The Bereaved Parent Needs Assessment: a new instrument to assess the needs of parents whose children died in the pediatric intensive care unit*.
OBJECTIVE
To evaluate the reliability and validity of the Bereaved Parent Needs Assessment, a new instrument to measure parents' needs and need fulfillment around the time of their child's death in the pediatric intensive care unit. We hypothesized that need fulfillment would be negatively related to complicated grief and positively related to quality of life during bereavement.


METHODS
Cross-sectional survey.


METHODS
Five U.S. children's hospital pediatric intensive care units.


METHODS
Parents (n = 121) bereaved in a pediatric intensive care unit 6 months earlier.


METHODS
Surveys included the 68-item Bereaved Parent Needs Assessment, the Inventory of Complicated Grief, and the abbreviated version of the World Health Organization Quality of Life questionnaire. Each Bereaved Parent Needs Assessment item described a potential need and was rated on two scales: 1) a 5-point rating of importance (1 = not at all important, 5 = very important) and 2) a 5-point rating of fulfillment (1 = not at all met, 5 = completely met). Three composite scales were computed: 1) total importance (percentage of all needs rated ≥4 for importance), 2) total fulfillment (percentage of all needs rated ≥4 for fulfillment), and 3) percent fulfillment (percentage of important needs that were fulfilled). Internal consistency reliability was assessed by Cronbach's α and Spearman-Brown-corrected split-half reliability. Generalized estimating equations were used to test predictions between composite scales and the Inventory of Complicated Grief and World Health Organization Quality of Life questionnaire.


RESULTS
Two items had mean importance ratings <3, and 55 had mean ratings >4. Reliability of composite scores ranged from 0.92 to 0.94. Total fulfillment was negatively correlated with Inventory of Complicated Grief (r = -.29; p < .01) and positively correlated with World Health Organization Quality of Life questionnaire (r = .21; p < .05). Percent fulfillment was also significantly correlated with both outcomes. Adjusting for parent's age, education, and loss of an only child, percent fulfillment remained significantly correlated with Inventory of Complicated Grief but not with World Health Organization Quality of Life questionnaire.


CONCLUSIONS
The Bereaved Parent Needs Assessment demonstrated reliability and validity to assess the needs of parents bereaved in the pediatric intensive care unit. Meeting parents' needs around the time of their child's death may promote adjustment to loss.
Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA. kmeert@med.wayne.edu
Kathleen L
KL
Meert
Thomas N
TN
Templin
Kelly N
KN
Michelson
Wynne E
WE
Morrison
Richard
R
Hackbarth
Joseph R
JR
Custer
Stephanie M
SM
Schim
Sherylyn H
SH
Briller
Celia S
CS
Thurston
D000293:Adolescent; D000328:Adult; D001601:Bereavement; D002648:Child; D002675:Child, Preschool; D003643:Death; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010290:Parents / Q000523:psychology*; D011594:Psychometrics; D011795:Surveys and Questionnaires