title: Disenfranchised grief following a non-fatal road traffic incident: a case study exploring a mother's experience.
abstract: This case study explores a scenario that was observed by a final year nursing student on placement in a paediatric emergency department, in a busy London teaching hospital. A mother appeared distressed following the news that her son who had survived a road traffic incident with minimal impact to his cognitive and physical abilities, was stable enough to be transferred to the children's medical ward. Whilst this appeared to be positive for supporting figures in her life and the emergency practitioners involved, observation and discussion with the mother revealed that her distress was related to her experience of losses that were undetected by those around her. This included losses related to her son's future and the loss of her previous world. Amongst the plethora of theories about how we as humans react to loss and change, one theory which could explain the mother's grief suggests that it was disenfranchised, i.e. it was not acknowledged or validated by society. There are consequences of disenfranchised grief, such as a lack of social support leading to a higher risk of adverse psychological outcomes. Nurses in the emergency department can help resolve negative outcomes for patients and families experiencing disenfranchised grief. The key steps are to have knowledge of disenfranchised grief to be able to detect it, and then to validate it as a form of grief.
authors.affiliation: King's College London, The Royal London Hospital, London E1 3DT, United Kingdom. Electronic address: shaminahrahman@yahoo.co.uk.
authors.forename: Shaminah
authors.initials: S
authors.lastname: Rahman
authors.affiliation: James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom.
authors.forename: Joanna
authors.initials: J
authors.lastname: De Souza
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology*; D001293:Attitude to Death; D002648:Child; D005190:Family; D005260:Female; D006117:Grief; D006801:Humans; D008131:London; D008297:Male; D009035:Mothers / Q000523:psychology*; D012944:Social Support
keywords: Ambiguous loss; Disenfranchised grief; Family centered care; Grief; Loss; Paediatric; Trauma