Emotional Roller Coaster Research Articles

How Critical Is Mental Health in Transplant Decisions?

Back to table of contents Previous article Next article Professional NewsFull AccessHow Critical Is Mental Health in Transplant Decisions?Leslie SinclairLeslie SinclairSearch for more papers by this authorPublished Online:5 Aug 2011https://doi.org/10.1176/pn.46.15.psychnews_46_15_10_1AbstractThe major motivation for transplanting a kidney from a healthy donor to a patient in kidney failure is to improve the patient's well-being. But does simply transplanting the organ necessarily achieve that end point? Researchers at the Ohio State University Medical Center and at Ashland University in Ohio believe too little attention has been paid to other factors, particularly the mental health of transplant recipients. Kristin Kuntz, Ph.D., notes that the transplantation process can be an emotional roller coaster. Moreover, patients often don't volunteer information about their emotional struggles to their care providers.Credit: Ohio State University"Despite the fact that kidney transplants have been performed for over 40 years, the study of psychosocial factors in transplantation has only really been examined over the past 15 to 20 years by a small number of researchers," said Kristin Kuntz, Ph.D., a clinical assistant professor of psychiatry and the transplant psychologist for the Ohio State University Comprehensive Transplant Center. "For years, the medical community has focused on medical and surgical barriers to transplant, and they have maybe dismissed depression and anxiety as a byproduct of living with a chronic illness. Of course, some patients may meet criteria for an adjustment disorder, and their symptoms may resolve once they feel better physically. But for those who have a longstanding history of psychological distress, continued distress after transplant can lead to poorer medical outcomes," she told Psychiatric News. Kuntz and co-researcher Diane Bonfiglio, in a report published in the online Journal of Clinical Psychology in Medical Settings in June, examined rates of psychological distress experienced by renal-transplant candidates using the Patient Health Questionnaire (PHQ) in a sample of 518 end-stage renal-disease patients at the point of first contact with the transplant center. In this sample, 15.1 percent of patients indicated symptoms consistent with a depressive condition, and 7.6 percent had symptoms consistent with an anxiety disorder. "Patients present to the transplant clinic in many cases after years of living with kidney disease and facing the challenges of chronic illness, which can lead to poor quality of life and depression. Transplantation may feel to them like their only hope of having an improved quality of life (and longer life), so anxiety about whether they will be approved for transplant often ensues," said Kuntz. The researchers expressed concern that the rates of psychiatric illness symptoms they detected were lower than expected. They cited a less distressed sample, selection biases, or underreporting of symptoms due to patients' motivation to present themselves positively as possible causes for the underreporting. They also noted that the PHQ was developed for use in medical settings and is less likely than other assessment methods to confound psychological diagnosis with unrelated somatic complaints, such as symptoms of uremia—anorexia, lethargy, trouble sleeping, and decreased mental acuity—that kidney-failure patients can experience. "This quality of the PHQ may make it more likely to estimate psychological distress in a more conservative manner," they noted. Kuntz explained why detecting mental health concerns in transplant candidates is so crucial: "In the early stages of evaluation, depression and anxiety can lead to problems with patients not showing up to appointments or not completing them in a timely manner. When psychological distress is identified early, we can help patients get the proper treatment to help them in coping successfully throughout the transplant process." Kidney transplant recipient Michelle Buonfiglio agreed: "Identifying mental health issues in renal-disease patients might help with medication compliance, will possibly have a positive effect on the overall health of the patient, and might increase patient 'mental readiness' at the time of the transplant, leading to more successful posttransplant compliance and success," she told Psychiatric News (see From Disease to Transplant: a Very Personal Travelogue). "I think patients also have to be taught skills to cope with issues that will develop posttransplant, to help them overcome setbacks and obstacles more quickly as they heal." The researchers offered advice to practitioners working with this patient population. "Patients should be informed that it is to their benefit to be honest about how they are coping during what can be a difficult time psychologically so they can be referred for appropriate treatment. Given that patients listed for kidney transplant may wait several years before receiving a transplant, there is time for them to pursue psychiatric treatment." An abstract of "Psychological Distress in Patients Presenting for Initial Renal Transplant Evaluation" is posted at <www.ncbi.nlm.nih.gov/pubmed/21630000>. ISSUES NewArchived

Mothering and intellectual disability: partnership rhetoric?

