Parental bereavement – impact of death of neonates and children under 12 years on personhood of parents: a systematic scoping review

• Published in: BMC palliative care 2021-09, Vol.20 (1), p.1-136, Article 136
• Main Authors: Vig, Prachi Simran, Lim, Jia Yin, Lee, Randal Wei Liang, Huang, Huixin, Tan, Xiu Hui, Lim, Wei Qiang, Lim, Marie Bernadette Xin Yi, Lee, Alexia Sze Inn, Chiam, Min, Lim, Crystal, Baral, Vijayendra Ranjan, Krishna, Lalit Kumar Radha
• Format: Article
• Language: English
• Subjects: Bereavement; Children; Death; Demographic aspects; End of life; Families & family life; Grief; Hospice care; Infant; Librarians; Neonate; Newborn babies; Paediatrics; Palliative care; Parents; Parents & parenting; Pediatrics; Personhood; Persons (Law); Psychological aspects; Roles; Social aspects; Society; Spirituality; Values; Well being
• ISSN: 1472-684X; 1472-684X
• DOI: 10.1186/s12904-021-00831-1

Background Losing a child tragically impacts the well-being and functioning of parents. With these effects extending beyond emotional, physical morbidity and compromising self-perceptions, appropriate, longitudinal, timely and personalised support is key to effective care of bereaved parents. However, in the absence of a comprehensive understanding of parental bereavement, effective support of bereaved parents remains suboptimal. To address this gap, we scrutinise prevailing data on the effects of a child's death, aged 0-12 years, through the lens of the Ring Theory of Personhood (RToP). Methods To study prevailing accounts of bereaved parents following the death of a child, we adopt Krishna's Systematic Evidence Based Approach (SEBA) to structure our Systematic Scoping Review (SSR in SEBA). Results Three thousand seventy-four abstracts were reviewed, 160 full text articles were evaluated, and 111 articles were included and analysed using thematic and content analysis. Four themes/categories were identified relating to the four rings of the RToP. Findings reveal that static concepts of protective and risk factors for grief are misplaced and that the support of healthcare professionals is key to assisting bereaved parents. Conclusion In the absence of consistent support of bereaved parents, this study highlights the need for effective training of healthcare professionals, beginning with an appreciation that every aspect of an individual parent's personhood is impacted by the loss of their child. Acknowledging grief as a complex, evolving and personalised process subjected to parental characteristics, settings, context and available support, this SSR in SEBA calls attention to effective nurturing of the relationship between parents and healthcare professionals, and suggests use of the RToP to assess and direct personalised, timely, specific support of parents in evolving conditions. We believe the findings of this review also call for further studies to support healthcare professionals as they journey with bereaved parents. Keywords: End of life, Palliative care, Death, Neonate, Infant, Paediatrics, Parents, Ring theory of personhood, Personhood, Bereavement