Abstract
BackgroundPrevious research shows that many cancer-bereaved youths report unresolved grief several years after the death of a parent. Grief work hypothesis suggests that, in order to heal, the bereaved needs to process the pain of grief in some way. This study explored acute grief experiences and reactions in the first 6 months post-loss among cancer-bereaved teenagers. We further explored long-term grief resolution and potential predictors of having had “an okay way to grieve” in the first months post-loss.MethodsWe used a population-based nationwide, study-specific survey to investigate acute and long-term grief experiences in 622 (73% response rate) bereaved young adults (age > 18) who, 6–9 years earlier, at ages 13–16 years, had lost a parent to cancer. Associations were assessed using bivariable and multivariable logistic regression.ResultsFifty-seven per cent of the participants reported that they did not have a way to grieve that felt okay during the first 6 months after the death of their parent. This was associated with increased risk for long-term unresolved grief (odds ratio (OR): 4.32, 95% confidence interval (CI): 2.99–6.28). An association with long-term unresolved grief was also found for those who reported to have been numbing and postponing (42%, OR: 1.73, 95% CI: 1.22–2.47), overwhelmed by grief (24%, OR: 2.02, 95% CI: 1.35–3.04) and discouraged from grieving (15%, OR: 2.68, 95% CI: 1.62–4.56) or to have concealed their grief to protect the other parent (24%, OR: 1.83, 95% CI: 1.23–2.73). Predictors of having had an okay way to grieve included being male, having had good family cohesion, and having talked about what was important with the dying parent.ConclusionMore than half of the cancer-bereaved teenagers did not find a way to grieve that felt okay during the first 6 months after the death of their parent and the acute grief experiences and reaction were associated with their grief resolution long-term, i.e. 6–9 years post-loss. Facilitating a last conversation with their dying parent, good family cohesion, and providing teenagers with knowledge about common grief experiences may help to prevent long-term unresolved grief.
Highlights
For a child, one of the most devastating experiences is the early death of a parent, which can seriously affect their health and wellbeing [2,3,4,5,6,7] in the short and long term
Bereavement in children and adolescents has been shown to be associated with increased risk of suicide attempts [8, 9] and increased mortality [10, 11], and previous research based on the same study sample as the current study showed almost a doubled risk of self-injury in the first 6–9 years following teenage bereavement [12, 13]
Differences were found between male and female participants in their reported grief experiences and reactions during the acute bereavement phase. Those who had talked with the dying parent about what they perceived as important, and those who had good family cohesion after the loss were more likely to have had an okay way to grieve in the immediate post-loss phase
Summary
For a child, one of the most devastating experiences is the early death of a parent, which can seriously affect their health and wellbeing [2,3,4,5,6,7] in the short and long term. Complicated or prolonged grief is another factor that has been shown to be associated with those negative healthrelated outcomes in bereaved children and adolescents [19, 20]. This includes symptoms such as separation distress, pre-occupation with thoughts about the deceased person, and difficulties in accepting the loss or in returning to normal functioning after the loss [21,22,23]. We further explored long-term grief resolution and potential predictors of having had “an okay way to grieve” in the first months post-loss.
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