title: Parental perspectives on hospital staff members' acts of kindness and commemoration after a child's death.
abstract: OBJECTIVE
  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.
authors.affiliation: Pediatric Palliative Care Program, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. mary.macdonald@elf.mcgill.ca
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Macdonald
authors.forename: Stephen
authors.initials: S
authors.lastname: Liben
authors.forename: Franco A
authors.initials: FA
authors.lastname: Carnevale
authors.forename: Janet E
authors.initials: JE
authors.lastname: Rennick
authors.forename: Susan L
authors.initials: SL
authors.lastname: Wolf
authors.forename: Donald
authors.initials: D
authors.lastname: Meloche
authors.forename: S Robin
authors.initials: SR
authors.lastname: Cohen
mesh_terms: D001601:Bereavement; D002648:Child; D003643:Death; D006776:Hospitals, Pediatric; D006801:Humans; D015278:Intensive Care Units, Pediatric; D010290:Parents / Q000523:psychology*; D010564:Personnel, Hospital; D011368:Professional-Family Relations; D012944:Social Support