Existing literature has identified that health care providers significantly shape the experiences of parents at the end-of-life in the pediatric intensive care unit. However, there is a gap in the literature of the specific nursing influence on parental experiences of a child’s death in this context. Employing the interpretive descriptive methodology, this qualitative study was designed to explore parents’ moral experiences of nursing care at the end-of-life in the pediatric intensive care unit, and was analyzed through a lens of nursing ethics. Face-to-face, semi-structured interviews were conducted with eleven parents (six mothers and five fathers) of six children who died in a pediatric intensive care unit at a university-affiliated tertiary hospital in Eastern Canada. Study results revealed close connections between parents’ abilities to meaningfully parent a child through their death and the nursing care that they received at the end-of-life, and highlighted the varying helpful guiding roles that nurses adopted at different moments in parental experiences. Results also indicated that parents attributed immense value to feeling that nurses cared-for-and-about their child and the parents themselves, since this made parents feel that their child’s death mattered to the nurses whom they had formed relationships with. This study enhances our understanding of the individualized nature of parents’ moral experiences of nursing care at the end-of-life in the pediatric intensive care unit, and study results suggest implications for nursing practice, education, and research.

The death of an infant/child is one of the most devastating experiences for parents and immediately throws them into crisis. Spiritual and religious coping strategies may help parents with their loss. The purposes of this longitudinal study were to: 1) describe differences in bereaved parents’ use of spiritual coping strategies across racial/ethnic and religious groups, mother/father dyads, and time – one (T1) and three (T2) months after the infant’s/child’s death in the neonatal (NICU) or pediatric intensive care unit (PICU), and 2) test the relationship between spiritual coping strategies and grief, mental health, and personal growth for mothers and fathers at T1 and T2. A sample of 126 Hispanic, Black/African American, and White parents of 119 deceased children completed the Spiritual Coping Strategies scale, Beck Depression Inventory-II, Impact of Events-Revised, Hogan Grief Reaction Checklist, and a demographic form at T1 and T2. Controlling for race and religion, spiritual coping was a strong predictor of lower grief, better mental health, and greater personal growth for mothers at T1 and T2 and lower grief for fathers at T1. The findings of this study will guide bereaved parents to effective strategies to help them cope with their early grief.

This qualitative study focuses on the stories of a bereaved couple living with the death of two of their children. The effect of the children's death on the parents is explored, as well as the way in which the parents live with the death of their two sons. The stories of the bereaved couple show their courage and resilience in continuing with their lives, maintaining their bond with their deceased sons and trying to make meaning of their death. As a study in practical theology and pastoral care one aim of this study was to help transform the lives of the parents for the better. In one of the chapters of the research report a study of some literature on bereavement and the death of children is presented. Dominant cultural discourses about death, bereavement, grief and mourning are discussed, as well as voices protesting against these discourses. / Practical Theology / M.Th. (Pastoral Therapy)

This qualitative study focuses on the stories of a bereaved couple living with the death of two of their children. The effect of the children's death on the parents is explored, as well as the way in which the parents live with the death of their two sons. The stories of the bereaved couple show their courage and resilience in continuing with their lives, maintaining their bond with their deceased sons and trying to make meaning of their death. As a study in practical theology and pastoral care one aim of this study was to help transform the lives of the parents for the better. In one of the chapters of the research report a study of some literature on bereavement and the death of children is presented. Dominant cultural discourses about death, bereavement, grief and mourning are discussed, as well as voices protesting against these discourses. / Philosophy, Practical and Systematic Theology / M.Th. (Pastoral Therapy)