Transitional social support: A developing framework for hospital-based bereavement care following the death of a child from cancer

Abstract

BACKGROUND/PURPOSE: Following the death of a child from cancer, families often describe feeling 'abandoned' and 'isolated' by healthcare professionals with whom they had built a trusting relationship throughout their child's extended care trajectory. Social support theory may inform the development of transitional psycho-social care for families which begins early in a child's care trajectory and continues in the early stages of bereavement, allowing families' time to simultaneously process their loss while rebuilding relationships in their local communities. METHODS: This paper (a) reviews the literature describing social support theory, (b) creates linkages between the functions of social support and bereavement interventions described in a mixed study review using PRISMA guidelines, and (c) proposes a new theoretical model for hospital-based bereavement interventions drawing on existing models of grief and bereavement to support families as they endeavor to find meaning in their personal and social worlds. RESULTS: The mixed study review identified 19 interventions/ services which were then categorized under four functions of social support including emotional, appraisal, instrumental, and informational support. Aligning the functions of social support and the dual process model of grief, a new theoretical framework is proposed for transitional hospital-based bereavement care following the death of a child. CONCLUSIONS: This paper acknowledges the individual and the collective as central to transforming our response to the bereaved. Drawing on a post-modern approach, our emerging theoretical framework may inform the development of transitional psycho-social care guidelines for palliative, end of life, and bereavement care in the pediatric oncology setting. Research Implications: We believe our emerging theoretical model for hospital-based bereavement caremay provide a foundation for further research into how bereaved families describe the impact of transitional bereavement support which sits within a framework of emotional, instrumental, informational, and appraisal functions of social support. Practice Implications: This developing theoretical model may facilitate an evidence-based approach to development and evaluation of bereavement support programs and their composite services/interventions by encouraging standardized metrics and outcome measures, eventually creating an evidence base.L719678422015-08-08 <br />