Browsing by Subject "Parent"

For most parents there is no imaginable event more devastating than the death of their child. Nevertheless, while bereaved parents grieve they are also expected to carry on with their life. The day-to-day activities that were once routine for these parents may now be challenging due to the emotional turmoil they are experiencing. To date parental bereavement has been described as complex, intense, individualized, and life-long and their grief responses are interwoven with their daily activities, but the nature of their daily life challenges are not known.

This dissertation highlights the significance of how parents respond to their bereavement challenges because bereaved parents have higher morbidity and mortality rates than non-bereaved parents or adults who have lost their spouse or parents. Many bereaved parents in their daily routines include activities that allow them to maintain a relationship with their deceased child. These behaviors have been described as “continuing bonds”, but with this dissertation the continuing bonds concept is analyzed to provide a clear conceptual definition, which can be used for future research.

Using the Adaptive Leadership Framework as the theoretical lens and a mixed method, multiple case study design, the primary study in this dissertation aims to provides knowledge about the challenges parents face in the first six months following the death of their child, the work they use to meet these challenges, and the co-occurrence of the challenges, and work with their health status. Bereaved parents challenges are unique to their individual circumstances, complex, interrelated and adaptive, as they have no easy fix. Their challenges were pertaining to their everyday life without their child and classified as challenges related to: a) grief, b) continuing bonds, c) life demands, d) health concerns, f) interactions, and g) gaps in the health care system. Parents intuitively responded to the challenges and attempted to care for themselves. However, the role of the healthcare system to assist bereaved parents during this stressful time so that their health is not negatively impacted was also recognized. This study provides a foundation about parental bereavement challenges and related work that can lead to the development and testing of interventions that are tailored to address the challenges with a goal of improving bereaved parents health outcomes.

Stroke is the fifth leading cause of death in the United States and the leading cause of disability. Historically, stroke has been considered a condition limited to older adults. However, stroke is affecting an increasing number of young and middle-aged adults. Effects of stroke may be more profound for younger adults due to the disruption in their life course at a time focused on employment, family routines, and childcare responsibilities. Beyond paid employment, there is a paucity of research on resuming meaningful life roles such as parenting. Any impairment from stroke can make it difficult to be a parent to the same extent and level of engagement as before the stroke. As parenting is a critical life role with numerous responsibilities and challenges, the intersection of parenting and stroke recovery must be explored.

The purpose of this dissertation research was to develop a better understanding of how parenting both affects and is affected by the experience of having a stroke among younger stroke survivors. The research purpose was accomplished through a systematic review examining the state of the science on parenting after stroke (chapter 2), a qualitative study assessing the parenting experiences of 10 younger survivors following stroke (chapter 3), and a longitudinal concurrent convergent mixed methods study exploring the change in health-related quality of life and acute recovery experiences among 30 younger stroke survivors with targeted analyses to explore the role of parenting (chapter 4).

Parenting tasks were severely limited following stroke, though the specific duties impacted were dependent upon the age of the child. Stroke impairments disrupted survivors’ identities, relationships, and roles as parents as well as those of their families. Parents’ heightened concern for their children and an inability to consistently meet their needs may have affected their recovery. Support from family, friends, and extended networks was vital to survivors during the recovery process. However, difficulty in accepting dependence and variation in survivors’ relationship dynamics likely influenced the role of social support. Insurance and finances, often related to employment and income changes, were determinants of access to care following hospital discharge. Accessing care allowed survivors to engage with healthcare providers who helped them to improve and manage their impairments. Coping strategies influenced survivors’ adaptation post-stroke while their level of determination contributed to their engagement in rehabilitation activities. Finally, being of younger age influenced survivors’ experiences with stroke recognition, diagnosis, and recovery. Findings from this dissertation will be used to inform future studies seeking to improve the lives, well-being, and health of younger stroke survivors living with minor children.