://doi.org/10.12968/ijpn.2008.14.5.29492" target="_blank" rel="noreferrer">10.12968/ijpn.2008.14.5.29492</a>
Research priorities in pediatric palliative care: a delphi study
Attitude of Health Personnel; Attitude to Health; Benchmarking; bereavement; Canada; Child; Consensus; Delphi Technique; Evidence-Based Practice; Family/psychology; Humans; Needs Assessment/organization & administration; Pain/prevention & control; Palliative Care/organization & administration; Pediatrics/organization & administration; Practice Guidelines as Topic; Psychological/prevention & control; Questionnaires; Research Design; Research/organization & administration; Stress
Pediatric palliative care is increasingly recognized to be a specialized type of care requiring specific skills and knowledge, yet, as found in several countries, there is little available research evidence on which to base care. Objectives: The goal of the project was to achieve consensus among palliative care practitioners and researchers regarding the identification of pertinents lines of research. Method: A Delphi technique was used with an interdisciplinary panel (n=14–16) of researchers and frontline clinicians in pediatric palliative care in Canada. Results: Four priority research questions were identified: What matters most for patients and parents receiving pediatric palliative services? What are the bereavement needs of families in pediatric palliative care? What are the best practice standards in pain and symptom management? What are effective strategies to alleviate suffering at the end of life? Conclusions: These identified priorities will provide guidance and direction for research efforts in Canada, and may prove useful in providing optimal care to patients and families in pediatric palliative care.
Steele R; Fletcher JM; Bosma H; Siden H; Straatman L; Fleming C; Cadell S; Davies B
Journal Of Palliative Care
2007
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<a href="http://scholars.wlu.ca/scwk_faculty/12/" target="_blank" rel="noreferrer">scwk_faculty/12</a>
Children in palliative medicine: An overview
Davies B; Siden H
In Hanks G, Cherny NI, Christakis NA, Fallon M, Kaasa S & Portenoy RK (Eds.). Oxford Textbook of Palliative Medicine (4th edition). Oxford: Oxford University Press, 1301-17.
Oxford: Oxford University Press
2009
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Research considerations in pediatric palliative care
Davies B; Widger K; Steele R; Cadell S; Siden H; Straatman L
In Wolff J, Sourkes B, & Hinds P (Eds.) Textbook of Interdisciplinary Pediatric Palliative Care, First Edition. New York: Elsevier, 96-103.
New York: Elsevier
2011
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Pediatric palliative care in Canada
In Knapp, Madden & Fowler-Kerry (Eds.) Pediatric Palliative Care: Global Perspectives. Springer Publishing, 301-321.
Widger K, Cadell S, Davies B, Siden H, Steele R
In Knapp, Madden & Fowler-Kerry (Eds.) Pediatric Palliative Care: Global Perspectives. Springer Publishing, 301-321.
Springer Publishing
2012
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Changes In Parents After The Death Of A Child From Cancer
Adaptation Psychological; Bereavement; Death; Adult; Canada; Child; Emotions; Family/ Psychology; Female; Humans; Male; Parents/ Psychology; Siblings/psychology; United States
CONTEXT: Few studies have compared multiple perspectives of changes experienced by parents after a child's death. OBJECTIVES: This study used interviews with bereaved parents and siblings to examine changes in parents during the first year after the death of a child from cancer. METHODS: Mothers (n=36), fathers (n=24), and siblings (n=39) from 40 families were recruited from three hospitals in the U.S. and Canada three to 12 months after the death (M=10.7, SD=3.5). Semistructured interviews with open-ended questions were conducted in the home with each participating parent and sibling separately. Content analysis identified emerging themes, and frequencies were compared between each paired set of reports (mother vs. sibling, father vs. sibling, and mother vs. father). RESULTS: Parents and siblings identified two major categories of change experienced by bereaved parents. These changes occurred in their personal lives (e.g., emotions, perspectives and priorities, physical state, work habits, coping/behaviors, spiritual beliefs, and feeling something is missing) and relationships (e.g., family, others). Ninety-four percent of the mothers, 87% of the fathers, and 69% of the siblings reported parental changes in at least one of these categories. Parents were more likely to report changes in priorities, whereas siblings reported more sadness in parents after the death. CONCLUSION: Positive and negative changes in parents after the death of a child from cancer occur in both personal and relational domains. Additional research is needed to determine the impact of a child's death on bereaved parents over time and to develop strategies to promote healthy adjustment.
Gilmer MJ; Foster TL; Vannatta K; Barrera M; Davies B; Dietrich MS; Fairclough DL; Grollman J; Gerhardt CA
Journal Of Pain And Symptom Management
2012
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<a href="https://doi.org/10.1016/j.jpainsymman.2011.10.017" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2011.10.017</a>
Moving Family-centered Care Forward: Bereaved Fathers' Perspectives
Bereaved Fathers; Family-centered Care; Pediatric Health Care Providers Behaviors
This paper describes the key behaviors of "excellent" pediatric healthcare providers - a term used by fathers of children with complex, life-threatening illness to describe providers who consistently and effectively engage in family-centered care for children and their families. Using interview data from a multi-site grounded theory study of 60 fathers with a deceased child, five behaviors were identified: getting to know the family as individuals, talking about non-healthcare related topics, connecting in a human-human relationship, including parents as team members, and applying specialized knowledge to help the family. These behaviors are consistent with the goals of family-centered care, but they are inconsistently practiced, resulting in less-than-optimal care for children and their families during periods of crisis and vulnerability. A renewed focus on relationship building and interactions with families is needed, as well as a re-evaluation of the training of pediatric healthcare providers.
Davies B; Baird J; Gudmundsdottir M
Journal Of Hospice And Palliative Nursing
2013
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<a href="https://doi.org/10.1097/NJH.0b013e3182765a2a" target="_blank" rel="noreferrer">10.1097/NJH.0b013e3182765a2a</a>
Best Practice In Provider/Parent Interaction
Pediatrics; Quality; Parents Experiences; Communication; Hospital Staff; Pediatric Palliative Care; Grounded Theory; Social Sciences; Biomedical; Family Perspectives; Qualitative Analysis; Empathy; Medicine; Practice Guidelines; Childs Death; Canada; Social Sciences; Interdisciplinary; Patient-provider; Reflection; Information Science & Library Science; Palliative Care; Relationships; Best Practice
In this 3-year prospective grounded theory study in three pediatric settings, we aimed to develop a conceptualization of best practice health care providers (BPHCPs) in interaction with parents of children with complex, chronic, life-threatening conditions. Analysis of semistructured interviews with 34 parents and 80 health care professionals (HCPs) and 88 observation periods of HCP/parent interactions indicated that BPHCPs shared a broad worldview; values of equity, family-centered care, and integrity; and a commitment to authentic engagement. BPHCPs engaged in direct care activities, in connecting behaviors, and in exquisitely attuning to particularities of the situation in the moment, resulting in positive outcomes for parents and HCPs. By focusing on what HCPs do well, findings showed that not only is it possible for HCPs to practice in this way, but those who do so are also recognized as being the best at what they do. We provide recommendations for practice and initial and ongoing professional education.
Davies B; Steele R; Krueger G; Albersheim S; Baird J; Bifirie M; Cadell S; Doane G; Garga D; Siden H; Strahlendorf C; Zhao Y
Qualitative Health Research
2016
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<a href="https://doi.org/10.1177/1049732316664712" target="_blank" rel="noreferrer noopener">10.1177/1049732316664712</a>