Loss in the family – A reflection on how schools can support their students

Each year, thousands of British schoolchildren experience the loss of a loved one. In this trying time, it is vital that school staff have a good understanding of how to offer support. Sadly, many school staff struggle with how to provide support and in what form. Based on experiences from Scandinavia, in this article we provide guidelines and practical advice for the forms of support which we consider beneficial. In cases of anticipated losses, the school can do its utmost to collaborate with the home and student in order to ensure efficient communication and good student care. Following a loss, the school should work to provide a caring climate that makes it easier to return to class. We recommend making most decisions in collaboration with the bereaved children in order to ensure they receive support they themselves find beneficial.publishedVersio

Anxiety and the Quality of Life of Children Living with Parental Cancer

Background: Previous research on children living with parental cancer has mainly focused on the psychosocial challenges, but few studies have explored their health-related quality of life (HRQOL). This is important to promote well-being and discover areas of distress, as well as positive aspects of the children’s life. Objective: The aim of this study was to study how children’s HRQOL is influenced by anxiety and whether age and gender act as moderators for this relationship. Methods: This study used a survey with a cross-sectional design, including 35 children between 8 and 18 years old (mean, 13.3 years old) living with parental cancer. Questionnaires of HRQOL (Kinder Lebensqualität) and anxiety (Revised Child Manifest Anxiety Scale) were used. Results: The children reported higher anxiety and lower HRQOL than the controls. The children’s physiological (P = .03), emotional (P = .04), and school (P = .00) functions were significantly impaired, whereas they scored in line with the controls on self-esteem, family, friends, and overall HRQOL. A negative correlation (r = −0.707, P < .01) between anxiety and HRQOL was found. Neither age nor gender acted as a moderator between anxiety and HRQOL. Conclusions: A one-dimensional focus on anxiety may not capture these children’s multidimensional challenges. In contrast, a focus on HRQOL may give important knowledge of the children’s challenges, as well as areas where they function well. Implications for Practice: Healthcare professionals need to work collaboratively across disciplines and have a multidimensional focus in caring for patients with cancer who have children. They must provide both the parents and children with adequate information and tools to handle their family health situation to promote the children’s HRQOL.publishedVersio

Systematic early intervention for bereaved: study protocol of a pilot randomized controlled trial with families who suddenly lose a partner and a parent

Background: Grief has been associated with several long-term negative outcomes for both surviving parents and bereaved children, especially when it is preceded by unnatural and violent deaths. Nevertheless, it has been an underestimated public health problem with few, if any, empirically documented early preventive intervention programs. The best time to start them is also a major question that requires further evidence. Objective: The overall aim of this study is to assess the feasibility of a future larger trial, informing sample size calculation, recruitment/randomization procedures, retention rates, data collection forms, and outcomes. This study will also explore: (1) the early effects of Systematic Early Intervention for Bereaved (SEIB) compared with the early effects of care as usual, and (2) the effects of the immediate SEIB version compared with the effects of the delayed SEIB version. Methods: In a pilot randomized controlled trial (RCT) with a delayed intervention design, suddenly bereaved families will be assigned to: the immediate-SEIB intervention group, or the delayed-SEIB intervention group. Participants will fill in a set of self-report measures at baseline, and after 3, 6, and 9 months follow-up. Quantitative data on traumatic stress symptoms, complicated grief, psychological wellbeing, daily functioning, social support, parental capacity, parenting practices, and family functioning will be collected to inform power calculations and explore SEIB’s preliminary effects. Data on the flow of participants throughout the trial will be analyzed in order to estimate recruitment and retention rates. Two brief questionnaires were developed to assess recruitment procedures, randomization, and data collection materials. Results: Recruitment for this project started in August 2015, and follow-up data collection will be completed in June 2017. Conclusions: This study prepares the ground work for the design and implementation of a main trial and may add preliminary knowledge to the significance of early supportive practices that have been commonly used regardless of their sparse evidence.publishedVersio

When young children grieve: daycare children’s experiences when encountering illness and loss in parents

This study presents the insights gained from interviewing 12 parentally bereaved children aged 5–8. All were below six years of age when bereft. Participants were interviewed through Sandtray interviews. The study finds that children are developing an understanding of what it means to live with loss, but want truthful information about the illness of their parent, and to understand the loss. They value help from the remaining parent, but also appreciate the support from daycare staff and friends. Findings further highlight that under the right circumstances, children have much to contribute when it comes to understanding their support needs.publishedVersio

Pandemic-Related Stress Symptoms Among Norwegian Parents of Adolescents in Grades 6 to 8

We investigated pandemic-related stress symptoms during the first COVID-19 lockdown period in spring 2020 among parents of adolescents that were 11 to 13 years old in the study period. We also investigated whether parental stress symptoms were associated with family situation and family activities during lockdown. Altogether 147 couples reported about their own trauma-related stress symptoms following the outbreak of the pandemic. Among the respondents, 9.5% of the mothers and 10.2% of the fathers had scores over cutoff on the screener (IES-6) measuring stress symptoms, a non-significant gender difference. Scores on the screener were not associated with family contamination or lockdown consequences. Family activities during lockdown did not impact the pandemic stress symptom levels. Whereas, the experience of the COVID-19 pandemic pose a stressor to most people, it is unlikely to be a criterion A event for other than directly affected families.publishedVersio

