Purpose: To examine bereaved parents’ physical, mental, and social health during the first 6 months after their child’s (<12 years) death from a life-threatening illness. Background and Significance: Bereaved parents have higher mortality and morbidity rates when compared to nonbereaved parents. Acute illnesses, hospitalizations, and medication changes are highest in the first 6 months. An understanding of bereaved parents’ health risk indicators can help inform development of health promotion and disease prevention measures. Methods and Analysis: A prospective descriptive study examined 8 parent dyads. Parents completed health surveys (Patient-Reported Outcomes Measurement Information System–global, social, and sleep; Brief Symptom Inventory [BSI] 18), which are used to assess parents’ health at 3 and 6 months after their child’s death. Demographic data included a medical history, hospital or emergency department visits, and smoking and alcohol intake. Descriptive statistics were used to compare parents’ scores to US general population scores. Findings: Mothers’ and fathers’ physical, mental, and sleep health scores were typically within 1 to 2 standard deviations of the population norms. However, their social health scores were as low as 3 standard deviations and all parents’ scores were below population norms. Four (25%) of the 16 parents had new diagnosis during the first 6 months. Based on the BSI-18, 3 parents had their scores above population cutoffs, which warranted a need for further clinical evaluation. Conclusions: Health data highlight the “at-risk” health status of bereaved parents. Further validation of these data is required to support the development of health promotion and disease prevention programs.

Aims: The purpose of this systematic literature review is to describe the interventions for bereaved parents, evaluate intervention effectiveness through study methodology rigor, replicability, and theoretical foundations. Methods: We searched MEDLINE via PubMed (1966-2018), CINAHL (1937-present), PsycINFO (1887-present), and Embase (1947-present) using various search words and MeSH terms related to the study purpose. A blinded screening of title/abstract was performed, with conflicting inclusion decisions resolved through group discussions. Matrices for remaining articles were created and discussed among the team. The levels of evidence of the 9 records were rated from very low to high based on the Grading of Recommendations Assessment, Development, and Evaluation guidelines. Results: Our initial pool included 1025 articles. After the screening of titles/abstracts, 63 articles were retained for full-text reviews. Evaluated based on the inclusion/exclusion criteria, 9 records met the review criteria. Of the 9 records, 1 was graded as very low, 3 low, and 5 low to moderate. The interventions for bereaved parents varied from using single-model interventions such as expressive arts therapy and telephone support to multimodal interventions that combined resources (ie, peer support, resource packets, and health-care support). Only 1 study explicitly illustrated how its bereavement intervention was designed based on the proposed theoretical model. Conclusions: This review highlights the need for individualized, well-tested, and effective bereavement care interventions to support bereaved parents. In summary, the state of the science on interventions for bereaved parents is poor and much work needs to be done to effectively address the needs of bereaved parents, including both their physical and emotional health needs.

Objective: The death of one’s child may negatively affect parental health. Existing models exploring parental bereavement do not provide sufficient frameworks to understand the complexities of health outcomes. The purpose of this study was to examine the health status of bereaved parents. Method: Cross-sectional retrospective study of bereaved parents whose children died at this hospital between 2002 and 2019. A study-specific demographic questionnaire, the National Institutes of Health Roadmap Patient-Reported Outcomes Measurement Information System (PROMIS) initiative. Depressive symptoms were assessed using the PROMIS v1.0 Emotional Distress–Depression—Short Form 8a ( Pilkonis et al., 2011 ). PROMIS measures (depressive symptoms, anxiety, applied cognitive functioning, physical functioning, sleep disturbance), and a measure of posttraumatic growth were mailed and included a link to self-enter data via Research Electronic Data Capture (REDCap, n.d. ) or return paper copies. Results: One hundred fifty surveys were returned (22% response rate). Mean participant age was 41.6 years ( SD = 10.3 years; 83% female). Participants’ health history responses show greater prevalence of depressive symptoms, anxiety, and sleep disorders after their child’s death. The largest difference on PROMIS measures was poorer physical function in the bereaved cohort than in the general population. There were no differences in PROMIS scores based on participant gender or on the presence of surviving siblings. Among those reporting smoking or alcohol consumption, qualitative data suggest that although some might increase use, such use might decrease over time. Conclusions: Bereaved parents manifest poorer psychological and cognitive functioning, and their physical functioning was substantially poorer than the general population mean. Bereaved parents may benefit from proactive guidance normalizing potential challenges to health status and behavior, including appropriate psychoeducational resources. Implications for Impact Statement: Bereaved parents have poorer physical and mental health when compared with the general population. Clinicians that care for these parents must offer health promotion and disease prevention measures early to improve their long-term health outcomes.

Current models of bereavement care do not address all of bereaved parents’ unique needs. Diverse challenges limit parents’ ability to access certain bereavement services. A web-based intervention prototype for bereaved parents was developed. Using convenience and snowball techniques, 14 participants (pediatric providers, software developers, and bereaved parents) were enrolled in a descriptive, cross-sectional feasibility and usability study. While the intervention was generally considered acceptable, three themes were identified to enhance its usability and acceptability: timing; delivery; and revisions. Further intervention development is needed to improve both short- and long-term physical and psychological outcomes for bereaved parents.

North Carolina home health and hospice agencies are experiencing serious shortages of registered nurses (RNs), particularly in rural areas. These shortages can negatively impact patients and families by delaying access to care and possibly resulting in avoidable hospitalizations/rehospitalizations. Many home health and hospice agencies do not hire newly graduated RNs due to limited patient care experience, limited or no opportunity for home health/hospice clinical rotations, and the autonomous nature of providing care in the home. The Hospice and Home Care Foundation of North Carolina was awarded a $468,196 3-year grant, and, in collaboration with key stakeholders, developed a model for clinical rotation experiences in home health and hospice settings for RN students as well as an onboarding model for newly graduated RNs. Seven home health and hospice project partner agencies were selected to pilot the models. This article describes program implementation and evaluation. We used a survey method and site visit interviews to assess program effectiveness. Students provided positive feedback about the clinical rotation and more than 80% indicated their clinical rotation met “most” or “almost all” of their learning needs. The focus group interviews provided substantive anecdotal examples to validate the survey results.