Thesis (M.S.)--Indiana University, 2007. / Includes bibliographical references (leaves 117-124).

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2010. / Title from title screen (site viewed July 8, 2010). PDF text: iv, 55 p. : ill. ; 2 Mb. UMI publication number: AAT 3397416. Includes bibliographical references. Also available in microfilm and microfiche formats.

Title from title page of PDF (University of Missouri--St. Louis, viewed March 1, 2010). Includes bibliographical references (p. 55-67).

In studies, grief due to the loss of a child is recognized as a complex process, one whose trajectory is influenced by a variety of factors. One factor, the age of the child at the time of death, may be an important influence in the trajectory of grief. The purpose of this interpretive phenomenological study was to explore the experiences of loss for 15 bereaved mothers and fathers whose children suddenly died between the ages of 2 and 12 years. This age range was selected to explore bereavement in parents of young and preteen children because they may feel a greater sense of daily care and responsibility for the safety of their children in comparison to bereaved mothers and fathers of older children or adults. The psychosocial transition theory was used to develop the research questions, which framed the exploration of the experiences and adaptive responses of the parent participants. There were 15 recorded semistructured interviews from which the data were collected. The transcribed data were validated with member checking. Data analysis was completed using open and hierarchical coding to identify meanings and recurrent themes in the participant narratives. Recurrent themes included that grieving was emotional and physical for these parents, and that grief made it difficult for them to do everyday tasks or care for surviving children. Mothers and fathers identified viewing their world as less safe and experienced a reevaluation or complete abandonment of their spiritual beliefs. Implications for positive social change include increasing social awareness in the general public about grief due to child death and challenging unrealistic expectations of grief trajectory. Furthermore, the findings of this study may be used by mental health professionals to create interventions specific to this type of loss.

The object of this two years master's thesis has been to study a specific genre of personal archives by examiningthe archives of nine parents who have lost one or several infants. Using internet-based methods, (e-mail, Skypeand digital photographs), I have conducted qualitative research using a general interview guide technique. Usingresearch from archival theory as well as other fields, my material has been arranged and analysed according tothemes and recurring thoughts picked up from my informants during the interviews.My main theoretical aid has been that the role of parent who has lost a child is the starting point for the creationof the personal archives. Another important theory is my definition of the term “document” as not dependent onmedium and format, but on usage: if an object has been used as a part of an archive, it is a document. I also claimthat study of personal archives is a way to help the archival profession and Swedish archival theory to becomemore democratic and inclusive, since especially the former is mandated to reflect all of society's many manifestationsof culture and memory. The results show that the archives contain a large selection of documents in differentformats and mediums, but that they also have many similarities. This is an effect of the fact that the parentshave all had roughly the same document-creating contacts with their relatives and friends, the authorities and theother parts of society often involved in the events proceeding the child's birth and death (or sickness and death).The reasons to create and maintain a personal archive are to preserve the memories of events, people, places,thoughts and feelings associated with the child and whatever time the parents got to spend with him or her. By remembering,the parents are also confirming the child's existence and place within the family, and helping themselvesconfirm their newly acquired role as parents who have lost a child. The archives and their constituent partsare used as physical and psychological “linking objects”, to help the parents feel (at least temporary) closer totheir child by watching, touching or talking about the most important documents. These are often the ones displayedon special memory shelves, on family photo walls or in memory boxes. It follows that arrangement of thedocuments is based mostly on the emotional attachment of the parent to the individual document, and that destructionof records are extremely rare in the studied archives. Their growth diminished with time, but does notstop completely since the parents, other relatives and friends still create new documents, mostly to observe holidaysand anniversaries. Furthermore, the way the parents use their archives and its constituent parts change astime passes. Individual documents may also change their emotional and cultural significance to the parent, orgain additional ones. Some of the underlying factors behind these findings are my informants views on creating,keeping and destroying documents. They all express a need to “save everything”, and most also want to “documenteverything”. The latter, their wish to create new documents to complement the ones created primarily byothers and as a result of specific events and processes, comes from a feeling of not having enough documents inthe archives. It can also be the result of dissatisfaction with those that do exist. Finally, as is commonplace amongpersonal archives, the archives in my study have multiple record creators within the immediate family and outsideit, even though my informants are usually the main creators. This is a two years master’s thesis in Archive,Library and Museum studies.

