Cause Of Parental Death Research Articles

Applying communication skills in the provision of family-centred care: a reflective account.

Providing family-centred care is fundamental to children's nursing and requires the development of therapeutic relationships with parents, notably parents of children who are acutely unwell. Gaining parents' trust and engaging them in their child's care involves the use of optimal verbal and non-verbal communication techniques. Children's nursing students need to develop skills and confidence in using these techniques. This article is a reflective account by a children's nursing student on how communication concepts and techniques learned at university can be applied to practice. The student had undertaken a theoretical and practical communication module during which she had been introduced to techniques such as active listening and the SURETY model shortly before starting a practice placement in an acute care setting. Here she uses the 'What?, So what?, Now what?' framework to reflect on and learn from her placement. The article demonstrates how complementing theoretical knowledge with experiential learning, and combining this with reflection on action, can enhance students' confidence to deliver family-centred care.

Grief as a predictor of long-term risk for suicidal ideation and attempts of parentally bereaved children and adolescents.

Although children who experience the death of a parent have a heightened risk of suicidality, the long-term associations between grief and suicidality among bereaved youth have yet to be examined. Research is needed to test the specific aspects of grief associated with suicidality, after controlling for other risk factors, in this population. Grief and covariates, including age, gender, parental cause of death, time since parental death, depression, anxiety, internalizing problems, posttraumatic stress symptoms, and child treatment involvement, were assessed at baseline, 6-year, and 15-year follow-ups in a sample of 244 parentally bereaved youth aged 8-16 years. Utilizing multiple grief measures, a bifactor approach was used to identify a general factor and two uncorrelated specific factors: Intrusive Grief Thoughts and Social Detachment/Insecurity. Suicidal thoughts and attempts were assessed at both follow-ups. The Intrusive Grief Thoughts specific factor had a prospective nonlinear association with suicidality at both follow-ups after controlling for all baseline covariates. The nonlinear relation consisted of a large effect, OR > 73 (using the rescaled scores), on the increased risk of suicidality from low to moderate levels of intrusive grief, with no association from moderate to high levels. At 6-year follow-up, the specific Social Detachment/Insecurity factor was significantly associated with suicidality after controlling for covariates. Specific grief factors assessed at different points were associated with suicidal thoughts or attempts among parentally bereaved youth. These findings highlight the significance of specific aspects of child and adolescent grief that have implications for the development of upstream suicide prevention services.

Bereavement and children's mental health: recognising the effects of early parental loss.

Parental death in childhood is a traumatic event and, as a consequence, bereaved children can be at an increased risk of developing mental health issues in adulthood. This article details an extended literature review that was undertaken to explore the effects of early parental death on bereaved children's mental health and identifies implications for healthcare practice. Several electronic databases were searched and eight articles were selected for inclusion in this review. Four themes were identified from the literature: child's age at parental death; cause of parental death; type of parental death; and cascading circumstances. Increased exposure to other adverse circumstances after a parent's death can also predispose an individual to psychopathology in adulthood, so such circumstances can serve as indicators of the potential effects on children's future mental health outcomes.

Trends in the prevalence and incidence of orphanhood in children and adolescents

BackgroundIn South Africa, large increases in early adult mortality during the 1990s and early 2000s have reversed since public HIV treatment rollout in 2004. In a rural population in KwaZulu-Natal, we investigate trends in parental mortality and orphanhood from 2000–2014.MethodsUsing longitudinal demographic surveillance data for a population of approximately 90,000, we calculated annual incidence and prevalence of maternal, paternal and double orphanhood in children and adolescents (<20 years) and, overall and cause-specific mortality of parents by age.ResultsThe proportion of children and adolescents (<20 years) for whom one or both parents had died rose from 26% in 2000 to peak at 36% in 2010, followed by a decline to 32% in 2014. The burden of orphanhood remains high especially in the oldest age group: in 2014, 53% of adolescents 15–19 years had experienced the death of one or both parents. In all age groups and years, paternal orphan prevalence was three-five times higher than maternal orphan prevalence. Maternal and paternal orphan incidence peaked in 2005 at 17 and 27 per 1,000 person years respectively (<20 years) before declining by half through 2014. The leading cause of parental death throughout the period, HIV/AIDS and TB cause-specific mortality rates declined substantially in mothers and fathers from 2007 and 2009 respectively.ConclusionsThe survival of parents with children and adolescents <20 years has improved in tandem with earlier initiation and higher coverage of HIV treatment. However, comparatively high levels of parental deaths persist in this rural population in KwaZulu-Natal, particularly among fathers. Community-level surveillance to estimate levels of orphanhood remains important for monitoring and evaluation of targeted state welfare support for orphans and their guardians.