This paper is about mothering an intellectually disabled child identified with special educational needs. It specifically looks at the parent partnership rhetoric that has dominated UK government policy and directives for nearly three decades and yet research suggests parents and more often mothers have to battle to be recognised as legitimate experts. This paper engages with sociological analysis as it highlights via qualitative narratives that mothers are weighed down by the sheer number of professionals involved in their day-to-day life. Moreover, mothers whose children are not identified in the early years are often blamed in the first instance for playing a part in their child’s difficult behaviour. This research ultimately suggests that partnership work is important and necessary for practice within health, education and social work professions, not least of all because the emotional roller-coaster that mothers experience during the assessment and statementing process is disabling.

Tales from an academic RNAi screening facility; FAQs

RNAi technology is now a well-established and widely employed research technique that has been adopted by many researchers for use in large-scale screening campaigns. Here, we offer our experience of genome-wide siRNA screening from the perspective of a facility providing screening as a service to a wide range of researchers with diverse interests and approaches. We have experienced the emotional rollercoaster of screening from the exuberant early promise of a screen, the messy reality of the data through to the recognition of screen data as a potential information goldmine. Here, we use some of the questions we most frequently encounter to highlight the initial concerns of many researchers embarking on a siRNA screen and conclude that an informed view of what can be reasonably expected from a screen is essential to the most effective implementation of the technology. Along the way, we suggest that for this area of research at least, either centralization of the resources or close and open collaboration between interested parties offers distinct advantages.

Hope and Realism: The Perfect Balance?

DOI: 10.1200/JCO.2010.34.5348 During my career as a thoracic oncologist, certain patients have left a lasting impression. Mrs R was one such patient: a woman in her early 50s who appeared younger than her age. When we first met, she greeted me with a smile that belied her underlying sense of anxiety. Mrs R had already been treated for lung cancer for more than 2 years before she was referred to my clinic. She had endured many chemotherapy regimens, including combinations with and without bevacizumab, and had also been treated with erlotinib twice without much benefit. Review of her records and scans revealed that her lungs were now filled with many metastases, some quite large, and that there was also disease in her liver and bones. After evaluating her, I was surprised by her continued good performance status. I even considered leaving the room to confirm that the scans I had just reviewed were actually hers. In the examination room, Mrs R was surrounded by numerous loving family members, including her husband and mother. She was a never-smoker, and before her lung cancer diagnosis, she had led a fulfilling life. She was one of those patients who make you wonder why such a calamity should befall such a warm person. I discussed with Mrs R and her family the available clinical trials at our center, with an assurance that probably conveyed a greater sense of optimism than her clinical condition warranted. In the lung cancer world, there is currently a great deal of buzz about patients with tumors that have alterations in the ALK gene and the exciting clinical benefit some such patients enrolled onto early-phase clinical trials have derived from therapy with an ALK inhibitor. I felt strongly that Mrs R’s tumor should be assessed for the presence of an ALK translocation. She was young and had never smoked, and her cancer had not responded well to erlotinib, making it unlikely that her tumor harbored an EGFR mutation. In such patients, available data suggest that there is approximately a 30% probability that their tumor will be positive for an ALK gene alteration, and among those with an ALK mutation, there is a 60% chance of response to ALK inhibition. Although I am sure that I quoted Mrs R and her family the correct probabilities, I later wondered whether my enthusiastic attitude in the consultation room had conveyed a much higher, and less realistic, likelihood that one of our trials could provide her with a lasting and meaningful clinical benefit. I myself experienced a sense of satisfaction that I had given hope to a patient who did not have many therapeutic options. We sent her diagnostic tumor tissue for ALK mutation testing. Unfortunately, after 2 weeks, the reference laboratory informed me that the available tumor material was not sufficient for ALK analysis. I decided that a computed tomography–guided biopsy of one of the many lung metastases would be appropriate. Although the incidence of complications after such a biopsy at our institution is quite low, she developed a pneumothorax that required hospitalization. She was clearly on an emotional rollercoaster, beginning with the optimism she had felt after her initial visit with me followed by the disappointment of learning that her available biopsy material was inadequate for testing and then the complication of the biopsy procedure. I am fairly certain that when she agreed to undergo the biopsy, she fully believed that her tumor would have an ALK mutation. Two weeks later, I obtained the results: the laboratory had not detected an ALK gene rearrangement. I felt a strong sense of failure, both for Mrs R and for myself. As promised, I called her as soon as I received the report. It was challenging for me to inform her of the negative results, but her immediate response was simply to ask what the next step would be. With a sigh of relief, I quickly moved on to discuss another clinical trial that might be appropriate for her. I scheduled her to come and see me again to discuss the other trial in person. During this visit, I noticed some whitish changes in her gums that did not seem consistent with oral candidiasis. I sent her to an oral surgeon who diagnosed osteonecrosis of the jaw. She had been on bisphosphonate therapy for more than 1 year for her bone metastases. The oral surgeon debrided her gums and prescribed a course of oral antibiotics, with plans for reevaluation in 3 weeks. I discussed her situation with the sponsor of the clinical trial I was considering for her and requested her inclusion in the trial. The JOURNAL OF CLINICAL ONCOLOGY T H E A R T O F O N C O L O G Y VOLUME 29 NUMBER 16 JUNE 1 2011

