Rigour and Rapport: a qualitative study of parents' and professionals' experiences of joint agency infant death investigation.
BACKGROUND
In many countries there are now detailed Child Death Review (CDR) processes following unexpected child deaths. CDR can lead to a fuller understanding of the causes for each child's death but this potentially intrusive process may increase the distress of bereaved families. In England, a joint agency approach (JAA) is used where police, healthcare and social services investigate sudden child deaths together and a key part of this is the joint home visit (JHV) where specialist police and paediatricians visit the home with the parents to view the scene of death. This study aimed to learn of bereaved parents' experiences of JAA investigation following Sudden Unexpected Death in Infancy (SUDI).


METHODS
This was a qualitative study of joint agency investigation of SUDI by specialist police, healthcare and social services including case note analysis, parental questionnaires, and in-depth interviews with parents and professionals. Families were recruited at the conclusion of the JAA. Data were analysed using a Framework Approach.


RESULTS
21/113 eligible families and 26 professionals participated giving theoretical saturation of data. There was an inherent conflict for professionals trying to both investigate deaths thoroughly as well as support families. Bereaved parents appreciated the JAA especially for the information it provided about the cause of death but were frustrated with long delays waiting to obtain this. Many parents wanted more emotional support to be routinely provided. Most parents found the JHV helpful but a small minority of mothers found this intensely distressing. In comparison to JHVs, when police visited death scenes without paediatricians, information was missed and parents found these visits more upsetting. There were issues with uniformed non-specialist police traumatising parents by starting criminal investigations and preventing parents from accessing their home or collecting vital possessions.


CONCLUSIONS
Overall most parents feel supported by professionals during the JAA; however there is scope for improvement. Paediatricians should ensure that parents are kept updated with the progress of the investigations. Some parents require more emotional support and professionals should assist them in accessing this.
Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, CV7 4AL, UK. Joanna.J.Garstang@warwick.ac.uk.
Joanna
J
Garstang
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV7 4AL, UK.
Frances
F
Griffiths
Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, CV7 4AL, UK.
Peter
P
Sidebotham
D001291:Attitude of Health Personnel; D001601:Bereavement; D002423:Cause of Death; D016265:Conflict of Interest; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D035846:Law Enforcement / Q000379:methods*; D008297:Male; D010290:Parents / Q000523:psychology*; D000072143:Pediatricians; D016495:Police; D011368:Professional-Family Relations; D036301:Qualitative Research; D012944:Social Support; D012947:Social Work; D013398:Sudden Infant Death / Q000175:diagnosis* / Q000209:etiology
Bereaved parents; Child Death Review; Inter-professional working; Physician-parent communication; Sudden Infant Death Syndrome (SIDS); Sudden Unexpected Death in Infancy (SUDI)