Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T03:17:54.714Z Has data issue: false hasContentIssue false

Morbidity, mortality, and parental grief: A review of the literature on the relationship between the death of a child and the subsequent health of parents

Published online by Cambridge University Press:  13 February 2009

Karrie Cummings Hendrickson*
Affiliation:
Yale School of Nursing, New Haven, Connecticut
*
Address correspondence and reprint requests to: Karrie Hendrickson, 470 Prospect Street, #39, New Haven, CT 06511. E-mail: [email protected]

Abstract

Objective:

This review was undertaken to analyze the research to date and identify areas for future research regarding the associations between parental grief after the death of a child and the subsequent health of the parents, including both their mortality and morbidity risks.

Methods:

Relevant literature was identified through a search of OVID-Medline, CINAHL, and PsycINFO using variations of the terms “parental grief and bereaved parents” combined with “health,” “illness,” “morbidity,” and “mortality.” Additionally, bibliographies of selected articles were reviewed to identify additional sources. The final sample includes 17 articles.

Results:

The literature search revealed a paucity of publications on the topic. However, it also showed that the studies that have been done examining the relationship between parental grief and health outcomes have produced conflicting results in almost every disease state examined. Additionally, several concerns with the quality of existing studies came to light that may bring their results into question. Three primary areas of concern surfaced including lack of consistency in measurement for psychological variables and “soft” self-report health outcomes, questionable methodologies in bereavement research in general, and the lack of a uniform definition of bereaved parents.

Significance of results:

