869

Abstract

Introduction: Bereaved parents have many needs around the time of their child’s death in the PICU. Unmet parental needs have been associated with the development of complicated grief. Descriptions of relevant unmet needs have as yet not been well defined. Hypothesis: We hypothesized that unmet needs related to the psychological processes of sense- and/or meaning making are associated with complicated grief among bereaved parents. Methods: 121 parents of 94 children completed a mailed or telephone survey 6 months after their child’s death in one of 5 PICUs. Surveys included the Bereaved Parent Needs Assessment (BPNA), the Inventory of Complicated Grief (ICG), and demographics. The BPNA is a PICU specific tool that measures the extent to which parents perceive each of 68 need items as having been met around the time of their child’s death using a 5-point scale (1=not at all met, 5=completely met). Items rated?3 were considered unmet. The ICG measures the extent to which each of 19 complicated grief symptoms are presently experienced; higher scores indicate more severe symptoms. Regression analysis using generalized estimating equations (GEE) was used to examine the relationship between each unmet need and the ICG. A final GEE regression analysis was performed to determine the contribution of all significant unmet needs to the total percent of variance accounted for in the ICG. All analyses were controlled for parental age, education, and loss of an only child. Results: Twelve BPNA items were identified as unmet (mean scores?3). Of these, 4 were significantly related to ICG scores (Bonferroni adjusted p<0.004) including the need to (1) Understand the medical cause of death, (2) Talk to other parents whose child died, (3) Find meaning in the loss, and (4) Have hope for the future. Multivariable analysis demonstrated that lack of understanding of the medical cause of death, lack of hope for the future, and decreased parent education accounted for 21% of the variance in ICG scores. Conclusions: Bereavement support that fosters successful sense- and/or meaning making (e.g., understanding cause, restoring hope) should be explored as a way to reduce adverse outcomes among parents after a child’s death in the PICU.