HIV-related stigma and the psychosocial well-being of children orphaned by AIDS: a systematic review

ABSTRACTThe study aimed to systematically review existing literature reporting on the effects of HIV-related stigma on the psychosocial well-being of children orphaned by AIDS. A systematic review methodology was used to search electronic databases and journals, including Academic Search Complete, AIDS Care, PsychArticles, PubMed and SA ePublications from January 2006 to December 2016. Included studies were required to be peer reviewed, full-text, English medium, embody a quantitative, qualitative or mixed methodology and focus on HIV-related stigma and its impact on the psychosocial well-being of children orphaned by AIDS. Findings were extracted in four steps: (1) identification; (2) screening; (3) eligibility; (4) inclusion. A meta-synthesis was used for the extraction and amalgamation of findings. Thirteen studies were included in the final review and consistently indicated that HIV-related stigma inhibited the psychosocial functioning and well-being of children orphaned by AIDS. This study sheds light on the impact of HIV-related stigma on the psychosocial well-being of children orphaned by AIDS, but has been limited by a culture of non-disclosure of parental HIV infection or death or failing to report on parental cause of death.

Exploring the fitness hypothesis in ALS: a population-based case-control study of parental cause of death and lifespan

ObjectiveTo investigate the theory of premorbid fitness in amyotrophic lateral sclerosis (ALS), we studied whether a common genetic profile for physical or cardiovascular fitness was manifest in progenitors leading to...

Psychosocial differences in children living in orphanages of Kashmir with and without psychiatric morbidity

Background/Objectives: Orphanages are emerging as an important source of care and child-raising for the ever-increasing number of orphans in the conflict-ridden Kashmir. These children are generally prone to develop psychiatric disorders even reared in well run institution. Objective is to highlight the psychosocial differences in children living in orphanages of Kashmir with and without psychiatric morbidity. Materials and Methods: Cross-sectional descriptive study was carried out where 348 children were recruited from eight registered orphanages of Srinagar, Jammu and Kashmir. Semistructured questionnaire was used to collect data related to sociodemographic profile of the children. Development and Well-Being Assessment (DAWBA) was used for one stage structured assessment of psychopathology. Data analysis was done by Statistical Package for Social Sciences for windows 20.0 version. Results: A total of 97.87% among those having psychiatric morbidity were males as against those without psychiatric morbidity where 28.99% were females. While 8.51% among those having psychiatric morbidity were double orphans, it formed only 1.45% of those without psychiatric morbidity. Likewise 25% among those having psychiatric morbidity had parental deaths due to fire-arm injury, while only 11.67% of them fall in the group without psychiatric morbidity. Among the group with psychiatric morbidity 31.91% had spent less than a year in an orphanage and 10.64% had spent ≥ 9 years as against those without morbidity where percentages were 14.49% and 4.35%, respectively. While 21.28% among those with psychiatric morbidity were enrolled in high education, it formed only 13.04% of those without psychiatric morbidity. Gender, type of orphan, length of stay, cause of parental death, and grade (education level) were significantly associated with the psychiatric morbidity (40.52%). Conclusion: The psychosocial differences in children with and without psychiatric morbidity may help in understanding the factors associated with the emerging psychopathology. Early timely intervention to the children especially “at risk” can be provided to alleviate their mental health problems.

Incidence of Suicide Among Persons Who Had a Parent Who Died During Their Childhood: A Population-Based Cohort Study.

