Grief and post-traumatic growth in parents 2-6 years after the death of their extremely premature baby.
OBJECTIVE
To assess grief and post-traumatic growth in parents 2-6 years after the death of a premature baby (24-26 weeks' gestation) and to evaluate Pictorial Representation of Illness and Self-Measure (PRISM) in the assessment of bereavement.


METHODS
Fifty-four parents were assessed for their experiences during hospitalization and by questionnaires regarding grief (MTS), post-traumatic growth, affective symptoms and the visual representation of the baby and the self of the parents (PRISM).


RESULTS
Even 2-6 years after the loss of their extremely preterm infant the parents still suffer a lot from their bereavement, mothers more so than fathers (Mann-Whitney U test, U = 230.5, p < 0.05). Having another child reduced the level of grief (U = 119.0, p < 0.05). Mothers showed more post-traumatic growth than fathers (U = 140.5, p < 0.001). For all parents a shorter distance between the baby and the self (PRISM) correlated with greater grief (rho = -0.62, p < 0.001); in multiple regression analysis MTS explained 38% of the SBS-variance.


CONCLUSIONS
Clinicians should be aware that the death of an extremely premature infant triggers not only a painful long-term process of mourning but also of individual personal growth. Adaptation processes after the death differ depending on gender, with mothers experiencing more intense grief but also more growth than fathers. The modified PRISM test is recommended as a visual, non-verbal and easy-to-use instrument to assess bereavement.
Büchi
Stefan
S
Department of Psychiatry, University Hospital, Zurich, Switzerland. Stefan.Buechi@usz.ch
Mörgeli
Hanspeter
H
Schnyder
Ulrich
U
Jenewein
Josef
J
Hepp
Urs
U
Jina
Eveline
E
Neuhaus
Rachel
R
Fauchère
Jean-Claude
JC
Bucher
Hans Ulrich
HU
Sensky
Tom
T
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001293:Attitude to Death; D001601:Bereavement; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006117:Grief; D006801:Humans; D007092:Imagination; D052577:Infant, Extremely Low Birth Weight / Q000523:psychology*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D010555:Personality Inventory; D012737:Sex Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires