title: Concept clarification of grief in mothers of children with an addiction.
abstract: OBJECTIVE
  To report an analysis of the concept of grief in mothers of children with an addiction.
  
  
  BACKGROUND
  The concept of grief in this context is poorly understood and often synonymously used with concepts depression, loss and chronic sorrow. In the US, the core concept grief has been recently revised by both NANDA and the DSM-V in efforts to better understand and characterize the concept. The plethora of literature on grief worldwide often characterizes grief as a response to a death.
  
  
  METHODS
  Concept analysis.
  
  
  METHODS
  Search terms 'parental grief' and 'substance abuse' yielded 30 articles. A second review using terms 'grief' and 'substance abuse' yielded 323 articles, in PsychInfo, CINAHL, PubMed databases from 1980-2013. Limits for articles in English and for the terms 'death' and 'child' yielded 13 usable articles.
  
  
  METHODS
  The hybrid model of concept analysis, using a theoretical phase, an empirical phase and a final phase when a clarified definition of grief emerged.
  
  
  RESULTS
  Definitions in the literature and defining characteristics of grief outline bio-psycho-social aspects of the concept. For one mother grief was accompanied by recurring feelings of sadness across time, while for the other mother grief was seen as coping, after having passed through a variety of stages of grief. For both, grief was seen to fall on a continuum.
  
  
  CONCLUSIONS
  Grief is a universal concept and has a trajectory. Case study data have been essential in clarifying understandings of grief as experienced by mothers of addicted children and will provide direction for meaningful and tailored interventions.
authors.affiliation: University of Massachusetts Amherst, Massachusetts, USA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Zucker
authors.forename: Kimberly
authors.initials: K
authors.lastname: Dion
authors.forename: Roxanna P
authors.initials: RP
authors.lastname: McKeever
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003210:Concept Formation; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009034:Mother-Child Relations / Q000523:psychology*; D009035:Mothers / Q000523:psychology*; D019966:Substance-Related Disorders; D014481:United States; D055815:Young Adult
keywords: addiction; case research; concept analysis; grief; hybrid model; mental health; mothers; nursing