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Abstract

Introduction: Research suggests that finding meaning after a traumatic event is associated with better psychological adjustment. To facilitate this process, the Collaborative Pediatric Critical Care Research Network developed a framework for conducting follow-up meetings between physicians and parents after a child's death in a PICU (Eggly, Pediatr Crit Care Med, 2011). Our objective is to identify and describe types of meaning-making processes that occur among bereaved parents during follow-up meetings with their child's PICU physician. Methods: 35 follow-up meetings including 54 bereaved parents and 23 physicians were conducted 3.4 ± 1.5 months after the child's death. Meetings were video recorded and transcribed verbatim. Using standard qualitative procedures, an interdisciplinary team analyzed the transcripts to identify and describe themes consistent with extant meaning-making theory. Results: Four major themes were identified: (1) sense making, (2) benefit finding, (3) continuing bonds, and (4) identity reconstruction. Sense making refers to seeking an explanation for the death including biomedical explanations, parents' role in the death, parents' prior decisions on treatment and end-of-life care, and blame. Benefit finding refers to exploring positive consequences of the death (i.e., a "silver lining") including ways to help others such as donations, feedback, volunteering, and contributing to medical knowledge. Continuing bonds refers to exploring ongoing connections with the deceased child including reminiscing about the child, photos/mementos, personal rituals (e.g., visiting the cemetery), and community events to honor the child. Identity reconstruction refers to exploring changes in parents' sense of self including life changes related to relationships, work, or home. Conclusions: Physician-parent follow-up meetings facilitate several types of meaning-making processes for bereaved parents. Further research should examine the extent to which meaning making during follow-up meetings affects parental health outcomes.