Blood and marrow transplantation (BMT) has become an increasingly acceptable treatment for children with life threatening malignant diseases. Survival rates for transplant recipients vary from 23% to 63%. Children with complications from BMT, typically die in the hospital after a prolonged stay. The parental decision to allow a child to die a natural death is typically made in an aura of emotional duress and bewilderment at the complexity and volume of new information that must be assimilated.The purpose of this study was to describe the process of parental decision making for Do Not Resuscitate (DNR) or to withdraw life support in pediatric BMT.The framework for this study was developed from the author's epistemology that blends neo-modernism (recognition of individual uniqueness yet acknowledgment that certain underlying universal principals exist) with the idea that the nature of all things may be viewed as an ongoing, self-constructing process.Grounded theory methodology was used. The sample (determined through theoretical sampling) consisted of seven parents of children who died following BMT and for whom the parent made an end-of-life decision. Data was analyzed using constant comparative analysis, a method that combines both substantive and theoretical coding of data with a qualitative style of theory development.The realization of parental knowing was the process that parents used to navigate the human problem of having to make the end-of-life decision for their children who were dying following blood and marrow transplantation. This process consisted of four categories: Developing Trust, Committed to Seeing It Through, Facing My Worst Fear, and Acceptance of Self.The knowledge gained from this study will inform nurses who care for children who are dying following pediatric BMT. Strategies may be developed that will assist nurses to support the development of parental trust, to help sustain the commitment of parents as they move through the BMT treatment journey, and to assist parents as they face their worst fear. As a result, parents should be better able to achieve an acceptance for themselves that will facilitate a more satisfying experience of the ever changing process occurring in their own lives.

The aim of the present study was to examine whether there was a significant difference within each spouse&amp / #8217 / s reports on grief reactions after an infant death. It was also aimed to investigate whether demographic variables including gender, age, education of grieved parents, gender and age of deceased infant, presence of other children were predictors of parental grief reactions after an infant death. The sample of the present study consisted of 55 couples experiencing an infant death within the last 2 years. Sample was recruited through death records kept in hospital and municipalities of Ankara by the researcher. To test the hypotheses of the study paired samples t-test and stepwise regression analyses were performed. According to the results of the study, it was found that there was a significant difference within each spouse&amp / #8217 / s reports on despair, panic behavior, blame and anger, detachment, and disorganization as separate dimensions of grief. Mothers experienced higher levels of despair, panic behavior, blame and anger, detachment, and disorganization than fathers. There was no significant difference within each spouse&amp / #8217 / s score on personal growth. It was found that being a mother and having lost boy infant were proved as the predictors of parents&amp / #8217 / higher levels of grief reactions. Age and education of grieved parents, age of deceased infant, presence of other children were not associated with parental grief reactions. It was found that younger age of deceased infant and presence of other children were proved as predictors of grieved parents&amp / #8217 / higher levels of personal growth. The findings of the study were discussed with related literature.

