Exploring the experiences of support with parentally bereaved children and their surviving parents using constructivist grounded theory

Abstract Background: In the UK, 46,300 children are bereaved of a parent each year. We understand bereaved people need a supportive response from those around them. However, there is limited evidence to inform our understanding of this. Aim: To explore how children and families best support each other after a parent's death and to understand how those within their existing networks can provide a supportive response. Methods: Following a systematic review to identify and synthesise the experiences of support for children and surviving parents following parental death, a qualitative study was undertaken. Using a constructivist grounded theory approach, in-depth interviews were conducted with children and their surviving parents after the death of a parent to explore their experiences and perspectives of support needs. Data were analysed using constant comparison, following Charmaz’s open, focused, and theoretical coding stages. Findings: Systematic review findings highlighted the limited studies, including children and parents, that explored bereavement support. Seventeen parents and eleven of their children participated in on-line interviews. Theoretical coding of key categories from both interview data sets culminated in developing a substantive theory, ‘masking your grief - because you feel you have to’, articulating the behaviour patterns amongst children, surviving parents and those around them following their bereavement. Families gave examples of the supportive response they received from each other and those within their networks. However, the response was not sustained. ‘Masking your grief - because you feel you have to’ is something children and parents do to protect each other and the people around them. It often happens because the immediate bereavement support dwindles as the people around them do not understand what they continue to go through. Conclusion: This study highlights gaps in bereavement support and how existing networks can provide a supportive response. It is essential that children and surviving parents’ grief is considered within the context of their social networks, which will impact how they grieve. A public health approach to bereavement is required, with everyone recognising their role in supporting bereaved families.