title: Meaning making during parent-physician bereavement meetings after a child's death.
abstract: OBJECTIVE
  Our goal was to identify and describe types of meaning-making processes that occur among parents during bereavement meetings with their child's intensive care physician after their child's death in a pediatric intensive care unit.
  
  
  METHODS
  Fifty-three parents of 35 deceased children participated in a bereavement meeting with their child's physician 14.5 ± 6.3 weeks after the child's death. One meeting was conducted per family. Meetings were video recorded and transcribed verbatim. Using a directed content analysis, an interdisciplinary team analyzed the transcripts to identify and describe meaning-making processes that support and extend extant meaning-making theory.
  
  
  RESULTS
  Four major meaning-making processes were identified: (1) sense making, (2) benefit finding, (3) continuing bonds, and (4) identity reconstruction. Sense making refers to seeking biomedical explanations for the death, revisiting parents' prior decisions and roles, and assigning blame. Benefit finding refers to exploring positive consequences of the death, including ways to help others, such as giving feedback to the hospital, making donations, participating in research, volunteering, and contributing to new medical knowledge. Continuing bonds refers to parents' ongoing connection with the deceased child manifested by reminiscing about the child, sharing photographs and discussing personal rituals, linking objects, and community events to honor the child. Identity reconstruction refers to changes in parents' sense of self, including changes in relationships, work, home, and leisure.
  
  
  CONCLUSIONS
  Parent-physician bereavement meetings facilitate several types of meaning-making processes among bereaved parents. Further research should evaluate the extent to which meaning making during bereavement meetings affects parents' health outcomes.
authors.affiliation: Department of Pediatrics.
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Meert
authors.affiliation: Department of Oncology, Karmanos Cancer Institute/Wayne State University.
authors.forename: Susan
authors.initials: S
authors.lastname: Eggly
authors.affiliation: Wayne State University College of Nursing.
authors.forename: Karen
authors.initials: K
authors.lastname: Kavanaugh
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.affiliation: Department of Pediatrics, Children's National Medical Center.
authors.forename: David L
authors.initials: DL
authors.lastname: Wessel
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles.
authors.forename: Christopher J L
authors.initials: CJ
authors.lastname: Newth
authors.affiliation: Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Shanley
authors.affiliation: Department of Pediatrics, Mattel Children's Hospital at University of California Los Angeles.
authors.forename: Rick
authors.initials: R
authors.lastname: Harrison
authors.affiliation: Department of Pediatrics, Phoenix Children's Hospital.
authors.forename: Heidi
authors.initials: H
authors.lastname: Dalton
authors.affiliation: Department of Pediatrics, University of Utah.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Dean
authors.affiliation: Department of Pediatrics, St. Louis Children's Hospital.
authors.forename: Allan
authors.initials: A
authors.lastname: Doctor
authors.affiliation: National Institute of Child Health and Human Development.
authors.forename: Tammara
authors.initials: T
authors.lastname: Jenkins
authors.affiliation: Department of Psychology, University of Connecticut.
authors.forename: Crystal L
authors.initials: CL
authors.lastname: Park
mesh_terms: D000328:Adult; D001293:Attitude to Death; D001601:Bereavement; D002648:Child; D003422:Critical Care / Q000523:psychology* / Q000639:trends; D003643:Death; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000639:trends; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D014741:Video Recording / Q000639:trends
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