Cette étude avait pour but d’évaluer, à partir d’un processus de co-construction avec les personnes concernées, dans un contexte de 1ère ligne, la mise en application d’interventions infirmières inspirées du Guide des meilleures pratiques de soins pour les endeuillés (GMPSE) auprès d’un couple ayant vécu une perte périnatale au cours des six dernier mois. Un devis de recherche d’étude de cas basé sur la démarche d’évaluation de la quatrième génération de Guba et Lincoln (1989) a été utilisé. Une infirmière expérimentée auprès des familles endeuillées, s’est inspirée de la guidance du GMPSE pour intervenir auprès d’un couple lors de cinq rencontres thérapeutiques, dont quatre ont été précédées d’une entrevue avec les personnes concernées . Ces entrevues ont permis à ces personnes d’identifier ensemble les interventions les plus utiles et les moins utiles. Le verbatim des rencontres et entrevues ont été enregistrées et transcrites à des fins d’analyses qualitatives, Les résultats de ces analyses font ressortir la pertinence des interventions inspirées du GMPSE et l’apport spécifique de la pratique infirmière auprès de la population visée. Il appert que la sensibilisation des décideurs et des cliniciens aux enjeux des personnes endeuilles soit nécessaire pour favoriser l’implantation du Guide dans les milieux de soins. Enfin, une meilleure appropriation du GMPSE est recommandée autant dans le cadre de la formation, que de la recherche et de la pratique en sciences infirmières. / The purpose of this study was to evaluate from a constructivist perspective, partnering with the stakeholders , the usefulness of nursing interventions inspired from The Best Practice Guidelines in Bereavement Care (BPGBC) in a first line context, during the follow up a couple whom had experienced a prenatal lost in the last six months. A case study design was used along with The Fourth Evaluation’s methodological approach designed by Guba and Lincoln (1989). An experienced nurse in the care of bereaved families, used the BPGBC to guide her interventions in five therapeutic meetings with the couple, followed by four interviews with the stakeholders. The interventions considered the most helpful and the less useful were identified. The gathering of the data and their analysis followed an interactive and ongoing process. The results support the pertinence of the nursing interventions inspired from the BPGBC, as well as the specific contribution of the nursing profession in the bereavement work. Implementing the BPGBC becomes a realistic goal when the managers and the clinical professionals are made aware of the issues encompassed by the grieving population. The nursing profession could incorporate the BPGBC in its training curriculum, in the research field and in the care offered to the bereaved population in different care settings.

Cette étude avait pour but d’évaluer, à partir d’un processus de co-construction avec les personnes concernées, dans un contexte de 1ère ligne, la mise en application d’interventions infirmières inspirées du Guide des meilleures pratiques de soins pour les endeuillés (GMPSE) auprès d’un couple ayant vécu une perte périnatale au cours des six dernier mois. Un devis de recherche d’étude de cas basé sur la démarche d’évaluation de la quatrième génération de Guba et Lincoln (1989) a été utilisé. Une infirmière expérimentée auprès des familles endeuillées, s’est inspirée de la guidance du GMPSE pour intervenir auprès d’un couple lors de cinq rencontres thérapeutiques, dont quatre ont été précédées d’une entrevue avec les personnes concernées . Ces entrevues ont permis à ces personnes d’identifier ensemble les interventions les plus utiles et les moins utiles. Le verbatim des rencontres et entrevues ont été enregistrées et transcrites à des fins d’analyses qualitatives, Les résultats de ces analyses font ressortir la pertinence des interventions inspirées du GMPSE et l’apport spécifique de la pratique infirmière auprès de la population visée. Il appert que la sensibilisation des décideurs et des cliniciens aux enjeux des personnes endeuilles soit nécessaire pour favoriser l’implantation du Guide dans les milieux de soins. Enfin, une meilleure appropriation du GMPSE est recommandée autant dans le cadre de la formation, que de la recherche et de la pratique en sciences infirmières. / The purpose of this study was to evaluate from a constructivist perspective, partnering with the stakeholders , the usefulness of nursing interventions inspired from The Best Practice Guidelines in Bereavement Care (BPGBC) in a first line context, during the follow up a couple whom had experienced a prenatal lost in the last six months. A case study design was used along with The Fourth Evaluation’s methodological approach designed by Guba and Lincoln (1989). An experienced nurse in the care of bereaved families, used the BPGBC to guide her interventions in five therapeutic meetings with the couple, followed by four interviews with the stakeholders. The interventions considered the most helpful and the less useful were identified. The gathering of the data and their analysis followed an interactive and ongoing process. The results support the pertinence of the nursing interventions inspired from the BPGBC, as well as the specific contribution of the nursing profession in the bereavement work. Implementing the BPGBC becomes a realistic goal when the managers and the clinical professionals are made aware of the issues encompassed by the grieving population. The nursing profession could incorporate the BPGBC in its training curriculum, in the research field and in the care offered to the bereaved population in different care settings.

