Children's Responses to Sibling Death in NICU/PICU in 3 Racial/Ethnic Groups

3 个种族/族裔群体的儿童对 NICU/PICU 中兄弟姐妹死亡的反应

• 批准号: 8508091
• 负责人: DOROTHY BROOTEN
• 金额: $ 45.89万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-29 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8508091
• 关键词: 18 year old; Acculturation; Acute; Adolescent; Adult; Affect; Age; Aggressive behavior; Anger; Anxiety; Area; Behavioral; Caring; Cause of Death; Cessation of life; Characteristics; Child; Child Care; Child Mental Health; Chronic; Clinical; Confusion; Data; Data Collection; Depressed mood; Early treatment; Emotional; Ethnic Origin; Ethnic group; Family; Family Characteristics; Family health status; Family member; Feeling; Feeling suicidal; Friends; Fright; Gender; Grief reaction; Growth; Guilt; Health; Health Care Costs; Health Personnel; Health Professional; Hispanics; Infant; Injury; Intervention; Interview; Latino; Left; Life; Literature; Mental Depression; Mental Health; Methods; Minority; Modeling; Newborn Infant; Not Hispanic or Latino; Outcome; Parents; Pattern; Performance; Population; Problem behavior; Provider; Race; Research; Resources; Risk; Role; Sampling; Sampling Biases; School-Age Population; Schools; Science; Siblings; Single Parent; Social support; Suicide attempt; Support System; Survivors; Theoretical model; Thinking; Time; Work; age group; base; boys; effective intervention; experience; externalizing behavior; family structure; girls; physical conditioning; public health relevance; racial and ethnic; response; role model; sex; socioeconomics; teacher

DESCRIPTION (provided by applicant): Death of a sibling is a double loss for surviving siblings - loss of a playmate, confidante, friend, role model - and loss of parents whose grief leaves them with little to no emotional energy to reach out to their hurting surviving children. Approximately 2 million US children experience this each year, leaving 25% of them in need of clinical intervention and more than 50% with significant behavior problems. Many children respond to a sibling's death with anger, aggression, guilt, depression, suicidal thoughts and attempts, anxiety, poor school performance distance from parents, and confusion. Research in this area has changed from a focus on having children "get over the sibling's death" to calls for a more comprehensive approach to children's responses to sibling death within a family context. Current studies on responses of surviving siblings suffer from small and frequently biased samples, little to no minority or lower socioeconomic representation, and inclusion of newborn to adult sibling deaths in the same sample often conducted many years after the sibling's death. The purpose of this longitudinal, mixed methods study is to examine children's mental health, physical health, personal growth, and functioning from 2 to 13 months after death of a sibling in the PICU/NICU and identify factors related to these outcomes in White non-Hispanic, Black non-Hispanic, & Hispanic/Latino children. The proposed study's theoretical model posits that characteristics of the situation surrounding the death, characteristics of the surviving sibling, parent and family characteristics, and supportive resources affect surviving sibling grief. Sibling grief and supportive resources are posited to affect surviving children's mental health, physical health, personal growth, and functioning (aggressive behavior and school performance). Surviving siblings between 6 and 18 years old living with the deceased sibling's parent(s) will be included if they are in their age- appropriate grade in school + 1 year. Quantitative data will be obtained from both parents and children. Qualitative interviews with each surviving sibling will focus on the time around the deceased sibling's death, their thoughts and feelings about the death and life since the death, roles and relationships within their family since the death, and relationships/activities with friends and teachers/child care providers. Study findings will provide much needed information on factors that influence outcomes for surviving siblings. Study data will provide a much more comprehensive examination of sibling loss in the context of the family, so timely, culturally appropriate and effective interventions can be developed to promote health of both the surviving siblings and the family.

描述（由申请人提供）：兄弟姐妹的死亡对幸存的兄弟姐妹来说是双重损失-失去玩伴，红颜知己，朋友，榜样-以及失去父母，他们的悲伤使他们几乎没有情感能量去接触他们受伤的幸存孩子。每年大约有200万美国儿童经历这种情况，其中25%需要临床干预，超过50%的儿童存在严重的行为问题。许多孩子对兄弟姐妹的死亡的反应是愤怒、攻击性、内疚、抑郁、自杀的想法和企图、焦虑、与父母的距离和混乱。这一领域的研究已经从关注让儿童“从兄弟姐妹的死亡中走出来”转变为呼吁采取更全面的方法来研究儿童在家庭环境中对兄弟姐妹死亡的反应。目前对幸存兄弟姐妹的反应的研究受到小样本和经常有偏见的样本，很少或没有少数民族或较低的社会经济代表性，并且在同一样本中包括新生儿到成年兄弟姐妹死亡通常在兄弟姐妹死亡多年后进行。这项纵向混合方法研究的目的是检查儿童的心理健康，身体健康，个人成长和功能，从2至13个月后死亡的兄弟姐妹在PICU/NICU，并确定与这些结果相关的因素在白色非西班牙裔，黑人非西班牙裔，西班牙裔/拉丁裔儿童。拟议的研究的理论模型假定，周围的死亡，幸存的兄弟姐妹，父母和家庭的特点，支持资源的特点的情况影响幸存的兄弟姐妹悲伤。兄弟姐妹的悲伤和支持资源被认为会影响幸存儿童的心理健康，身体健康，个人成长和功能（攻击行为和学校表现）。与已故兄弟姐妹的父母一起生活的6至18岁的幸存兄弟姐妹将被包括在内，如果他们在学校的年龄适当的年级+ 1年。将从父母和孩子那里获得定量数据。与每个幸存的兄弟姐妹的定性访谈将集中在已故兄弟姐妹死亡的时间，他们对死亡和死亡后的生活的想法和感受，自死亡以来家庭中的角色和关系，以及与朋友和老师/儿童保育提供者的关系/活动。研究结果将为影响幸存兄弟姐妹结局的因素提供急需的信息。研究数据将提供一个更全面的检查兄弟姐妹的损失在家庭的背景下，及时，文化上适当的和有效的干预措施，可以制定促进健康的幸存的兄弟姐妹和家庭。