The Divorced Family-Focused Care Model: A Nursing Model to Enhance Child and Family Mental Health and Well-Being of Doubly Bereaved Children Following Parental Divorce and Subsequent Parental Cancer and Death

Perceptions of haemodialysis nurses regarding patients' and families' loss and grief

BACKGROUND

The experience of loss and grief in patients' lives with life-long treatment in haemodialysis, and in their families' lives is a major cause of mental health problems. In practice, nurses often describe a lack of time and limited knowledge of how to provide nursing care in situations of loss and grief, thus finding out from nurses' perspectives of what competencies they need to provide care would be useful for the development of nursing practice.

OBJECTIVES

To develop knowledge in a nursing perspective of competencies to provide care for patients and their families, who experience grief linked to loss due to kidney failure, haemodialysis and/or death.

DESIGN

The study took a phenomenological-hermeneutical approach. Semi-structured interviews were conducted 12 nurses caring for patients receiving haemodialysis with no kidney transplantation option and family members. Ricoeur's interpretation theory involving naïve reading, structural analysis and critical interpretation and discussion was used for analysis.

RESULTS

Four themes emerged of nurse's experiences: (1) patient's loss and grief in everyday life, (2) dealing with supportive conversations when caring for patients, (3) families' losses are resulting in grief reactions and (4) importance of close relationships when caring for families.

CONCLUSIONS

To nurses, patients on haemodialysis and their families have multiple loss and grief experiences. Nurses' working in kidney care need to develop competencies to support patients and families to cope with grief and loss. Further research is needed to develop these competencies and then to implement in education and practice.

Nursing care and nurses' understandings of grief and bereavement among patients and families during cancer illness and death - A scoping review

PURPOSE

Grief and bereavement is often present among patients and families during courses of cancer. Offering support for both patients and families is essential in the context of cancer nursing. Present scoping review offers an overview of existing knowledge, which can be used for inspiration in cancer-nursing. Hence, the objective of this study was to identify understandings of grief and bereavement, which is present in a cancer-nursing context and to develop insight on existing knowledge about nursing interventions targeted patients and their families' experiences of grief and bereavement due to cancer illness.

METHOD

The scoping review is conducted, inspired by the methodology of Joanna Briggs Institute. Sources of evidence are retrieved from a large number of databases and resources.

RESULTS

Twenty-two studies are included in the scoping review. The studies are retrieved from eight different countries. Findings are mapped in nine categories. Eight categories related to nursing care targeted patients and/or families experiencing grief and/or bereavement; One category related to understandings of grief and/or bereavement targeted patients and families.

CONCLUSION

Nursing interventions to support patients and their families during grief and bereavement covers a broad spectrum of interventions. E.g. communication; using artwork; cultural and spiritual care; bereavement care; supporting coping strategies. Different models and theoretical understandings were identified. E.g. The dual process model of coping with bereavement; A Divorced Family-focused Care Model; Family Strengths-Oriented Therapeutic Conversation (Fam-SOTC); and understandings of children's grieving process.

A Qualitative Systematic Review About Children's Everyday Lives when a Parent Is Seriously Ill with the Prospect of Imminent Death - Perspectives of Children and Parents

Parental dying is a life changing experience for children. This study explores children's strategies and (inter)actions in their everyday life when facing critically ill parents and imminent death, from the children's and parents' perspectives. A qualitative systematic review was carried out, registered in PROSPERO (CRD42022306862). A literature search and screening in six databases resulted in eighteen articles. Thematic analysis showed that children were capable of developing various strategies to cope in everyday life, even in vulnerable situations. From parents' and children's perspectives, inclusion, openness, and communication about parents' situations, taking children's age and needs into consideration, were important to face and cope with the situation. Children were life-capable, also in vulnerable and difficult situations. This calls for the necessity of developing children-led support, by acknowledging, and taking the children's experiences, and resources, as starting points to tailor adequate support for children of critically ill parents.

The Case for Multidimensional Co-Parenting Behaviors as Sources of Chronic Stress: Understanding Pathways to Mental Health Symptomology Among Divorced and Separating Adults

The co-parenting relationship matters for postdivorce parental adjustment. This study explores the relative impact of different forms of co-parenting behaviors, coupled with an individual's psychological resources, in explaining parent mental health in recently divorced or separated parents (n = 355). A latent variable structural equation model was fit to examine pathways between dimensions of co-parenting (support, overt conflict, self-controlled covert conflict, and externally controlled covert conflict), various psychological resources (satisfaction with the divorce decree, perceived competence of the co-parent, and self-efficacy), and adverse mental health symptomology. Significant direct pathways were identified between overt co-parenting conflict and adverse mental health. Indicators of co-parenting quality were tied differentially to various resources. Indirect effects were found for both self-controlled covert conflict and overt conflict on adverse mental health symptomology through self-efficacy. Leverage points and considerations for health professionals and practitioners working with divorcing parents are discussed.

Family Structure Diversity and Youth Health Care Access and Interactions With Health Care Providers

Using data from the 2019 National Survey of Children's Health, we evaluated family structure differences in youth health care access and experiences. We found youth living with their married biological/adoptive parents generally had greater health care access than youth living in structurally diverse families. Differences, however, varied based on which aspect of health care access was examined and the specific types of structurally diverse families youth were living in. Youth living in single-father and other relative-headed families showed the most consistent differences in health care access from youth living with their married biological/adoptive parents. In terms of health care experiences, youth living in several structurally diverse families were more likely to have had time alone with health care providers. Furthermore, there were differences in family-centered care, but the effect size and magnitude of the differences were small.