Multiple Perspectives Of Symptoms And Suffering At End Of Life In The Nicu
Shultz E; Switala M; Winning AM; Keim MC; Baughcum AE; Gerhardt C; Fortney CA
Advances In Neonatal Care
2017
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
10.1097/anc.0000000000000385
Relationship Between Response To Stress & Meaning Making And The Effects On Grief After Child Death
General & Internal Medicine
Learning Objectives: Parents that experience the death of a child are at high risk for complicated grief, which may be related to unsuccessful attempts to find meaning in their loss. Responses to stress include involuntary reactions that reflect temperament or conditioned responses (intrusive thoughts, emotional numbness), as well as coping which refers to responses that are voluntary and involve conscious effort (problem solving, cognitive restructuring). A parent’s ability to find meaning in their child’s death may be influenced by their reaction to stress & coping. In this study we explored the relationship between a bereaved parent’s response to stress and their ability to make meaning of their child’s death. We hypothesized that parents with more meaning making would have less complicated grief. Methods: This was a prospective survey study of bereaved parents whose children died in the PICU & CICU at Nationwide Children’s Hospital from 2012 to 2014. Parents were enrolled 6 months after their child’s death and completed measured that assessed demographics, response to stress (RSQ), prolonged grief (PG-13), grief reactions (Hogan GRC), and meaning making (ISLES). Results: The sample consisted of 26 parents of 17 children. More meaning making was seen amongst parents that demonstrated higher levels of voluntary primary (r=.452, p=.023) & secondary control coping (r=.620, p=.002). Parents with higher levels of involuntary stress response demonstrated lower levels of meaning making (engagement r=-.558, p=.004; disengagement r=-.687, p=<.001). Bereaved parents with higher levels of meaning making demonstrated less symptoms of prolonged grief (r=-.548, p=.005) and less negative reaction to grief (despair r=-.739, p=<.001; panic r=-.612, p=.001; blame/anger r=-.565, p=.003; detachment r=-.653, p=<.001; disorganization r=-.664, p=<.001). Conclusions: Bereaved parents with higher levels of meaning making show less overall symptoms of prolonged grief and less negative reactions to grief. This may be related to higher levels of voluntary coping; whereas higher levels of involuntary response to stress may be detrimental.
Suttle M; Gerhardt C; Fults M; Shultz E
Critical Care Medicine
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
The Relationship Between Bereaved Parental Knowledge Of Events And Satisfaction With Care
Learning Objectives: Parents have described high-quality end of life care as care that involves giving news with sensitivity, giving clear information on what to expect, and generally preparing families for the circumstances surrounding their child's death. Because of the often rapid nature of death in the pediatric intensive care unit, intensivists may have less time to adequately prepare families, leaving them unsatisfied with care. In this study we compared bereaved parents' perceived understanding of the medical events surrounding their child's death to their overall satisfaction with ICU care. We hypothesized that parents that reported higher perceived knowledge would have higher satisfaction with care. Methods: This was a survey study of bereaved parents whose children died in the PICU & CICU at Nationwide Children's Hospital from 2012 to 2014. Parents were enrolled 6 months after their child's death and completed measures that assessed demographics, perceived knowledge of care, and healthcare satisfaction (Peds QL). Results: The sample consisted of 26 parents of 17 children. Parents who rated their understanding of the medical events surrounding their child's death highly, had higher overall satisfaction (r=.485, p=.026); whereas parents with more lingering questions about their child's death had less overall satisfaction (r=-.541, p=.011) and less information satisfaction (r=-.508, p=.022). Parents that relied more on support staff (nurses, social work) and family & friends for understanding medical events had higher satisfaction with regard to their emotional needs (r=.559, p=.047; r=.657, p=.015). Reliance on family & friends for understanding also correlated with higher overall satisfaction (r=.439, p=.036). Conclusions: Bereaved parents with higher perceived knowledge of the medical events surrounding their child's death and less lingering questions about the death have higher overall satisfaction with care. Parents who rely more on support staff and family & friends for understanding of medical events have higher satisfaction of their emotional needs.
Suttle M; Gerhardt C; Fults M; Shultz E
Critical Care Medicine
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).