Men's involvement in antenatal screening: A qualitative pilot study using e-mail

Objectives this study aimed to explore and analyse men's involvement in antenatal genetic screening and testing in England, and evaluate the use of e-mail communication as a method of health research with men. Design after receiving a favourable ethical opinion, a longitudinal qualitative pilot study was undertaken. Participants eight men, whose partners were pregnant, were recruited by purposive sampling. Findings findings indicated that the men experienced ambivalence, doubts and uncertainty about medically identified genetic risks, and also experienced an ‘emotional rollercoaster’, which was associated with their involvement in antenatal genetic screening and testing. Although connectedness with their partners and shared decision making were highly valued, men's involvement was mediated by their partners and health professionals, including midwives. Conclusions and implications for practice the implications of findings for medicalisation theory and future research are discussed. Using e-mail was a success in that the strong pilot data produced provides a stimulus for future research. In addition, implications for policy and practice are also considered, specifically the importance of addressing ambivalence and mediation if midwives are to communicate effectively when working with men and women regarding antenatal genetic screening and testing.

The Unsilencing of Military Wives: Wartime Deployment Experiences and Citizen Responsibility

One of therapists' contemporary moral imperatives is to support American service members and their families regardless of personal position on the Global War on Terrorism. One way therapists can respond to this imperative is by seeking to understand Army wives' experiences during their husbands' wartime deployments. Therefore, this study utilized a combination of individual interviews with Army wives and a reflecting team of military wives and civilians to explore military wives' experiences. Two main themes were identified: the wives' experience was an emotional roller coaster and they felt silenced--and could be unsilenced--in their interactions with civilians. Therapists working with Army wives should (a) normalize the roller-coaster experience; (b) encourage wives to recognize negative and positive influencers and explore their idiosyncratic coping skills; (c) support positive civilian-military connections; and (d) as a civilian and as a therapist, seek to be a positive civilian connection by proactively showing support.