Parental death from suicide is associated with increased risk of suicide in the bereaved child, but little is known about the long-term risks of suicide after parental death from other causes. A better understanding of this association may improve suicide prevention efforts. To examine the long-term risks of suicide after parental death and how the risk trajectories differed by cause of parental death while accounting for major potential confounding variables. A population-based matched cohort study was performed using information from nationwide registers (data from 1968 to 2008) in 3 Scandinavian countries (for a total of 7,302,033 persons). We identified 189,094 children (2.6%) who had a parent who died before the child reached 18 years of age (ie, the bereaved cohort). Each bereaved child was matched by sex and age to 10 children who did not have a parent who died before they reached 18 years of age (for a total of 1,890,940 children) (ie, the reference cohort). Both cohorts were followed for up to 40 years. Poisson regression was used to calculate the incidence rate ratio (IRR), while accounting for age at parental death, sex, time since bereavement, maternal/paternal death, birth order, family history of psychiatric illness, and socioeconomic status. Data analyses were finalized June 24, 2015. The main exposure was death of a parent within the first 18 years of life. Incidence of suicide among persons who had a parent who died during their childhood. During follow-up, 265 bereaved persons (0.14%) and 1342 nonbereaved persons (0.07%) died of suicide (IRR = 2.02 [95% CI, 1.75-2.34]); IRR = 3.44 (95% CI, 2.61-4.52) for children who had a parent who died of suicide, and IRR = 1.76 (95% CI, 1.49-2.09) for children who had a parent who died of other causes. The IRR tended to be higher for children who had a parent who died before they reached 6 years of age, and the IRR remained high for at least 25 years. During 25 years of follow-up, the absolute risk of suicide was 4 in 1000 persons for boys who experienced parental death and 2 in 1000 persons for girls who experienced parental death. Parental death in childhood is, irrespective of cause, associated with an increased long-term risk of suicide. The consequences of parental death in childhood are far-reaching, and suicide risk trajectories may be influenced by early-life conditions. Future public health efforts should consider helping highly distressed children to cope with bereavement.

Mortality after Parental Death in Childhood: a Nationwide Cohort Study from Three Nordic Countries.

Background Bereavement by spousal death and child death in adulthood has been shown to lead to an increased risk of mortality. Maternal death in infancy or parental death in early childhood may have an impact on mortality but evidence has been limited to short-term or selected causes of death. Little is known about long-term or cause-specific mortality after parental death in childhood. Methods and Findings This cohort study included all persons born in Denmark from 1968 to 2008 (n = 2,789,807) and in Sweden from 1973 to 2006 (n = 3,380,301), and a random sample of 89.3% of all born in Finland from 1987 to 2007 (n = 1,131,905). A total of 189,094 persons were included in the exposed cohort when they lost a parent before 18 years old. Log-linear Poisson regression was used to estimate mortality rate ratio (MRR). Parental death was associated with a 50% increased all-cause mortality (MRR = 1.50, 95% CI 1.43–1.58). The risks were increased for most specific cause groups and the highest MRRs were observed when the cause of child death and the cause of parental death were in the same category. Parental unnatural death was associated with a higher mortality risk (MRR = 1.84, 95% CI 1.71–2.00) than parental natural death (MRR = 1.33, 95% CI 1.24–1.41). The magnitude of the associations varied according to type of death and age at bereavement over different follow-up periods. The main limitation of the study is the lack of data on post-bereavement information on the quality of the parent-child relationship, lifestyles, and common physical environment. Conclusions Parental death in childhood or adolescence is associated with increased all-cause mortality into early adulthood. Since an increased mortality reflects both genetic susceptibility and long-term impacts of parental death on health and social well-being, our findings have implications in clinical responses and public health strategies. Please see later in the article for the Editors' Summary

Commentary: Childhood parental loss and adulthood health: Discussing the role of parental cause of death, child's age at death and historical context

Commentary : childhood parental loss and adulthood health: discussing the role of parental cause of death, child's age at death and historical context.

Mortality after parental death in childhood: a nationwide cohort study from three Nordic countries.