Grief trajectories among bereaved parents after the 2011 Utøya terror attack: A qualitative analysis

This study took a qualitative approach to explore terror-bereaved parents’ long-term experiences with grief. Data were drawn from a larger, longitudinal study, and interviews with 10 bereaved parents were selected based on their reported change in scores on Inventory of Complicated Grief (ICG) over a period of 6.5 years, including the five parents with the largest change (group 1) and the five parents with the least change (group 2). Reflexive thematic analysis of the interview transcripts resulted in four main themes: “I felt completely lost and helpless, like I was stuck in a whirlwind” and “I have been fighting to get back to my everyday life”, which both groups contributed to. Participants in group 1 contributed to the theme “I have found a way to a new life,” while participants in group 2 contributed to the theme “I cannot seem to find a way to a new life.” Findings suggest that sense of control, acceptance, and social support enhanced experienced coping following terror-related bereavement, while comorbid mental health problems, difficulties with acceptance, and repetitive thoughts about the death was experienced as contributing to long-term struggles following terror-related bereavement.publishedVersio

The social health domain of people bereaved by a drug-related death and associations with professional help: A cross-sectional study

People bereaved by traumatic deaths are vulnerable to long-lasting impairments in social health, including the quality of social relationships and the capacity to manage their social lives. In this Norwegian study involving 255 participants bereaved by a drug-related death, we aimed to investigate their social health and associations with professional help. The results of a cross-sectional survey showed that participants on average rated their social health as poor, though with large variations within the group. Participants who reported high satisfaction with professional help reported significantly higher scores on most social health-related variables. More research is needed on professional help focusing on the social health of traumatically bereaved people.publishedVersio

Needs for help and received help for those bereaved by a drug-related death: a cross-sectional study

Background and aims: Individuals bereaved after sudden and unexpected deaths can benefit from professional help to cope after the loss, and the bereaved call for proactive, early and flexible help from professional services. Most drug-related deaths (DRDs) happen suddenly and unexpectedly. DRDs are a significant public health issue, yet few studies have examined DRD-bereaved people’s needs and experiences with professional help. This article investigates the needs for help and received help reported by DRD-bereaved family members and friends, and suggests improvements in services based on the findings. Data and method: A heterogeneous convenience sample of DRD-bereaved family members and close friends (n = 255) were recruited for a survey from February to December 2018. Descriptive analyses were conducted for experiences with professional help, chi-square analyses to find predictors for help needs and received help, and logistic regression analysis to find predictors for satisfaction with the help provided. Results: Most DRD-bereaved individuals reported a need for professional help after the death regardless of family relation to the deceased, and about half of the participants received help. Nearly half of them were satisfied with the help. Our results indicated higher satisfaction with help among older bereaved, and the participants who received help from a crisis team or psychotherapist. The latter was particularly stated for younger participants. Few participants with children in the family reported that the children had received help, and less than one-third were satisfied with this help. Conclusion: The study shows that younger age groups and children need particular recognition, and a family perspective from services is essential. When assessing the help needs of the DRD-bereaved, relations of both psychological and biological closeness should be recognised. Help efforts should be tailored according to established knowledge of the provided help that bereaved populations deem effective.publishedVersio

Paths to positive growth in parents bereaved by drug-related death: A mixed-method study

Introduction: Drug-related deaths (DRDs) are a major public health challenge. Losing a child to a DRD can be a very stressful life event, which places parents at risk of mental and physical health problems. However, traumatic experiences like losing a child to DRD can paradoxically also lead to positive psychological changes. A mixed-method approach was used to understand the complexity of the phenomenon of post-traumatic growth experienced by parents following a DRD. Method: By combining data from a survey (n = 89) and interviews (n = 14), we explored positive growth experiences among Norwegian parents. We conducted descriptive analyses of the sample’s demographic characteristics and mean scores for Post-traumatic Growth Inventory (PTGI-SF) items. Hierarchical multiple regression was used to examine the influence of the ability to perform daily activities (WSAS), self-efficacy (GSE-SF), social support (CSS), and symptoms of prolonged grief (PG-13) on the outcome variable of post-traumatic growth (PTGI-SF). Reflexive thematic analysis was applied to analyze the qualitative data. Finally, we integrated the results of the survey and the interviews. Results: For items measuring post-traumatic growth, parents scored highest on the item “I discovered that I’m stronger than I thought I was” and lowest on the item “I am able to do better things with my life.” Self-efficacy and social support had a statistically significant relation with post-traumatic growth. Two themes were generated from the interviews: (I) new perspectives on life and (II) new paths in life. Even though the “New Possibilities” subscale had the lowest mean score for the PTGI-SF, new paths in life were important for many of the interviewed parents. Discussion: Parents described traumatic stressors associated with having a child who uses narcotics and hence experienced positive changes even before losing their child. We argue that on an individual level, the consequences of spillover stigma, low self-efficacy, and intrusive rumination can hinder potential post-traumatic growth. On a group level, enhancing network support may increase post-traumatic growth experiences. Hence, parents who have experienced a DRD can benefit from help to activate their social networks and strengthen their self-efficacy.publishedVersio