School nurses' support for bereaved students: a pilot study.

Children may have difficulty with schoolwork because of grief over the death of an important person in their lives. School nurses provide support to these children. This pilot study consisted of a Web-based survey completed by 6 school nurses in a 3-county area in Washington state. The purpose of this pilot study was to assess the need for additional support for bereaved children and the extent to which school nurses meet the needs of these students. Results indicated that many school nurses have large caseloads that preclude spending as much time with bereaved students as the nurses feel is necessary. Bereaved students exhibit a wide variety of grief symptoms that may interfere with learning. In addition, rural areas do not have adequate community bereavement resources that nurses can use to refer students who need help beyond that offered at school. Nurses must be more active in supporting students within the school setting despite limited resources.

Suicide ideation among parents bereaved by the violent deaths of their children.

Suicidal behaviors of parents bereaved by a child's suicide have received considerable attention by researchers, but deaths by other violent causes have not. We observed 175 bereaved parents for five years following three types of violent death: accidents, homicides, and suicides. The results showed that the incidence of suicidal ideation (SI) among the study parents was 13% (n = 34) over the 5 years and 9% (n = 24) at the initial data collection four months after the death of an adolescent or young adult child. Comparisons of study parents grouped by the presence or absence of SI showed that after corrections were made for the number of t-tests conducted, statistically significant differences on three of four outcome variables remained (mental distress, depression, and posttraumatic stress disorder [PTSD], but not on acceptance of the child's death). The groups also differed significantly on four of seven mediating variables examined. The hypothesis that parents whose children died by suicide would report the highest incidence of suicidal ideation was not supported. Regression analyses showed that SI was a significant predictor of depression one year, but not five years, after the violent death of a child. The hypothesis that SI would predict both depression and PTSD one year postdeath was not supported. Clinical and policy recommendations are offered.

Bereaved parents' outcomes 4 to 60 months after their children's deaths by accident, suicide, or homicide: a comparative study demonstrating differences.

In this article, the authors revisit a controversial issue in the bereavement field: Does one violent cause of death of a child influence parents' outcomes more than another? To address this question, we observed 173 parents prospectively 4, 12, 24, and 60 months after their children's deaths by accident, suicide, or homicide. Quantitative and qualitative research methods were used to examine the influence of three types of a child's violent death and time since death upon 4 parent outcomes (mental distress, post-traumatic stress disorder [PTSD], acceptance of the child's death, and marital satisfaction). The results showed a significant interaction for the bereavement Group x Time effect for acceptance of death, a significant main effect for time for all four outcomes, and a significant main effect for group (homicide) for PTSD. Nearly 70% of the parents reported that it took either 3 or 4 years to put their children's death into perspective and continue with their own lives; however the child's cause of death did not significantly influence parents' sense of timing in this regard. Clinical and research implications of the findings are discussed.

Challenging the myths about parents' adjustment after the sudden, violent death of a child.

PURPOSE: To examine three commonly held myths: (a) a child's death by suicide results in the worst parental outcomes compared with other causes of violent death, (b) divorce is not only more common among bereaved than nonbereaved married couples, it might be inevitable, and (c) "letting go and moving on" is an essential bereavement task needed for a satisfactory adjustment following the violent death of a child. DESIGN AND METHODS: Review of empirical evidence and critical reviews, review of Internet resources available to the general public, and the inclusion of original data obtained from a longitudinal, prospective study conducted by the authors. FINDINGS: Conclusive evidence was found to dispel two of the three myths, but sufficient evidence was not found to draw conclusions about the third myth regarding parents' adjustment to a child's suicidal death. CONCLUSIONS: Myths in regard to parental bereavement are resistant to disconfirming evidence and they appear to persist among professional practitioners and the general public despite contrary empirical evidence.

Bereaved parents' use of individual, family, and community resources 4 to 60 months after a child's violent death.

We recruited a community-based sample of 261 parents bereaved by the violent deaths of their 12- to 28-year-old children. Parents were observed over time, and data were collected from several sources. The findings showed that of six individual, family, and community resources examined, none of the resources seemed to improve parents' outcomes either 1 or 5 years later. Implications of the findings are discussed.