Grief and Bereavement in Parents After the Death of a Child in Low- and Middle-Income Countries
Abstract
:1. Introduction
2. Methods
3. Current State of Bereavement Research in High-Income Countries
3.1. Definitions
3.2. Parental adverse effects
3.3. Supportive interventions
3.4. Health-Related Grief and Bereavement in LMICs
3.5. Perinatal Death
3.6. Infant Mortality
3.7. Infectious Disease
3.8. Interventions
3.9. Provider Comfort and Perceived Need
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Paper | Year | Type of Paper | Countries Evaluated | Key Findings |
---|---|---|---|---|
Stillbirth | ||||
Shakespeare et al. [36] | 2019 | Systematic Review | Bangladesh, Benin, Brazil, China, Ethiopia, Ghana, India, Indonesia, Iran, Malawi, Malaysia, Nigeria, Russia, Somalia, South Africa, Tanzania, Uganda | Common themes from the review include: positive community support, as opposed to stigmatization and blame, can improve the bereavement experience. Women’s experience of grief is often unrecognized by the healthcare community and wider society and that access to timely and culturally appropriate psychological support is valued. |
Lizcano Pabon et al. [37] | 2019 | Qualitative Study | Columbia | Fathers often suffer alone as they focus on the suffering of their partner. They felt neglected and forgotten by the hospital staff and were not allowed in the room to support their partners or to have meaningful moments with their child. |
Roberts et al. [38] | 2017 | Mixed Methods Study | India | Women were discouraged from grieving a stillbirth and pushed to conceive again. Men with a history of stillbirths had greater anxiety and depression and perceived less social support and were also more likely to be emotionally or physically abusive. |
Infant | ||||
Meyer et al. [39] | 2016 | Qualitative Study | Ghana | Mother’s were discouraged in discussing or thinking about their child after they had died. Few mothers felt that this avoidance was beneficial in their grief process. |
Fouts and Silverman [40] | 2015 | Observational Study | Central African Republic | Those children whose mother had lost 2 children were significantly more likely to be held and have significant physical contact than those children whose mothers had lost 0 to 1 child and they were also held more as compared to those children whose mothers had lost 3 or more children. |
Goldstein et al. [41] | 2018 | Cross-Sectional Survey | South Africa | High rates of prolonged grief disorder were not significantly different despite extremely varied and diverse cultural contexts. While culture may impact grief expression, there is an ingrained response to child loss that is maintained regardless of cultural circumstances. |
Infectious | ||||
Demmer et al. [42] | 2010 | Qualitative Study | South Africa | Several stressors impact a mother’s grief including remaining silent about their grief due to the fear and persistent stigma about Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). The mothers also felt guilt for feeling like they were the cause of their child’s sickness. They struggled to find time to grieve as they faced the challenges of extreme poverty. |
Interventions | ||||
Yildiz et al. [43] | 2017 | Intervention study with pre- and post-test control group | Turkey | A grief support program was created for parents whose child had died. The intervention included brochures and other literature about grief and bereavement as well as interactions with a researcher at various time points. There was no difference between the control and intervention groups at 3 and 6 months. At 12 months, there was a difference that was not statistically significant. |
Hunt 2002, Hunt et al. 2007 [44,45] | 2002, 2007 | Intervention tool development and qualitative feedback | India, Kenya, South Africa, Zimbabwe | Participants trained with this tool learned the impact that culture has in determining grief reactions and that the bereaved may behave normally but that this does not mean they are not feeling pain. |
Provider Perceptions | ||||
Chan et al. [46] | 2010 | Cross-Sectional Survey | China, Singapore | More senior nurses, those who had previous encounters with bereaved parents, and those that had received training on palliative care and bereavement, felt more comfortable working with bereaved families. Most of the nurses in the study agreed or strongly agreed that training in bereavement care is important. |
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McNeil, M.J.; Namisango, E.; Hunt, J.; Powell, R.A.; Baker, J.N. Grief and Bereavement in Parents After the Death of a Child in Low- and Middle-Income Countries. Children 2020, 7, 39. https://doi.org/10.3390/children7050039
McNeil MJ, Namisango E, Hunt J, Powell RA, Baker JN. Grief and Bereavement in Parents After the Death of a Child in Low- and Middle-Income Countries. Children. 2020; 7(5):39. https://doi.org/10.3390/children7050039
Chicago/Turabian StyleMcNeil, Michael J., Eve Namisango, Jennifer Hunt, Richard A. Powell, and Justin N. Baker. 2020. "Grief and Bereavement in Parents After the Death of a Child in Low- and Middle-Income Countries" Children 7, no. 5: 39. https://doi.org/10.3390/children7050039