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一项关于儿童临终期间父母悲伤动态变化的扎根理论研究。

A grounded theory study on the dynamics of parental grief during the children's end of life.

作者信息

Kochen Eline M, Grootenhuis Martha A, Teunissen Saskia C C M, Boelen Paul A, Tataranno Maria-Luisa, Fahner Jurrianne C, de Jonge Roos R, Houben Michiel L, Kars Marijke C

机构信息

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Department of Psycho-Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.

出版信息

Acta Paediatr. 2023 May;112(5):1101-1108. doi: 10.1111/apa.16716. Epub 2023 Mar 1.

Abstract

AIM

Parents are increasingly confronted with loss during their child's end of life. Healthcare professionals struggle with parental responses to loss. This study aimed to understand parental coping with grief during their child's end of life.

METHODS

A grounded theory study was performed, using semi-structured interviews with parents during the child's end of life and recently bereaved parents. Data were collected in four children's university hospitals and paediatric homecare services between October 2020 and December 2021. A multidisciplinary team conducted the analysis.

RESULTS

In total, 38 parents of 22 children participated. Parents strived to sustain family life, to be a good parent and to ensure a full life for their child. Meanwhile parents' grief increased because of their hypervigilance towards signs of loss. Parents' coping with grief is characterised by an interplay of downregulating grief and connecting with grief, aimed at creating emotional space to be present and connect with their child. Parents connected with grief when it was forced upon them or when they momentarily allowed themselves to.

CONCLUSION

The parents' ability to engage with grief becomes strained during the end of life. Healthcare professionals should support parents in their search for a balance that facilitates creating emotional space.

摘要

目的

在孩子生命末期,父母越来越多地面临丧亲之痛。医护人员在应对父母对丧亲之痛的反应时倍感艰难。本研究旨在了解父母在孩子生命末期如何应对悲痛。

方法

开展了一项扎根理论研究,对孩子生命末期的父母以及近期丧亲的父母进行了半结构化访谈。2020年10月至2021年12月期间,在四家儿童大学医院和儿科家庭护理服务机构收集了数据。由一个多学科团队进行分析。

结果

共有22名儿童的38位父母参与。父母努力维持家庭生活,努力成为好父母,并确保孩子过上充实的生活。与此同时,由于对丧亲迹象过度警惕,父母的悲痛加剧。父母应对悲痛的特点是在减轻悲痛和直面悲痛之间相互作用,目的是创造情感空间陪伴孩子并与孩子建立联系。当悲痛强加于他们或他们暂时允许自己面对时,父母会直面悲痛。

结论

在生命末期,父母应对悲痛的能力变得紧张。医护人员应支持父母寻求一种平衡,以利于创造情感空间。

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