Young children's grief: parents' understanding and coping.

The grief experiences of young children and the interactional dynamics between parents and children leading to healthy grieving remain comparatively under researched. This article reports a qualitative evaluation of a Norwegian Bereavement Support Program where 8 parents described their young child's grief reactions and coping and how these intersected with their own grief. Successful parental coping with their child's grief involves understanding the child's genuine concerns following the death and an intricately holistic balance between shielding and including, between informing and frightening, and between creating a new life while cherishing the old.

Balance artistry: the healthy parent's role in the family when the other parent is in the palliative phase of cancer--challenges and coping in parenting young children.

OBJECTIVES: The aim of this review was to provide a systematic overview of knowledge on how advanced cancer in a parent impacts the healthy parent's role in a family with children aged 6-12 years, and the types of help that they require in order to cope. Despite the large number of families living with a parent affected by cancer, the literature is limited concerning the needs and outcomes for the healthy parents and their need for support in managing their children's needs, when the partner is seriously ill or is in the palliative phase of cancer. METHOD: Comprehensive literature searches were undertaken by systematically searching for qualitative articles published during the period 1989-2009. The quality assessment was evaluated using a predefined "checklist to assess qualitative research." RESULTS: Seven articles met our eligibility criteria. Four distinct themes emerged that describe the healthy parent's role in the family, whose life is now characterized by uncertainty and who is attempting to maintain a balance between the needs of their children, the patient, and themselves: (1) new roles without a script, (2) attempting to maintain a safe and normal life, (3) feeling alone even within the family, and (4) support to help young family members. SIGNIFICANCE OF RESULTS: The present review provides new knowledge and insight into how healthy parents manage the challenges in parenting young children, coping with their everyday lives, and taking on new roles when their partner has advanced cancer or is dying. The healthy parent cannot balance the needs of all family members. To reach the goals of palliative care, nurses and other health professionals are encouraged to offer the patient, the healthy parent, and the children practical and emotional support.

Adolescent bereavement: embodied responses, coping and perceptions of a body awareness support programme.

AIMS AND OBJECTIVES: This study describes the implementation and evaluation of a new Body Awareness Programme (BAP) in bereavement support for adolescents. The BAP's aims were to provide information and insight into adolescents bodily reactions, to help them develop a deeper understanding of the reasons for bodily reactions and to introduce adolescents to healthy coping techniques. BACKGROUND: Three main bodily reactions can follow a traumatic event such as the death of a loved one. The arousal of physical responses causes restlessness, concentration problems and disturbed sleep while 'flashbacks' of unpleasant memories contribute to increased tension. Active avoidance manifests as increased activity and avoidance of talking or thinking about unpleasant memories. These reactions may interfere with an adolescent's development and inhibit a healthy grieving process. DESIGN: A qualitative, hermeneutic-phenomenological design. METHODS: Data were collected using the BAP together with in-depth interviews with adolescents, focusing particularly on their experiences or recollections of their bodily reactions and coping. Seven adolescents participated, aged 13-18 years, who use our bereavement services. RESULTS: The adolescents in our study internalised their struggles, and beneath their facade of coping, they reported having painful bodies that were stiff and restless. They were also anxious, experiencing painful thoughts of the deceased. The adolescents found the BAP helpful because they gained awareness of the body-behaviour-feelings connections, experiencing the techniques as helpful and possibly useful in their everyday lives. CONCLUSION: The results of this evaluation of the BAP are positive and suggest that this approach is both necessary and valuable in a bereavement support programme for adolescents. RELEVANCE TO CLINICAL PRACTICE: Adolescents must recognise their own embodied reactions and understand their underlying causes before they can change their attitudes or seek appropriate help during bereavement. Health professionals should see beyond adolescents' facades and offer them support.

Parents' experiences of a Family Support Program when a parent has incurable cancer.

AIMS AND OBJECTIVES: The Family Support Program was created to support children and parenting when one of the parents has incurable cancer. We chose a family-based approach to support parent's coping and to help families pull together, identify strengths in the family and learn how to seek help. BACKGROUND: Cancer is usually a new experience for young families. In most cases, parents do not have the necessary knowledge about their children's need for information and support about their parent's serious illness and impending death. DESIGN: A qualitative evaluation study based on data collected through in-depth interviews focusing on parent's experiences with the Family Support Program. METHODS: Participants were patients with incurable cancer and their partners and ex-partners with children aged between 5-18 years. Thirteen parents were in-depth interviewed. RESULTS: Parents described how the Family Support Program helped them gain greater insight into their children's thoughts and reactions and into how the situation affected their daily living. Parents reported that conflicts were reduced, they could talk more openly about the situation in the family and that they were shown how to support their children's coping. CONCLUSION: The Family Support Program met the parents in the study's needs for more information and support about how to cope with their children during the patient's terminal illness. RELEVANCE TO CLINICAL PRACTICE: The Family Support Program is described in detail in a manual that makes it easy for other health workers to use the same programme. The Family Support program was in use in outpatient clinics, oncology wards and palliative care units and was provided both from nurses and social workers trained in cancer care. Parent's in the study would like the Family Support Program to be available to all patients who receive the poor prognosis that their cancer cannot be cured.

Children's experiences of participation in a family support program when their parent has incurable cancer.

For a child, facing the imminent death of a parent is a highly stressful situation. This study assessed a preventive support program for children aged between 5 and 18 years and their families when a mother or father has an incurable form of cancer. We chose a family-based approach to reduce risk factors and enhance protective factors by increasing positive interactions between parents and children and by increasing their mutual understanding of the illness and its family impact. In this article, we focus especially on the children's experiences of how the Family Support Program met their needs and supported their coping. The qualitative study involved collecting descriptive data via in-depth interviews with children of cancer patients in palliative care after participation in the Family Support Program. The program helped the children to feel more secure; increased their knowledge and understanding; helped them become aware of their own role, their family's strengths, and whom they could approach for help; and helped them realize that it was good and helpful to talk about the illness situation. They needed to talk in private without having to think about other family members' reactions, but they also needed to be in dialogue with other family members.