The study of the loss of a sibling in mainstream bereavement literature has been largely neglected in psychology. This sentiment has often, and still continues, to be expressed by those outside and within the psychological field. The focus in the childhood bereavement literature has been on the loss of a parent and, in adulthood, on the loss of a child or of a spouse. Despite the growing interest in sibling loss in more recent times (since the 1980s), more specifically in childhood and adolescent sibling loss, in reality bereaved siblings remain ‘forgotten’ and even marginalised. The present study concerned the experience of the loss of a brother or sister in young adulthood, an area that has been largely neglected. The phenomenon was explored using a qualitative approach and employing the empirical phenomenological psychological research method as articulated by Amedeo Giorgi. In-depth interviews with three research participants who were asked to describe their experience of the loss of their sibling were used to gather the data. The emphasis was on discovery, on allowing the siblings to speak for themselves by posing an open-ended question rather than focusing on isolated aspects of the loss experience. The general psychological structure revealed that the experience of the loss of a brother or sister evolves over time and cannot meaningfully be understood as an event that can be contained within a specified moment in time. The experience is a fundamentally relational and paradoxical phenomenon and is reflective of the context in which it occurs. With the loss, the sibling's whole world changes in a very radical way. It is a triple loss: the loss of the brother or sister, the loss of the family unit and the 'loss' of the parents as the siblings had known them. Initially bereaved siblings put aside their grief in an attempt to protect parents and significant others. A conspiracy of silence evolves which conceals their pain and as they continue with life as ‘normal’ there is a deceptive belief of ‘coping well’, of personal stability. Yet internally the bereaved sibling struggles with intense emotions and a lonely struggle ensues. The lack of acknowledgement of the sibling’s grief by others compounds the sense of isolation and alienation and he/she begins to feel like an “implicated alien”, a participant-spectator; part-of and also apart-from the grief situation. Finding a safe space to grieve is critical to bereaved siblings and when this is possible they are able to let go of their deep emotions and grieve the loss of their brother or sister. The loss of a sibling is the experience of losing various parts of the self and needing to reclaim and reintegrate self. The main contribution of this study can be described as providing insights concerning the complex, multi-layered and multi-dimensional process of this loss experience to clinicians and others who care for bereaved siblings. Where the extant psychoanalytic and object relations literature is willing to concede that a sibling relationship exists, screened behind parental relationships, the present study reveals that siblings have a unique relationship of their own and that the loss of this relationship demands radical mourning. This study also reveals that death in the family is a fundamentally relational experience. The loss of a sibling and the loss of a child frequently overlap and tumble into each other and it is difficult to know for whom the sibling is grieving at any particular moment. Thus, grief over the loss of a brother or sister cannot be reduced to a purely intra-psychic or psycho-social process. The fact that sibling grief is not visible, does not mean that it does not exist. Clinicians and caregivers need to be aware of the existential chaos, the trauma, and the ambiguous and paradoxical nature of the sorrow experienced by a sibling-who-loses-a-sibling. Future research into the loss of a brother or sister beyond young and middle adulthood, an area that has also largely been neglected, would constitute an important contribution to the psychology of siblings and of sibling loss/bereavement throughout the life cycle. Also significant would be the exploration of what happens in the sibling group following the loss of one of their members. / Thesis (PhD (Psychotherapy))--University of Pretoria, 2007. / Psychology / unrestricted