Cited by 246Grief, Bereavement, and Mental HealthDeath, Funerary Practices, and MourningPalliative and Oncologic Care

Unresolved grief in a national sample of bereaved parents: impaired mental and physical health 4 to 9 years later

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Lannen, Patrizia K., Wolfe, Joanne, Prigerson, Holly G., Onelov, Erik, Kreicbergs, Ulrika C.·2008·Journal of Clinical Oncology

Abstract

Purpose: To assess unresolved parental grief, the associated long-term impact on mental and physical health, and health service use. Patients and Methods: This anonymous, mail-in questionnaire study was performed as a population-based investigation in Sweden between August 2001 and October 2001. Four hundred forty-nine parents who lost a child as a result of cancer 4 to 9 years earlier completed the survey (response rate, 80%). One hundred ninety-one (43%) of the bereaved parents were fathers, and 251 (56%) were mothers. Bereaved parents were asked whether or not, and to what extent, they had worked through their grief. They were also asked about their physical and psychological well-being. For outcomes of interest, we report relative risk (RR) with 95% CIs as well as unadjusted odds ratios and adjusted odds ratios. Results: Parents with unresolved grief reported significantly worsening psychological health (fathers: RR, 3.6; 95% CI, 2.0 to 6.4; mothers: RR, 2.9; 95% CI, 1.9 to 4.4) and physical health (fathers: RR, 2.8; 95% CI, 1.8 to 4.4; mothers: RR, 2.3; 95% CI, 1.6 to 3.3) compared with those who had worked through their grief. Fathers with unresolved grief also displayed a significantly higher risk of sleep difficulties (RR, 6.7; 95% CI, 2.5 to 17.8). Mothers, however, reported increased visits with physicians during the previous 5 years (RR, 1.7; 95% CI, 1.1 to 2.6) as well as a greater likelihood of taking sick leave when they had not worked through their grief (RR, 2.1; 95% CI, 1.2 to 3.5). Conclusion: Parents who have not worked through their grief are at increased risk of long-term mental and physical morbidity, increased health service use, and increased sick leave.

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  • A majority (73.5%) of parents who had lost a child to cancer had sleep difficulties 4-9 years later.

    “One previous study (Lannen et al., 2008) has reported that a majority (73.5%) of parents who had lost a child to cancer had sleep difficulties 4–9 years later.”

    From Feasibility and preliminary efficacy of guided internet-delivered cognitive behavioral therapy for insomnia after the loss of a child to cancer: Randomized controlled trial (2021) · cites this paper as Lannen et al., 2008

    The paper studied parents 4–9 years after losing a child to cancer, but its outcome tables (Tables 3 and 4, indexed under Discussion; page unavailable) report regular difficulty falling asleep in 10%–27% of the father and mother subgroups, not 73.5% of parents overall. The Discussion highlights persistent sleep disturbance particularly among fathers with unresolved grief; it does not report that a majority of all bereaved parents had sleep difficulties. (LLM, conf=0.89)

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Research works printed but not linked: 1

  1. [2]2. Osterwers M, Solomon F, Green M: Bereave- ment Reactions, Consequences, and Care: Commit- tee for the Study of Health Consequences of the Stress of Bereavement. Washington, DC, National Academy Press, 1984

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Authors
Lannen, P. K., Wolfe, J., Prigerson, H. G., Onelov, E., & Kreicbergs, U. C.
Affiliations
  • From the Phyllis F. Cantor Center; the Department of Psychooncology and Palliative Care Research; and the Department of Pediatric Oncology and the Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; and the Department of Medicine, Children's Hospital, Boston, MA; the Department of Psychology, Universität Bern, Bern, Switzerland; the Division of Clinical Cancer Epidemiology; and the Department of Women and Child's Health, Karolinska Institutet, Stockholm, Sweden
  • University of Bern (CH)
Venue
Journal of Clinical Oncology
Published
2008-12-20
Volume
26
Issue
36
Pages
5870-5876
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W2129225171
Cited by
246
References
34
Citations by year
2026: 12 · 2025: 14 · 2024: 13 · 2023: 12 · 2022: 13 · 2021: 24 · 2020: 19 · 2019: 15 · 2018: 19 · 2017: 18 · 2016: 17 · 2015: 14 · 2014: 8 · 2013: 13 · 2012: 13
FWCI
7.81
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion)
Funders
  • Charles H. Hood Foundation
  • Svenska Sällskapet för Medicinsk Forskning
  • National Cancer Institute (K07CA096746)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
unresolved grief, parental bereavement, child cancer, bereaved parents, mental health, physical health, sleep disorders, health care utilization, sick leave, grief processing, parents
MeSH terms
Adaptation, Psychological, Adolescent, Adult, Bereavement, Fathers, Female, Grief, Health Services, Health Status, Humans, Male, Mental Health, Mothers, Neoplasms, Parents, Surveys and Questionnaires, Sweden, Time Factors

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