Published online September 30, 2005
PEDIATRICS Vol. 116 No. 4 October 2005, pp. 884-890 (doi:10.1542/peds.2004-1980)
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Parental Perspectives on Hospital Staff Members' Acts of Kindness and Commemoration After a Child's Death

Mary Ellen Macdonald, PhD*, Stephen Liben, MD*, Franco A. Carnevale, RN, PhD{ddagger}, Janet E. Rennick, RN, PhD§, Susan L. Wolf, BA*, Donald Meloche, MA, LTH, DMIN|| and S. Robin Cohen, PhD,#

* Pediatric Palliative Care Program
{ddagger} Critical Care
§ Department of Nursing
|| Pastoral Services, Montreal Children's Hospital of the McGill University Health Centre, Montreal, Canada
DepartmentS of Oncology
# DepartmentS of Medicine, McGill University, Montreal, Canada

Objectives. Acts of kindness and commemoration by staff members often follow the death of a patient. Acts include attending funerals, sending sympathy cards, sending cards on birthdays/anniversaries, telephoning/visiting family homes, and attending memorial services. This study explores the significance of these acts for bereaved parents.

Methods. Twelve parents whose children died in the ICU of a tertiary care pediatric hospital were interviewed, to explore their experiences of the death. Investigators reviewed transcripts and observational field notes. Multidisciplinary team triangulation was used to corroborate themes, with cross-case analysis.

Results. Three themes emerged regarding parental experiences of staff members' acts, ie, (1) parents placed great importance on the hospital's memorial service and on staff members' presence at the service; (2) parents found it difficult to return to the hospital after the child's death but all attended the memorial service, finding some closure in the return; and (3) parents appreciated receiving cards and greatly valued staff members' efforts to telephone/visit and to attend the funeral. Months later, parents remembered positively which staff members engaged in which activities. Conversely, parents expressed disappointment when staff members did not engage in these activities and/or were absent from memorial/funeral services.

Conclusions. Efforts to support families and to commemorate deceased children are appreciated by bereaved parents. Staff members' absences at commemorative events and a lack of supportive acts are noticed and regretted by families. Staff members and program administrators should attempt to arrange workloads to ensure meaningful contact between staff members and parents during the bereavement period.

Key Words: PICU • bereavement • child • palliative care • parental perception

Accepted Jan 13, 2005.


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