Based on these findings, it is clear that more methodologically sound research is necessary to clarify the relationship between parental grief after the death of a child and the parents' subsequent morbidity and mortality risks.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Arnold, J., Gemma, P.B., & Cushman, L.F. (2005). Exploring Parental Grief: Combining Quantitative and Qualitative Measures. Archives of Psychiatric Nursing, 19(6), 245255.Google Scholar
Baum, A. & Grunberg, N. (1995). Measurement of stress hormones. In Strategies for Measuring Stress in Studies of Psyciatric and Physical Disorders, Cohen, S., Kessler, R., & Gorden, U. (eds.), pp. 175192. New York: Oxford University Press.Google Scholar
Bedford, A. & Foulds, G. (1977). Validation of the Delusions-Symptoms-States Inventory. British Journal of Medical Psychology, 50(2), 163171.CrossRefGoogle Scholar
Birenbaum, L.K., Stewart, B.J., & Phillips, D.S. (1996). Health status of bereaved parents. Nursing Research, 45(2), 105109.CrossRefGoogle ScholarPubMed
Brazil, K., Bedard, M., & Willison, K. (2002). Correlates of health status for family caregivers in bereavement. Journal of Palliative Medicine, 5(6), 849855.CrossRefGoogle ScholarPubMed
Carter, B.S., Howenstein, M., Gilmer, M.J., et al. (2004). Circumstances surrounding the deaths of hospitalized children: Opportunities for pediatric palliative care. Pediatrics, 114(3), e361e366.CrossRefGoogle ScholarPubMed
Charlton, R., Sheahan, K., Smith, G., et al. (2001). Spousal bereavement—Implications for health. Family Practice, 18(6), 614618.CrossRefGoogle ScholarPubMed
Christakis, N.A. & Iwashyna, T.J. (2003). The health impact of health care on families: A matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses. Social Science & Medicine, 57(3), 465475.CrossRefGoogle ScholarPubMed
Clayton, P.J. (1973). The clinical morbidity of the first year of bereavement: A review. Comprehensive Psychiatry, 14(2), 151157.CrossRefGoogle ScholarPubMed
Cohen, S., Kessler, R., & Gorden, U. (1995). Strategies for measuring stress in studies of psychiatric and physical disorders. In Measuring Stress, Cohen, S., Kessler, R., & Gorden, U. (eds.), pp. 326. New York: Oxford University Press.CrossRefGoogle Scholar
Costa, B.M., Hall, L., & Stewart, J. (2007). Qualitative exploration of the nature of grief-related beliefs and expectations. Omega, 55(1), 2756.CrossRefGoogle ScholarPubMed
Davies, R. (2004). New understandings of parental grief: Literature review. Journal of Advanced Nursing, 46(5), 506513.CrossRefGoogle ScholarPubMed
Davies, D.E. (2006). Parental suicide after the expected death of a child at home. BMJ, 332(7542), 647648.CrossRefGoogle ScholarPubMed
Dyregrov, A. & Matthiesen, S.B. (1991). Parental grief following the death of an infant--a follow-up over one year. Scandinavian Journal of Psychology, 32(3), 193207.CrossRefGoogle ScholarPubMed
Dyregrov, K. (2004). Bereaved parents' experience of research participation. Social Science & Medicine, 58(2), 391400.CrossRefGoogle ScholarPubMed
Fletcher, P.N. (2002). Experiences in family bereavement. Family & Community Health, 25(1), 5770.CrossRefGoogle ScholarPubMed
Gilliss, C.L., Moore, I.M., & Martinson, I.M. (1997). Measuring parental grief after childhood cancer: Potential use of the SCL-90R. Death Studies, 21(3), 277287.Google ScholarPubMed
Goodenough, B., Drew, D., Higgins, S., et al. (2004). Bereavement outcomes for parents who lose a child to cancer: Are place of death and sex of parent associated with differences in psychological functioning? Psycho-Oncology, 13(11), 779791.CrossRefGoogle Scholar
Hart, C.L., Hole, D.J., Lawlor, D.A., et al. (2007). Effect of conjugal bereavement on mortality of the bereaved spouse in participants of the Renfrew/Paisley Study. Journal of Epidemiology & Community Health, 61(5), 455460.CrossRefGoogle ScholarPubMed
Hasui, C. & Kitamura, T. (2004). Aggression and guilt during mourning by parents who lost an infant. Bulletin of the Menninger Clinic, 68(3), 245259.CrossRefGoogle ScholarPubMed
Hinds, P.S., Oakes, L.L., Hicks, J., et al. (2005). End-of-life care for children and adolescents. Seminars in Oncology Nursing, 21(1), 5362.CrossRefGoogle ScholarPubMed
Hoyert, D.L., Hsiang-Ching, K., & Smith, B.L. (2005). Deaths: Preliminary data for 2003. National Vital Statistics Reports, 53(15), 148.Google ScholarPubMed
Imara, M. (1983). Growing Through Grief. In C. a. C. Corr, D. (Ed.), Hospice care: principles and practice. New York: Springer Publishing Company.Google Scholar