Bereavement by spousal death and child death in adulthood has been shown to lead to an increased risk of mortality. Maternal death in infancy or parental death in early childhood may have an impact on mortality but evidence has been limited to short-term or selected causes of death. Little is known about long-term or cause-specific mortality after parental death in childhood. This cohort study included all persons born in Denmark from 1968 to 2008 (n = 2,789,807) and in Sweden from 1973 to 2006 (n = 3,380,301), and a random sample of 89.3% of all born in Finland from 1987 to 2007 (n = 1,131,905). A total of 189,094 persons were included in the exposed cohort when they lost a parent before 18 years old. Log-linear Poisson regression was used to estimate mortality rate ratio (MRR). Parental death was associated with a 50% increased all-cause mortality (MRR = 1.50, 95% CI 1.43-1.58). The risks were increased for most specific cause groups and the highest MRRs were observed when the cause of child death and the cause of parental death were in the same category. Parental unnatural death was associated with a higher mortality risk (MRR = 1.84, 95% CI 1.71-2.00) than parental natural death (MRR = 1.33, 95% CI 1.24-1.41). The magnitude of the associations varied according to type of death and age at bereavement over different follow-up periods. The main limitation of the study is the lack of data on post-bereavement information on the quality of the parent-child relationship, lifestyles, and common physical environment. Parental death in childhood or adolescence is associated with increased all-cause mortality into early adulthood. Since an increased mortality reflects both genetic susceptibility and long-term impacts of parental death on health and social well-being, our findings have implications in clinical responses and public health strategies. Please see later in the article for the Editors' Summary.

The Burden of Secrecy Among South African Adolescents Orphaned By HIV And AIDS

HIV thrives in an atmosphere of silence and secrecy. The stigma, real or feared, of HIV/AIDS is often a barrier to support and care that adolescent orphans need. The purpose of this article is to describe the burden of silence borne by adolescents orphaned by HIV and AIDS. A phenomenological study using photography and photo-elicitation was done among orphaned adolescents. Fifteen adolescents orphaned by HIV and AIDS, living in an urban area of South Africa, participated in the study. Participants photographed objects, such as graveyards, hearses, and a room where a parent committed suicide. These photographed objects were grouped as symbols of death. Nature and people also were photographed. Photo-elicitation revealed the psychosocial impact that results from the secrecy about parental cause of death. Implications for mental health practitioners are also discussed.

Demographic and clinical features of orphans and nonorphans at a pediatric HIV centre in North India

To determine the prevalence of orphanhood among HIV positive children and to compare their social and demographic and clinical characteristics with that of HIV-positive non-orphans. From February 2008 through March 2009, data was collected from 148 children registered at the antiretroviral (ART) clinic of a tertiary care hospital in Delhi, on their demographic profile, HIV status of parents, orphan status and cause of parental death, mode of transmission of the infection, current caregiver, school enrollment and clinical and immunologic parameters of HIV infection at presentation. The prevalence of orphanhood was 49.3%. Majority of the orphans were paternal orphans. The primary caregiver was either the surviving parent or extended family members. The orphans were older at presentation and had shorter mean duration of follow-up. They lagged behind the non-orphans in immunisation, nutritional status, school enrollment and attendance and socioeconomic status. They presented more frequently with severe immunosuppression and had a higher prevalence of opportunistic infections. There was no significant difference between the orphans and the non-orphans in the WHO clinical stage of presentation and adherence to ART. The prevalence of orphanhood among the HIV-positive children is high. Although extended family is a cornerstone for care of HIV-positive orphans, these families are overwhelmed by the added responsibility of these children. Larger community-based studies are needed to determine the true magnitude of orphanhood and to evolve methods to socially and financially support the families taking care of these children.

Implications of Parental Suicide and Violent Death for Promotion of Resilience of Parentally-Bereaved Children

This article considers the implications of suicide and violent deaths (including suicide, homicide, and accidents) for the development of interventions for parentally bereaved children. Analyses of data from the Family Bereavement Program find minimal differences in children's mental health problems, grief or risk and protective factors based on cause of parental death. In addition, cause of death did not substantially affect the relations between risk and protective factors and bereaved children's outcomes. It is concluded that cause of death from violence or suicide is not a very useful indicator of bereaved children's need for or likelihood of benefiting from an intervention.