Perceptions of recovery during the early transition phase from hospital to home following acquired brain injury: A journey of discovery

The increasing volume of literature concerning community-based rehabilitation for individuals with acquired brain injury (ABI) has recently brought into focus the importance of the early hospital-to-home transition phase. The present study aimed to explore the perspectives of individuals with ABI and their family caregivers concerning recovery and adjustment during the early transition phase from hospital to home. The study utilised a qualitative phenomenological design and included 20 participants with ABI and 18 family caregivers. Participants completed in-depth semi-structured interviews at the following time points: pre-discharge, and 1 and 3 months post-discharge. Data analysis entailed thematic analysis of the interview transcripts and incorporated open, axial and selective coding techniques. The following four primary themes emerged from the analysis process: (1) adapting to life in the real world; (2) variations in recovery; (3) the emotional adjustment rollercoaster; and (4) discovering the new me. Collectively, the findings highlight that while returning home was typically perceived to facilitate ongoing recovery, the process of adjusting emotionally to life at home posed a significant challenge for many participants during the transition phase. The clinical/service implications of the findings relate to the need for: (1) contextually appropriate rehabilitation options during the transition phase; and (2) the expansion of transition-based models of service delivery to include targeted psychological intervention approaches.

Women’s perceptions and experiences of a traumatic birth: a meta‐ethnography

This study presents the findings a meta-ethnographic study reporting women's perceptions and experiences of traumatic birth. Childbirth is viewed by many as a life transition that can bring a sense of accomplishment. However, for some women, birth is experienced as a traumatic event with a minority experiencing post-traumatic stress. A traumatic birth experience can have a significant impact on the physical and emotional well-being of a woman, her infant and family. The CINAHL, MEDLINE, Scopus and PubMed databases were searched for the period January 1994 to October 2009 using the keywords birth trauma, traumatic birth, qualitative research, birth narrative and birth stories. A meta-ethnographic approach was used. Quality appraisal was carried out. An index paper served as a guide in identifying particular findings and comparing them with other findings. This 'reciprocal translation' process started with a search for common themes, phrases and metaphors. Ten qualitative studies were included in the final sample. Six major themes were identified: 'feeling invisible and out of control', 'to be treated humanely', 'feeling trapped: the reoccurring nightmare of my childbirth experience', 'a rollercoaster of emotions', 'disrupted relationships' and 'strength of purpose: a way to succeed as a mother'. It is evident that a small percentage of women experience a traumatic birth. Although some women who experience a traumatic birth do not necessarily have physical or psychological adverse outcomes, others identify a significant personal impact. Healthcare professionals must recognize women's need to be involved in decision-making and to be fully informed about all aspects of their labour and birth to increase their sense of control.

Voices - The election has been an emotional roller coaster for Elizabeth Anionwu

Voices - The election has been an emotional roller coaster for Elizabeth Anionwu

Achievement motivation and intraindividual affective variability during competence pursuits: A round of golf as a multilevel data structure

Competence pursuits can create an emotional roller-coaster for performers but little is known about how affect, thoughts, or behaviors vary over time during such pursuits. This study applied achievement motivation theory to predict intraindividual variability in affect, goals, and performance during a round of golf. In general terms, results indicated that golfers’ mood influenced the strength of achievement goals; however, neither affect nor goals predicted performance for a given hole. Performance, mastery-based goals, avoidance goals, and fear of failure were linked to affective changes from the beginning to end of a hole. These results illustrate how individual differences in achievement motivation are a part of an integrated system of affect, cognition, and behavior during competence pursuits.

Grandparenting a child with a disability: An emotional rollercoaster

As our knowledge about the experiences of grandparents when their grandchild has a disability is extremely limited, the purpose of this research was to explore the emotional journey of Australian grandparents. This qualitative research utilised purposive sampling and semi-structured in-depth interviews to explore the experiences of 22 Australian grandparents, whose grandchild had been diagnosed with a disability. Three key themes characterized grandparent's emotional journey: adjusting (the transition from anger to acceptance), the 'double grief' (sadness about what might have been for both their child and grandchild) and pride in family (pride in family's ability to adjust to the challenges of the situation). As the first Australian study to explore the experiences of grandparents when their grandchild has a disability, the research provides important new knowledge about the emotional journey for grandparents. Unlike overseas research, Australian grandparents view themselves as being there to support their own children, rather than 'holding the family together'. The findings will provide current policy debates about the role of grandparents and highlight the importance of support services that help facilitate grandparent's role within their family.

What's stopping you?: shatter the 9 most common myths keeping you from starting your own business

“This book dispels the myths surrounding the process of starting a business, and gives hope and encouragement to people who would like to give it a try.”-Tim Berry, Founder and CEO, Palo Alto Software Creators of the World's Most Popular“Bruce Barringer and Duane Ireland's new book, What's Stopping You? is an insightful and thought-provoking examination of nine common myths that discourage individuals from starting new businesses. ... This book is much-needed and long overdue.... The value of What's Stopping You? is that it effectively debunks the false premises that too often preclude acts of business start up. What's Stopping You? is an encouraging, instructive, and eloquently written book that would be a valuable addition to any aspiring entrepreneur's bookshelf.”Jeffrey G. Covin, Samuel and Pauline Glaubinger Professor of Entrepreneurship, Kelley School of Business, Indiana University, Bloomington, Indiana“Over the years I have observed many seemingly great business opportunities never get off the ground. Quite often, what holds these aspiring entrepreneurs back are common misconceptions about the difficulties and risks of starting a new business. In What's Stopping You?, Professors Barringer and Ireland systematically break down the myths that hold many entrepreneurs back from pursuing their dreams.”Jeffrey R. Cornwall, The Jack C. Massey Chair in Entrepreneurship, Belmont University, Nashville, Tennessee“Barringer and Ireland simultaneously demystify start-up misconceptions and empower readers to explore their own opportunity with renewed passion. Many prospective entrepreneurs feel trapped by myths, the authors carefully detail the myth's fallacies and encourage the reader to see beyond start-up stereotypes. Future and experienced entrepreneurs have much to learn from What's Stopping You?”Sarah Schupp, Founder/CEO, University Parent Media, Boulder, Colorado“Creating your own business from scratch can be a mental, emotional, and financial roller coaster ride. Bruce Barringer and Duane Ireland's book provides a 'voice of reason' and helps give you the confidence to realize you can do it. They recognize that starting a business is hard work, but that it is attainable-and that you should celebrate your accomplishments every step of the way.”Jan Stephenson Kelly, Cofounder/CEO, Spark Craft Studios, Cambridge, MABusiness Plan Software Follow Your Dream! Start Your Own Winning Businessi¾–Now!·Get past the myths that keep you from making the leap·Gain the practical skills and confidence you need to succeed·Quickly evaluate business ideas and pick a winner·Launch your company and watch it grow and profitBuild the business you've always dreamed of! Take control of your future and achieve the breakthrough success that's only possible when you're working for yourself. You can do it-and this book will show you how.Forget the myths that have been standing in your way. You don't need to be rich. You don't need extensive business experience. You don't need to be a genius. You don't need a revolutionary product or service. You can handle the risk, the competition, and the challenges.The proof's on every page of this book: case studies of “ordinary” people building great businesses and practical techniques you can use, too-every step of the way!

A Systematic Review of Relocation Stress Following In-House Transfer Out of Critical/Intensive Care Units.

A Systematic Review of Relocation Stress Following In-House Transfer Out of Critical/Intensive Care Units.

