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Learning Objective 1: describe parents' mental health, dyadic relationships, and family functioning 1-2 months after a child's death in the pediatric or neonatal intensive care unit.
Learning Objective 2: identify factors that related to mental health, dyadic relationships, and family functioning 1-2 months after a child's death in the PICU or NICU.
To describe a mother’s grief, mental health, and dyadic relationships 1-2 months after the death of an infant/child in the NICU/PICU.
Significance:
Loss of a child is devastating for families. Although many children die in ICUs, few studies have focused on outcomes for parents.
Methods:
Mothers of 88 deceased children, aged 22 hours to 16 years, recruited from 4 level III NICUs and 4 PICUs. Racial breakdown: mothers, 48% Hispanic, 36% Black non-Hispanic, 16% white non-Hispanic. Half of the mothers anticipated the child’s death. Data collected in the home at 1-2 months postdeath with Multidimensional Scale of Perceived Support, Inventory of Social Support, Hogan Grief Reaction Checklist, Beck Depression Inventory II, Impact of Events Scale-revised, FACES II, Dyadic Adjustment Scale.
Findings:
Depression scores were categorized as moderate or severe for 46% of mothers, but only 14% were in counseling. These mothers experienced significantly greater PTSD and grief than those with mild or no depression; only severely depressed mothers rated their health lower. Ratings of their relationships with a surviving child and their partner and family functioning did not differ by depression category (oneway ANOVA). Greater social support was related to better couple and family relationships, r=.31-.47, and less detachment and disorganization, r=-.23 for both. Greater religiosity was related to less depression, PTSD, and grief, r=-.29 to -.34. Hispanic mothers had more PTSD than white mothers and less personal growth than both white and Black mothers. Mother’s age and education, child age and birth order, and family income had little effect on mental health or family functioning.
Discussion:
One to two months after their child’s death in the ICU, mothers with moderate to severe depression also report greater grief, PTSD, and stress in their relationships within the family. Social support and religiosity are important factors in decreasing these negative parent and family outcomes.
Funding NINR #R01NR009120
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