title: Grief and post-traumatic growth in parents 2-6 years after the death of their extremely premature baby.
abstract: 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.
authors.affiliation: Department of Psychiatry, University Hospital, Zurich, Switzerland. Stefan.Buechi@usz.ch
authors.forename: Stefan
authors.initials: S
authors.lastname: Büchi
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Mörgeli
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.forename: Josef
authors.initials: J
authors.lastname: Jenewein
authors.forename: Urs
authors.initials: U
authors.lastname: Hepp
authors.forename: Eveline
authors.initials: E
authors.lastname: Jina
authors.forename: Rachel
authors.initials: R
authors.lastname: Neuhaus
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Fauchère
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Bucher
authors.forename: Tom
authors.initials: T
authors.lastname: Sensky
mesh_terms: 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