A Systematic Review of Relocation Stress Following In-House Transfer Out of Critical/Intensive Care Units

A Systematic Review of Relocation Stress Following In-House Transfer Out of Critical/Intensive Care Units

‘A real rollercoaster of confidence and emotions’: learning to be a university student

Accounts of emotion and affect have gained popularity in studies of learning. This article draws on qualitative research with a group of non‐traditional students entering an elite university in the UK to illustrate how being and becoming a university student is an intrinsically emotional process. It argues that feelings of loss and dislocation are inherent to the students’ experiences of entering university, and that ‘coming to know’ a new community of practice is an emotional process that can incorporate feelings of alienation and exclusion, as well as of excitement and exhilaration. A broader understanding of how students learn then depends not just upon the individual’s emotional commitment to developing a new learning identity, but on the emotional interaction between the student and the learning environment of the university.

Becoming a foundation year 1 doctor in August 2008?

It’s a cliche but also very true: the year ahead will be a huge rollercoaster of emotions and experiences. You may begin to doubt this if you’ve been left with unbanded jobs and few on-calls but it will still be one heck of an experience. No other occupation involves the highs and lows and the number of times a serious career change is considered as a career in medicine. That is even after just one year. Having emerged from an unbanded, though fairly busy 9-5-ish medical house officer job, I moved through a very busy surgical rotation with on-call commitments and am currently doing an interesting yet laid back psychiatry post. The first few weeks of every job are the hardest. While trying to get your head around different policies, the mind numbing rotas, and trying to ensure you get paid, thoughts often fill your mind—“Will my team like me?” “Will the nursing staff make my life a misery?” “Will I look like a fool …

Applying for doctorate in clinical psychology training courses: A roller-coaster of emotions

This article describes the reflections of two assistant psychologists on the turbulent journey for the Holy Grail that is a clinical psychology training place. Psychological literature and personal experiences provide a framework to understand challenges faced.

The Laugh Factory?: Humor and Horror at Le Théâtre du Grand Guignol

The Laugh Factory? Humor and Horror at Le Théâtre du Grand Guignol Felicia J. Ruff Jean Aragny and Francis Neilson’s Le baiser de sang opens with the following stage direction and dialogue: [Professor Leduc and Dr. Volguine are wearing surgical masks as the curtain rises. Stage right, dressed head to foot in white, the Male Nurse stands next to the trolley. . . . The Patient is a bald man. He is in pain, in spite of the chloroform, stirring and crying out from time to time. A cross-shaped incision has been made on the forehead above the right eye. The flaps of skin are clipped back so that the frontal bone of the skull is exposed. Holes have been drilled in the trepanning drill. Everybody is leaning over, with outstretched necks, and attentively following the Professor ’s every move.] prof. leduc. It’s no good. It’s not going to work. The lesion means that I’m going to have to drill here . . . and not here after all . . . there’s no alternative . dr. volguine. That’s the most resistant spot. leduc. Yes. A compress . . . and another . . . and another one . . . a swab . . . how’s his pulse? volguine. Very weak. leduc. What about his legs? Are they cold? volguine. Very cold. leduc. (raising his eyelids, then raising his eyes upwards): I only hope he’s not going to give us any trouble with his circulation like the Dutchman the other day. Get the caffeine ready, a small amount. (The Male Nurse bustles about.) Swab! (He begins to drill. The Patient stirs.) Just a moment ! (The Professor stops drilling. Volguine hands him a stethoscope. He listens.) This is bad . . . give him a jab immediately. (He listens) This is bad. 66 F E L I C I A J . R U F F (Volguine gives an injection.) Let’s do this quickly. (He succeeds in drilling the hole. The Patient groans almost silently. The Professor hands back the stethoscope.) All done. volguine. I can’t feel a pulse. Within seconds they pronounce the patient dead, lamenting that “he was brought in . . . ten minutes too late.”1 A man has just died, a scenario that seems poorly designed to prompt laughter. Truth be told, however, I laughed really hard when I saw the play performed this fall by a New York company, Blood Brothers, and not because it was poorly done. Quite the contrary. When I found myself laughing, which I did several times during the scenes of graphic violence, I immediately had these reflexive moments, “What does this say about me?” and “What must my friend think of me?” Originally, the play debuted in 1929 as part of Le Théâtre du Grand Guignol’s season . This notorious French theatre remains famous for having staged plays of horror that featured scenes of graphic violence. Today the term Grand Guignol has evolved into an adjective, accurately conjuring images of blood and gore. But this company of artists, who entertained through scenes of strangling, limb-severing, disemboweling, and maiming , among numerous other tortures, deliberately incorporated laughter into the macabre entertainment. Grand Guignol is perhaps an appropriately bizarre topic in an academic consideration of comedy; however, Grand Guignol merits serious study because this horror theatre employed comedy and laughter very strategically. Like a variety show, a night at the Grand Guignol featured at least three or four short plays; from Grand Guignol’s inception, a night’s performance featured scenes of horror alternating with one-act comedies. The integration of comedy was designed to offer more than simple comic relief. Grand Guignol is a theatre of extremes, most especially extreme emotional states, and by comingling fear and laughter, the theatre artists manipulate the audience. A term was designated that summarized the emotional roller coaster an audience member experienced : douche ecossaise, a hot and cold shower.2 An examination of the function of comedy at Le Théâtre du Grand Guignol from historical, performative, and generic perspectives raises the specter of the relationship between humor and horror. Since this performance tradition consciously strove to provoke laughter, important questions are raised regarding comedy and genre categories. A night at the Grand Guignol negotiates laughter and terror, bringing into...

