Aynsley-Green Sir Al
Visiting Professor of Advocacy for Children and Childhood, Nottingham Trent University, Nottingham NG1 5LT, UK.
Br Med Bull. 2017 Sep 1;123(1):5-17. doi: 10.1093/bmb/ldx026.
Bereaved children and young people in the UK are 'hidden mourners'.
Review of primary and secondary evidence on childhood bereavement.
Children experience grief that varies according to the circumstance of death and their cognitive ability. Voluntary organizations can be supportive, but provision is patchy and vulnerable to austerity.
Adult-centric denial of the importance and long-term consequences of childhood grief; uncertainty in how best to relate to bereaved children in faiths and in schools.
Increased awareness of the immediate and long-term consequences of childhood bereavement; even young children can experience loss through death.
Better knowledge of the numbers of affected children; longitudinal data to track experiences and outcomes; measuring effectiveness of different approaches; identifying risk factors for early intervention in complicated or prolonged grief; the importance of faith and rituals around death; mapping the provision of services to monitor the impact of austerity.
'Think adult-think child' means that all staff caring for dying adults should take responsibility for asking what the death means for the children in the family, with schools, primary care and faith organizations having protocols and expertise available to support grieving children; recent catastrophes expose need for agencies to have management plans that focus on vulnerable children and young people.
英国失去亲人的儿童和年轻人是“被忽视的哀悼者”。
对儿童丧亲之痛的一级和二级证据的综述。
儿童经历的悲伤会因死亡情况和认知能力的不同而有所变化。志愿组织能够提供支持,但服务提供情况参差不齐,且易受财政紧缩影响。
以成年人为主导,否认儿童悲伤的重要性及其长期影响;在宗教团体和学校中,如何与失去亲人的儿童建立最佳关系存在不确定性。
对儿童丧亲之痛的直接和长期后果的认识有所提高;即使是幼儿也会因死亡而经历丧失。
更清楚地了解受影响儿童的数量;跟踪经历和结果的纵向数据;衡量不同方法的有效性;确定对复杂或长期悲伤进行早期干预的风险因素;死亡相关信仰和仪式的重要性;绘制服务提供情况图,以监测财政紧缩的影响。
“从成年人角度思考,也要从儿童角度思考”意味着,所有照顾濒死成年人的工作人员都有责任询问死亡对其家庭中的儿童意味着什么,学校、初级保健机构和宗教组织应制定相关规程并具备专业知识,以支持悲伤的儿童;近期的灾难凸显了各机构需要制定侧重于弱势儿童和年轻人的管理计划。