Complicated grief and associated risk factors among parents following a child's death in the pediatric intensive care unit.
OBJECTIVE
To investigate the extent of complicated grief symptoms and associated risk factors among parents whose child died in a pediatric intensive care unit.


METHODS
Cross-sectional survey conducted by mail and telephone.


METHODS
Seven children's hospitals affiliated with the Collaborative Pediatric Critical Care Research Network from January 1, 2006, to June 30, 2008.


METHODS
Two hundred sixty-one parents from 872 families whose child died in a pediatric intensive care unit 6 months earlier.


METHODS
Assessment of potential risk factors, including demographic and clinical variables, and parent psychosocial characteristics, such as attachment style, caregiving style, grief avoidance, and social support.


METHODS
Parent report of complicated grief symptoms using the Inventory of Complicated Grief. Total scale range is from 0 to 76; scores of 30 or higher suggest complicated grief.


RESULTS
Mean (SD) Inventory of Complicated Grief scores among parents were 33.7 (14.1). Fifty-nine percent of parents (95% confidence interval, 53%-65%) had scores of 30 or higher. Variables independently associated with higher symptom scores in multivariable analysis included being the biological mother or female guardian, trauma as the cause of death, greater attachment-related anxiety and attachment-related avoidance, and greater grief avoidance.


CONCLUSIONS
Parents who responded to our survey experienced a high level of complicated grief symptoms 6 months after their child's death in the pediatric intensive care unit. However, our estimate of the extent of complicated grief symptoms may be biased because of a high number of nonresponders. Better understanding of complicated grief and its risk factors among parents will allow those most vulnerable to receive professional bereavement support.
Children's Hospital of Michigan, 3901 Beaubien Blvd., Detroit, MI 48201, USA. kmeert@med.wayne.edu
Kathleen L
KL
Meert
Amy E
AE
Donaldson
Christopher J L
CJ
Newth
Rick
R
Harrison
John
J
Berger
Jerry
J
Zimmerman
K J S
KJ
Anand
Joseph
J
Carcillo
J Michael
JM
Dean
Douglas F
DF
Willson
Carol
C
Nicholson
Katherine
K
Shear
D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006117:Grief; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D012944:Social Support; D014481:United States