Institute of Medicine. (2004). When children die: Improving palliative and end-of-life care for children and their families. Washington, DC: Author.Google Scholar
Jacobs, S. & Ostfeld, A. (1977). An epidemiological review of the mortality of bereavement. Psychosomatic Medicine, 39(5), 344357.CrossRefGoogle ScholarPubMed
Johnson, L.C., Murphy, S.A., & Dimond, M. (1996). Reliability, construct validity, and subscale norms of the Brief Symptom Inventory when administered to bereaved parents. Journal of Nursing Measurement, 4(2), 117127.CrossRefGoogle ScholarPubMed
Koop, P.M. & Strang, V. (1997). Predictors of bereavement outcomes in families of patients with cancer: A literature review. Canadian Journal of Nursing Research, 29(4), 3350.Google ScholarPubMed
Kreicbergs, U., Valdimarsdottir, U., Onelov, E., et al. (2004). Anxiety and depression in parents 4–9 years after the loss of a child owing to a malignancy: A population-based follow-up. Psychological Medicine, 34(8), 14311441.CrossRefGoogle ScholarPubMed
Kubler-Ross, E. (1969). On Death and Dying. New York: Macmillan.Google Scholar
Kvikstad, A. & Vatten, L.J. (1996). Risk and prognosis of cancer in middle-aged women who have experienced the death of a child. International Journal of Cancer, 67(2), 165169.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Laakso, H. & Paunonen-Ilmonen, M. (2002). Mothers' experience of social support following the death of a child. Journal of Clinical Nursing, 11(2), 176185.CrossRefGoogle ScholarPubMed
Lang, A., Gottlieb, L.N., & Amsel, R. (1996). Predictors of husbands' and wives' grief reactions following infant death: The role of marital intimacy. Death Studies, 20(1), 3357.CrossRefGoogle ScholarPubMed
Lang, A., Goulet, C., & Amsel, R. (2004). Explanatory model of health in bereaved parents post-fetal/infant death. International Journal of Nursing Studies, 41(8), 869880.CrossRefGoogle ScholarPubMed
Levav, I., Friedlander, Y., Kark, J.D., et al. (1988). An epidemiologic study of mortality among bereaved parents. New England Journal of Medicine, 319(8), 457461.CrossRefGoogle ScholarPubMed
Levav, I., Kohn, R., Iscovich, J., Abramson, J. H., Tsai, W. Y. & Vigdorovich, D. (2000). Cancer incidence and survival following bereavement. American Journal of Public Health, 90(10), 16011607.Google ScholarPubMed
Li, J., Hansen, D., Mortensen, P.B., et al. (2002 a). Myocardial infarction in parents who lost a child: A nationwide prospective cohort study in Denmark. Circulation, 106(13), 16341639.CrossRefGoogle Scholar
Li, J., Johansen, C., Bronnum-Hansen, H., et al. (2004 a). The risk of multiple sclerosis in bereaved parents: A nationwide cohort study in Denmark. Neurology, 62(5), 726729.CrossRefGoogle ScholarPubMed
Li, J., Johansen, C., Hansen, D., et al. (2002 b). Cancer incidence in parents who lost a child: A nationwide study in Denmark. Cancer, 95(10), 22372242.CrossRefGoogle Scholar
Li, J., Johansen, C., & Olsen, J. (2003 a). Cancer survival in parents who lost a child: a nationwide study in Denmark. British Journal of Cancer, 88(11), 16981701.CrossRefGoogle Scholar
Li, J., Johnsen, S.P., & Olsen, J. (2003 b). Stroke in parents who lost a child: A nationwide follow-up study in Denmark. Neuroepidemiology, 22(3), 211216.CrossRefGoogle Scholar
Li, J., Norgard, B., Precht, D.H., et al. (2004 b). Psychological stress and inflammatory bowel disease: A follow-up study in parents who lost a child in Denmark. American Journal of Gastroenterology, 99(6), 11291133.CrossRefGoogle ScholarPubMed
Martinson, I.M., Davies, B. & McClowry, S. (1991). Parental depression following the death of a child. Death Studies, 15(3), 259267.CrossRefGoogle Scholar
McAliley, L.G., Hudson-Barr, D.C., Gunning, R.S., et al. (2000). The use of advance directives with adolescents. Pediatric Nursing, 26(5), 471480.Google ScholarPubMed
McClowry, S.G., Davies, E.B., May, K.A., et al. (1987). The empty space phenomenon: The process of grief in the bereaved family. Death Studies, 11(5), 361374.CrossRefGoogle Scholar
McCorkle, R., Robinson, L., Nuamah, I., et al. (1998). The effects of home nursing care for patients during terminal illness on the bereaved's psychological distress. Nursing Research, 47(1), 210.CrossRefGoogle ScholarPubMed
Middleton, W., Raphael, B., Burnett, P., et al. (1998). A longitudinal study comparing bereavement phenomena in recently bereaved spouses, adult children and parents. Australian & New Zealand Journal of Psychiatry, 32(2), 235241.CrossRefGoogle ScholarPubMed
Murphy, S.A., Lohan, J., Braun, T., et al. (1999). Parents' health, health care utilization, and health behaviors following the violent deaths of their 12- to 28-year-old children: A prospective longitudinal analysis. Death Studies, 23(7), 589616.Google ScholarPubMed
Murphy, S.A., Tapper, V.J., Johnson, L.C., et al. (2003). Suicide ideation among parents bereaved by the violent deaths of their children. Issues in Mental Health Nursing, 24(1), 525.CrossRefGoogle ScholarPubMed
Neidig, J.R. & Dalgas-Pelish, P. (1991). Parental grieving and perceptions regarding health care professionals' interventions. Issues in Comprehensive Pediatric Nursing, 14(3), 179191.CrossRefGoogle ScholarPubMed
Ott, C.H., Lueger, R.J., Kelber, S.T., et al. (2007). Spousal bereavement in older adults: Common, resilient, and chronic grief with defining characteristics. Journal of Nervous & Mental Disease, 195(4), 332341.CrossRefGoogle ScholarPubMed
Parkes, C.M. (1998). Bereavement: Studies of Grief in Adult Life. New York: International Universities Press.Google Scholar
Phillips, A.C., Carroll, D., Burns, V.E., et al. (2006). Bereavement and marriage are associated with antibody response to influenza vaccination in the elderly. Brain, Behavior, & Immunity, 20(3), 279289.CrossRefGoogle ScholarPubMed
Prigerson, H.G., Bierhals, A.J., Kasl, S.V., et al. (1997). Traumatic grief as a risk factor for mental and physical morbidity. American Journal of Psychiatry, 154(5), 616623.Google ScholarPubMed
Prigerson, H.G., Maciejewski, P.K., & Rosenheck, R.A. (2000). Preliminary explorations of the harmful interactive effects of widowhood and marital harmony on health, health service use, and health care costs. Gerontologist, 40(3), 349357.CrossRefGoogle ScholarPubMed
Qin, P. & Mortensen, P.B. (2003). The impact of parental status on the risk of completed suicide. Archives of General Psychiatry, 60(8), 797802.CrossRefGoogle ScholarPubMed
Rallison, L. & Moules, N.J. (2004). The unspeakable nature of pediatric palliative care: Unveiling many cloaks. Journal of Family Nursing, 10(3), 287301.CrossRefGoogle Scholar
Romesberg, T.L. (2004). Understanding grief: A component of neonatal palliative care. Journal of Hospice and Palliative Nursing, 6(3), 161170.CrossRefGoogle Scholar
Rubin, S.S. (1993). The death of a child is forever: The life course impact of child loss. New York, NY: Cambridge University Press.Google Scholar
Rubin, S.S. (1999). The two-track model of bereavement: Overview, retrospect, and prospect. Death Studies, 23(8), 681714.CrossRefGoogle ScholarPubMed
Sanders, C.M. (1979). A comparison of adult bereavement in the death of a spouse, child, and parent. Omega, 10(4), 303322.CrossRefGoogle Scholar
Schulz, R., Beach, S.R., Lind, B., et al. (2001). Involvement in caregiving and adjustment to death of a spouse: Findings from the caregiver health effects study. JAMA, 285(24), 31233129.CrossRefGoogle ScholarPubMed
Seecharan, G.A., Andresen, E.M., Norris, K., et al. (2004). Parents' assessment of quality of care and grief following a child's death. Archives of Pediatrics & Adolescent Medicine, 158(6), 515520.CrossRefGoogle ScholarPubMed
Sirki, K., Saarinen-Pihkala, U.M., & Hovi, L. (2000). Coping of parents and siblings with the death of a child with cancer: Death after terminal care compared with death during active anticancer therapy. Acta Paediatrica, 89(6), 717721.CrossRefGoogle ScholarPubMed
Talbot, K. (1996). Transcending a devastating loss: The life attitude of mothers who have experienced the death of their only child. Hospice Journal, 11(4), 6782.CrossRefGoogle ScholarPubMed
Theut, S.K., Pedersen, F.A., Zaslow, M.J., et al. (1989). Perinatal loss and parental bereavement. American Journal of Psychiatry, 146, 635639.Google ScholarPubMed
Vance, J.C., Najman, J.M., Boyle, F.M., et al. (1994). Alcohol and drug usage in parents soon after stillbirth, neonatal death or SIDS. Journal of Paediatrics & Child Health, 30(3), 269272.CrossRefGoogle ScholarPubMed
Vance, J.C., Najman, J.M., Thearle, M.J., et al. (1995). Psychological changes in parents eight months after the loss of an infant from stillbirth, neonatal death, or sudden infant death syndrome—A longitudinal study. Pediatrics, 96(5), 933938.CrossRefGoogle ScholarPubMed
Woolley, M.M. (1997). The death of a child—The parent's perspective and advice. Journal of Pediatric Surgery, 32(1), 7374.CrossRefGoogle ScholarPubMed
Zisook, S., Chentsova-Dutton, Y., & Shuchter, S.R. (1998). PTSD following bereavement. Annals of Clinical Psychiatry, 10(4), 157163.CrossRefGoogle ScholarPubMed
Znoj, H. & Keller, D. (2002). Mourning parents: Considering safeguards and their relation to health. Death Studies, 26(7), 545565.CrossRefGoogle ScholarPubMed