Aim. The aim of the present research was to investigate the relationship of personality guilt- and shame-proneness to grief and psychological dysphoria following bereavement due to stillbirth or death in the newborn period. Methods. Participating parents completed self-report questionnaire measures of proneness to situational guilt and shame (Test of Self-Conscious Affect-2), chronic guilt and shame (Personal Feelings Questionnaire-2) and interpersonal guilt (Interpersonal Guilt Questionnaire-67), grief (Perinatal Grief Scale-33) and psychological dysphoria (General Health Questionnaire-28) one month (�early�, N = 158) and 13 months (�late�, N = 149) after a perinatal death. Results. Women compared with men self-reported more intense grief, anxiety and depression one month after the death, but there were no significant sex differences in grief or psychological dysphoria one year later. Hierarchical multiple regression analyses showed that composite shame (situational and chronic) explained a small but statistically significant proportion of the variance in early total grief (adjusted R 2 = .09) and anxiety (adjusted R 2 = .07) in women, and early total grief (adjusted R 2 = .19), anxiety (adjusted R 2 = .13) and depression (adjusted R 2 = .10) in men. Composite guilt (situational, chronic and interpersonal) controlled for shame did not make a significant further contribution to the variance in early total grief, anxiety or depression in either sex. Composite shame explained not only significant but meaningful proportions of the variance in late grief (adjusted R2=.27), anxiety (adjusted R2=.21) and depression (adjusted R2=.27) in women, and late grief (adjusted R2= .56),anxiety (adjusted R 2= .30) and depression (adjusted R2= .51) in men. Composite guilt controlled for shame made significant further contributions to the variancein late grief (∆R 2 = .21), anxiety (∆R 2 = .16) and depression (∆R 2 = .25) in women, and late grief (∆R 2 = .11) in men. Shame and guilt together explained a substantial proportion of the variance in late grief (adjusted R2= .45), anxiety (adjusted R2= .33) and depression (adjusted R2= .49) in women, and late grief (adjusted R2= .64), anxiety (adjusted R2= .35) and depression (adjusted R2= .56) in men. Situational shame, chronic guilt and survivor guilt made positive unique contributions to the variance in late grief in women. Chronic shame and survivor guilt made unique contributions to the variance in late grief in men. Situational guilt made a significant unique negatively valenced contribution to the variance in late grief in women. Early composite shame, but not guilt, predicted late grief, anxiety and depression in men. Early composite shame and/or guilt did not predict late grief, anxiety or depression in women. Conclusion. Personality proneness to shame was more relevant to late grief, anxiety and depression in men than in women, but survivor guilt was equally important to late grief in both sexes. Chronic guilt and functional situational guilt were pertinent to late grief, anxiety and depression in women, but not in men. Personality shame- and guilt-proneness have important relationships with parental grief after perinatal death that have not hitherto been recognised.