Family members’ experiences of the intensive care unit waiting room

This paper is a report of a study to explore family members' perspectives and experiences of waiting rooms in adult intensive care units. Waiting to visit family members who are hospitalized in intensive care units can be very stressful. Although flexible and or open visiting is practised in many hospitals, family members may spend a great deal of time in the waiting room. A qualitative design using semi-structured interviews was used and the data were collected in 2004. A convenience sample of six visitors was recruited from waiting rooms of three different adult intensive care units. Data collection and analysis were concurrent. Six categories emerged from the data that included structural and subjective aspects of waiting: 'close proximity' referred to the importance of a close physical distance to their family member; 'caring staff' captured the comfort family members felt when staff showed caring behaviours towards relative; 'need for a comfortable environment' represented the impact of the design of the waiting room on family members well-being; 'emotional support' referred to the waiting room as a place where comfort was found by sharing with others; 'rollercoaster of emotions' captured the range of emotions experienced by family members; 'information' referred to the importance of receiving information about their relative. Future research should focus on the impact of the interior design of waiting rooms on the comfort and welfare of family members and on identifying needs of family members across different cultures.

Loss of a preterm infant: psychological aspects in parents.

The unexpected death of a preterm infant is an extremely painful situation for parents. Despite a number of quantitative studies, little is known about parents' inner experience. The aim of this study was to gather more in-depth information about what preoccupies parents in this situation of suffering, thus leading to a deeper understanding of their dealing with the stressful event and enabling more adequate support to be provided by professionals. 10 mothers and 9 fathers, who had lost their extremely premature infant born between 24 and 26 weeks of gestation were invited for a semi-structured interview and retrospectively asked about their emotional, cognitive, physical and social experience at three different points in time (time of hospitalisation, 6 months and 3.5-6.5 years after the loss). The interviews were analysed by method of qualitative context analysis. The loss of a preterm infant is an extremely intense experience for parents resulting in a rollercoaster of emotions and perceptions as well as relevant effects on the social network. The strain of this situation notwithstanding, parents also experience positive aspects, eg, feelings of closeness to their infant, comforting thoughts or help from their social network. Although still mourning the loss of their baby, most parents have overcome the tragic event. Most parents seem to have the psychological strength to overcome the traumatic experience of losing their premature infant and are able to face life normally again. Professionals can play an important role in supporting them. Some parents require additional help to overcome the loss.