Healthcare Professionals' Reactions After a Child's Death

Abstract

As the medical world aims towards multidisciplinary work, we wanted to extend previous research to describe the impact of the memorable death of a child on all healthcare professionals. Objectives: To evaluate the intensity of the grief experienced by healthcare professionals after a child's death, to explore factors associated with a memorable death and to identify the needs of healthcare professionals in dealing with this event. Method: A cross sectional survey using a self-administered questionnaire in a pediatric and neonatology department in a Canadian general hospital. Healthcare professionals completed the questionnaire assessing their emotional reactions to a child's death using the French version of the Texas Revised Inventory of Grief (TRIG), the use of coping strategies, and the expression of their needs when a child dies. Results: 101 healthcare professionals (22 doctors, 11 pediatric residents, 46 nurses, 13 respiratory therapists, and 9 physiotherapists, social workers, occupational therapists, psychologists, and nutritionists) completed the questionnaire. The present study corroborates many conclusions put forward in other descriptive studies about healthcare professionals' intensity of grief over the loss of a child. Respiratory therapists showed higher intensity of grief after a memorable death, measured by the TRIG, than other healthcare professionals (29.4 +/- 15 vs 16 +/- 14, p= 0.0024). Males had higher early grief score than females (26 +/- 19 versus 17 +/- 14; p = 0.06), although this result was not statistically significant. Younger healthcare professionals (20 to 25 years old) reported higher early grief score than older ones (> 50 years old) (22 +/- 16 vs 10 +/- 8; p = 0.01). If the respondent said he was comfortable caring for a dying patient, his intensity of grief tended to be lower (p = 0.02). There is no significant association between the TRIG score and the fact of being a parent, to have lost a child, to have received formation regarding palliative care, and the length of the relation with the children and his family. Seventy percent talked with their colleagues about the death and 48% with family and friends. Many respondents (37%) answered that this social support helped them the most to overcome this hardship. Conclusion: For healthcare professionals, bereavement after a memorable death is intense. Difference between different professions raises concern about their training and the emotional support received following the death of a patient. We suggest that work-place-based training and debriefing sessions after the death of a patient should be more available for all healthcare professionals.