Parents\u27 Experiences After the Death of an Only Child in the U.S.

There are more than 14,000 parents who lose their only child each year. Following the death of a child, recent studies found bereaved parents experienced a higher level of grief, family dysfunction, more physical and psychological problems. The loss of an only child is one of the risk factors related to parents’ poorer outcomes. In the last 20 years, all the studies about the death of an only child were conducted in China under the Chinese only child policy. According to the literature review, parents who lost an only child had more negative outcomes than parents who have surviving child(ren). This study based on the Resiliency Model of Family Stress, Adjustment and Adaptation model to describe parents’ experiences from 2 weeks to 11 years after their only child’s death in the U.S. This study used the conventional content analysis approach to understand the online stories posted by the bereaved parents. The sample included 30 parents who lost their only child in the previous 2 weeks to 11 years and wrote blogs online ranging from 1 day to 6 years. The findings included parents’ feelings, family functioning, health problems, coping strategies, and related factors. The bereaved parents who lost their only child used words like “lonely”, “empty” and “fear, scared or afraid” to describe their feelings. Bereaved parents tried to pretend they were functioning normally, and they did not want to “move on”. They have jealous feelings about other families who have a surviving child or children. Parents also experienced role identity conflict. The bereaved parents did not want to work in jobs handling complaints and their marital relationships suffered negative effects of the child’s death. The most common physical problem was sleep disturbances. Some bereaved parents reported psychological problems and suicidal ideation. Also, many parents had problems with daily living activities. Parents’ descriptions vary with the child’s age/ gender, parent’s age/ gender, cause of death, and time since the death. The findings from this study can be beneficial for nursing practice, research, and education; grief management; and better tailoring interventions to help parents bereaved of their only child

Measuring the Level of Non-normal Students’ Usage Behavior and Satisafction with Art and Design Online Course in Hunan, China

Purpose: This research examines the factors influencing actual usage and satisfaction of non-normal students with the art and designs online course at four Universities in Hunan, China. The conceptual framework was constructed with commitment, self-efficacy, transformational leadership, service quality, satisfaction, and actual usage. Research design, data, and methodology: Sample data was collected from 500 students. The quantitative method is to collect the data by a questionnaire. Before the large-scale data collection, the Item-Objective Congruence Index (IOC) and pilot test of 30 participants were secured to approve content validity and Cronbach’s Alpha reliability test. The sampling procedure involves judgmental, quota, and convenience sampling. Data were analyzed by Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) to validate the model’s goodness of fit and confirm the causal relationship among variables for hypothesis testing. Results: The results indicated that actual usage is the strongest factor that significant impacts student satisfaction, followed by commitment, self-efficacy, transformational leadership, and service quality. In addition, self-efficacy is directly related to actual usage. Conclusions: The conceptual framework proposed in this study had high reliability and validity. Hence, art and design online courses should improve students’ cognitive level, student satisfaction, and actual usage to strengthen the curriculum construction

Editorial: Parent, Grandparent, and Sibling Responses to the Death of an Infant or Child in Intensive Care

The death of a child is a devastating event for most parents and other family members1. However, responses to a child’s death vary by culture, generation, and often the age of the deceased child. For the Chinese, child death is a “bad death” and brings shame to the family2. Filipino parents of a deceased child feel severe guilt after their loss3. In some Caribbean cultures young mothers are prevented from attending the child’s funeral or going to the cemetery by women in the previous generation in the belief that if you “take one to the cemetery you will be taking all of your other children there as well.” In other cultures, those who die as children have not sinned, securing their place in heaven4. In the ethnically-diverse US, more than 43,000 children aged 18 and younger die each year5, most in intensive care units6. Friends, relatives, co-workers, and healthcare providers (HCP) often are uncomfortable with the parents after their child’s death, not knowing what to do, what to say, and what would help the deceased’s parents and family members. Many assume that parents and family members want to be left alone after the infant’s or child’s death. As a result, parents, siblings, and grandparents report feeling isolated and abandoned by those close to them when they need them most7–10. Little research has been done with these US family members in the difficult first year after the child’s death. What has been done has shown that studies of parents have been conducted years, even 3–7 decades11, after their infant’s or child’s death. However, many studies have very diverse samples regarding the age of the “child” at death. In some studies, family members are responding to the death of a “child” who died in childhood (≤18 years old) and a “child” who died as an adult (19 and above), sometimes as old as 40, in the same study12. In addition, studies of siblings whose brother or sister died during the sibling’s childhood are often retrospective. Some studies postpone data collection until the sibling reaches adulthood; and some studies recruit bereaved siblings when they are adults. Very few studies have been undertaken with grandparents of the deceased child. With funding from the US NIH National Institute of Nursing Research and the National Institute of General Medical Sciences, a body of research has been conducted on parents’, grandparents’ and siblings’ health and functioning during the first year after the infant’s or child’s death in the neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU) to fill our knowledge gap

Exploring the workload balance effects of including continuity-based factors in nurse-patient assignments

Workload balance in nurse-patient assignments is important for ensuring quality in patient care. Unbalanced workloads can lead to high levels of nursing stress, medical errors, lower-quality outcomes, and higher costs. Studies have pro-posed assignment strategies based on patient acuity, location, and characteristics of specialized units. These methods do not address the part of workload associated with continuity in care coordination, and the potential benefits associated with continuity-based assignments. We present the results of a pilot simulation study comparing an acuity-oriented method to a continuity-based approach, using acuity as a measure of workload. Our results suggest that a purely continuity-based approach can result in skewed workloads when measured by patient acuity. In future work, we plan to consider hybrid methods, which may be able to provide the benefits of both continuity and acuity based methods