The dying child and overt parental behavior.

In order to study the immediate grief reaction in parents of children dying in the hospital each parental reaction was scored on a 'grief reaction and intervention' (GRI) scale (minimum 0; maximum 4). The death events of 73 children comprised the study. The GRI score was 0 in 10 (13.7%), 1 in 19 (26.1%), 2 in 21 (28.7%), 3 in 15 (20.5%) and 4 in 8 (11%) cases; the mean (+/- SD) score was 1.89 (+/- 1.20). Crying, weeping spells, hostility, restlessness, denial of death, mutism, impulsivity and destructive behavior were observed. A significantly higher grief reaction was observed among parents of grown up children and those from an urban background. An intense reaction was also seen in cases when the course of illness was acute and death was not anticipated. Parents of male children of the first and second birth order also had higher GRI scores. Our findings suggest that socio-cultural factors may influence the intensity of the parental grief reaction.