Aim. The aim of the present research was to investigate the relationship of personality guilt- and shame-proneness to grief and psychological dysphoria following bereavement due to stillbirth or death in the newborn period. Methods. Participating parents completed self-report questionnaire measures of proneness to situational guilt and shame (Test of Self-Conscious Affect-2), chronic guilt and shame (Personal Feelings Questionnaire-2) and interpersonal guilt (Interpersonal Guilt Questionnaire-67), grief (Perinatal Grief Scale-33) and psychological dysphoria (General Health Questionnaire-28) one month (�early�, N = 158) and 13 months (�late�, N = 149) after a perinatal death. Results. Women compared with men self-reported more intense grief, anxiety and depression one month after the death, but there were no significant sex differences in grief or psychological dysphoria one year later. Hierarchical multiple regression analyses showed that composite shame (situational and chronic) explained a small but statistically significant proportion of the variance in early total grief (adjusted R 2 = .09) and anxiety (adjusted R 2 = .07) in women, and early total grief (adjusted R 2 = .19), anxiety (adjusted R 2 = .13) and depression (adjusted R 2 = .10) in men. Composite guilt (situational, chronic and interpersonal) controlled for shame did not make a significant further contribution to the variance in early total grief, anxiety or depression in either sex. Composite shame explained not only significant but meaningful proportions of the variance in late grief (adjusted R2=.27), anxiety (adjusted R2=.21) and depression (adjusted R2=.27) in women, and late grief (adjusted R2= .56),anxiety (adjusted R 2= .30) and depression (adjusted R2= .51) in men. Composite guilt controlled for shame made significant further contributions to the variancein late grief (∆R 2 = .21), anxiety (∆R 2 = .16) and depression (∆R 2 = .25) in women, and late grief (∆R 2 = .11) in men. Shame and guilt together explained a substantial proportion of the variance in late grief (adjusted R2= .45), anxiety (adjusted R2= .33) and depression (adjusted R2= .49) in women, and late grief (adjusted R2= .64), anxiety (adjusted R2= .35) and depression (adjusted R2= .56) in men. Situational shame, chronic guilt and survivor guilt made positive unique contributions to the variance in late grief in women. Chronic shame and survivor guilt made unique contributions to the variance in late grief in men. Situational guilt made a significant unique negatively valenced contribution to the variance in late grief in women. Early composite shame, but not guilt, predicted late grief, anxiety and depression in men. Early composite shame and/or guilt did not predict late grief, anxiety or depression in women. Conclusion. Personality proneness to shame was more relevant to late grief, anxiety and depression in men than in women, but survivor guilt was equally important to late grief in both sexes. Chronic guilt and functional situational guilt were pertinent to late grief, anxiety and depression in women, but not in men. Personality shame- and guilt-proneness have important relationships with parental grief after perinatal death that have not hitherto been recognised.

Thesis advisor: June Horowitz / Parents who simultaneously grieve the loss of one twin and nurture the surviving twin experience a paradox of grief and joy. The acute grief of losing a twin coincides with a critical time in the development of the parental role and relationship with the surviving twin. Very few researchers have addressed the unique parenting situation in which one twin infant dies. The aim of this qualitative descriptive study was to describe the experience of parents who lose one twin in utero, at birth, or in the neonatal period. The study question was "What is the parenting experience of mothers and fathers who simultaneously face the grief of the loss of one twin while nurturing the surviving twin during infancy?" Nine parents, recruited via a support group, were interviewed. Systematic content analysis, emphasizing in-vivo coding (participant's own words), was conducted until data saturation was reached. A comprehensive description of the experience of raising a surviving twin was constructed. Four descriptive themes were identified: (1) Living with ambiguity: the irony of raising a lone twin, belonging and not belonging, and at least there is one; (2) Communicating the family journey: telling or not telling, deciding who needs to know, and how many children; (3) Parenting with wonder and worry: doubt and hyper-vigilance, unanswered questions, and the living twin as a unique person; and (4) Life is different now: loss of innocence, honoring both twins, making and keeping relationships, work-life challenges, and accepting that it doesn't go away. Issues raised by parents included the ambiguity and irony of losing one twin, no one understands, multiple losses, and living with this loss. The description of this experience gives insight to the dynamics and burden of this loss. Data from this study can inform pediatric nurses about the issues, concerns, and needs of parents who sustain this kind of loss. Therapeutic interventions based by the tenets of family-centered nursing care can be developed by understanding the long-term effects of grief on parenting. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

In the U.S., Black mothers experience fetal and infant mortality at alarming rates when compared to White and Latina mothers (Gregory, Drake, & Martin, 2018). The intent of this study was to examine perinatal loss among Black American women and to expand understanding of how the Strong Black Woman (SBW) ideology influences bereavement. Data were gathered from (N=109) Black American bereaved mothers. It was predicted that endorsement of differing aspects of the SBW would moderate the relationship between perinatal grief and psychosocial outcomes (i.e., depression and post-traumatic growth). Regression analyses, alongside a bootstrapping procedure via PROCESS (Hayes, 2017), were used to evaluate the moderation models. Results yielded a model of perinatal bereavement among Black American mothers. In particular, reliance on spirituality moderated the relationship between perinatal grief and depression, while the obligation to manifest strength moderated the relation between perinatal grief and posttraumatic growth (PTG). Neither moderated moderation model was significant. The model provided significant implications for clinical practice and intervention.

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.