Regret and unfinished business in parents bereaved by cancer: A mixed methods study

Background: Prior research has demonstrated that the presence of regret and unfinished business is associated with poorer adjustment in bereavement. Though there is a growing literature on these constructs among caregivers of adult patients, the literature on regret and unfinished business in bereav...

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Published inPalliative medicine Vol. 34; no. 3; pp. 367 - 377
Main Authors Lichtenthal, Wendy G, Roberts, Kailey E, Catarozoli, Corinne, Schofield, Elizabeth, Holland, Jason M, Fogarty, Justin J, Coats, Taylor C, Barakat, Lamia P, Baker, Justin N, Brinkman, Tara M, Neimeyer, Robert A, Prigerson, Holly G, Zaider, Talia, Breitbart, William, Wiener, Lori
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.03.2020
Sage Publications Ltd
Subjects
Adult
Bereavement
Cancer
Caregivers
Caregiving
Child
Children
Clinical decision making
Clinical research
Cognitive behavioral therapy
Cognitive-behavioral factors
Decision making
Female
Grief
Humans
Male
Meaning
Mixed methods research
Neoplasms - nursing
Neoplasms - psychology
Parents & parenting
Parents - psychology
Pediatrics
Psychological distress
Questionnaires
Regret
Self report
Time Factors
Regret
caregivers
neoplasm
decision-making
pediatric
grief
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Summary:Background: Prior research has demonstrated that the presence of regret and unfinished business is associated with poorer adjustment in bereavement. Though there is a growing literature on these constructs among caregivers of adult patients, the literature on regret and unfinished business in bereaved parents has been limited. Aim: The aim of this study was to examine regret and unfinished business in parents bereaved by cancer, as well as their associations with caregiving experiences and prolonged grief. Design: This was a cross-sectional mixed methods study that utilized self-report questionnaires with open-ended items. Setting/Participants: The multisite study took place at a tertiary cancer hospital and pediatric cancer clinical research institution. Participants were 118 parents (mothers = 82, fathers = 36) who lost a child aged 6 months to 25 years to cancer between 6 months and 6 years prior. Results: Results showed that 73% of the parents endorsed regret and 33% endorsed unfinished business, both of which were more common among mothers than fathers (p ⩽ 0.05). Parents were on average moderately distressed by their regrets and unfinished business, and both regret-related and unfinished business–related distress were associated with distress while caregiving and prolonged grief symptoms. Conclusion: Findings have implications for how providers work with families, including increasing treatment decision-making support, supporting parents in speaking to their child about illness, and, in bereavement, validating choices made. Grief interventions that use cognitive-behavioral and meaning-centered approaches may be particularly beneficial.
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Authorship: Lichtenthal: Conception and design of the work; acquisition, analysis, and interpretation of data; drafting and revising the work for important intellectual content. Roberts: Analysis and interpretation of data; drafting and revising the work for important intellectual content. Catarozoli: Acquisition, analysis, and interpretation of data; drafting and revising the work for important intellectual content. Schofield: Analysis and interpretation of data; drafting and revising the work for important intellectual content. Holland: Interpretation of data; revising the work for important intellectual content. Fogarty: Analysis of data; drafting and revising the work for important intellectual content. Coats: Analysis of data; drafting and revising the work for important intellectual content. Barakat: Interpretation of data; revising the work for important intellectual content. Baker: Interpretation of data; revising the work for important intellectual content. Brinkman: Interpretation of data; revising the work for important intellectual content. Neimeyer: Interpretation of data; revising the work for important intellectual content. Prigerson: Interpretation of data; revising the work for important intellectual content. Zaider: Interpretation of data; revising the work for important intellectual content. Breitbart: Interpretation of data; revising the work for important intellectual content. Wiener: Conception and design of the work; acquisition and interpretation of data; revising the work for important intellectual content.
ISSN:0269-2163
1477-030X
DOI:10.1177/0269216319900301