Familial or sporadic clusters of presenile dementia in Scotland

Between 1974 and 1988, discrete areas within Scotland had unexpectedly high incidences of presenile Alzheimer's disease. To examine whether these clusters might be attributable to ‘familial’ cases occurring in the same locality, we performed a case-control study of parental cause of death entered on death certificates. Cases comprised (1) 145 presenile Alzheimer's disease patients and (2) 73 vascular dementia patients presenting in Lothian between 1974 and 1988. Two control individuals per case, of the same sex, born in the same registration district, and whose fathers had the same occupation as the case's father, were chosen from birth registration data. Parental death certificates for 131 presenile Alzheimer's disease and 65 vascular dementia cases were located. There was no significant association detected between a diagnosis of presenile Alzheimer's disease and dementia as a parental cause of death (p = 0.25), nor for vascular dementia (p = 0.67). Presenile Alzheimer's disease cases were less likely to have a parent die with cerebrovascular disease (χ2 = 4.80, p < 0.05) and vascular dementia cases more likely to have a parent die with cerebrovascular disease (χ2 = 5.28, p < 0.05). There was no increased incidence of other vascular disease or bronchogenic carcinoma in cases' parents compared with control individuals' parents.

Familial or sporadic clusters of presenile dementia in Scotland

Between 1974 and 1988, discrete areas within Scotland had unexpectedly high incidences of presenile Alzheimer's disease. To examine whether these clusters might be attributable to 'familial' cases occurring in the same locality, we performed a case-control study of parental cause of death entered on death certificates. Cases comprised (1) 145 presenile Alzheimer's disease patients and (2) 73 vascular dementia patients presenting in Lothian between 1974 and 1988. Two control individuals per case, of the same sex, born in the same registration district, and whose fathers had the same occupation as the case's father, were chosen from birth registration data. Parental death certificates for 131 presenile Alzheimer's disease and 65 vascular dementia cases were located. There was no significant association detected between a diagnosis of presenile Alzheimer's disease and dementia as a parental cause of death (p = 0.25), nor for vascular dementia (p = 0.67). Presenile Alzheimer's disease cases were less likely to have a parent die with cerebrovascular disease (chi 2 = 4.80, p < 0.05) and vascular dementia cases more likely to have a parent die with cerebrovascular disease (chi 2 = 5.28, p < 0.05). There was no increased incidence of other vascular disease or bronchogenic carcinoma in cases' parents compared with control individuals' parents.

Cancer, cholesterol, and lipoprotein cholesterols

Within the frame of reference of possible relationships between history of carcinoma, low serum cholesterol, and/or high fecal cholesterol, and keeping in mind familial aggregation of plasma cholesterols and lipoprotein cholesterols, the purpose of this report was to assess relationships of parental mortality and longevity to cancer and coronary heart disease risk factors (cholesterol and lipoprotein cholesterols) in their adult progeny, utilizing the cross-sectional Cincinnati Lipid Research Clinic's Prevalence Study. Multivariate analysis of covariance was used to assess the effect of parental cause of death, if dead, and parental longevity, if alive, for plasma total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol (C-HDL, C-LDL), of their adult progeny. The age, sex, race, cigarette use, alcoholic beverage consumption, dietary saturated fat and cholesterol intakes, recall group, and Quetelet index of the offspring served as covariables, the mothers' and fathers' “death” outcome served as classification variables. Family history was available on 1,702 parents (851 fathers, 851 mothers) of 851 adult offspring. There were several significant parental mortality history: covariable interactions for progeny's plasma cholesterol, C-HDL, and C-LDL. When progeny's dietary cholesterol intake increased, C-LDL fell in progeny whose mothers had lethal carcinoma and rose in those whose mothers had lethal coronary heart disease. As dietary cholesterol increased, C-HDL fell in progeny whose fathers had lethal cancer, and rose in those whose fathers were alive and older than age 75 years. As wine intake increased, C-HDL of progeny whose fathers had lethal cancer rose most markedly, while the C-LDL of progeny whose fathers had lethal cancer fell. Similarly, as mixed alcoholic beverage intake increased, C-HDL levels rose and C-LDL levels fell appreciably in progeny whose mothers and/or fathers had lethal carcinoma. Black progeny whose fathers had lethal carcinoma had low total cholesterol and C-LDL levels when compared with whites. These significant interactions of parental mortality history for their adult progeny's cancer and coronary heart disease risk factors (cholesterol and lipoprotein cholesterols) suggest that familial aggregations of risk factors for both cancer and coronary heart disease appear to involve plasma cholesterol, C-LDL, and C-HDL. Currently, the significant interactions and associations observed in this study cannot be equated with causal relationships. However, these interactions present hypotheses for further longitudinal assessment and substantiation which might explicate causal relationships.