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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Black, White, and Hispanic Children's Health and Function 2-13 Months After Sibling Intensive Care Unit Death
JoAnne M Youngblut1, Dorothy Brooten1, Teresa Del-Moral2
1Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL.
Insights
Children experienced significant anxiety after sibling death, particularly girls and Black children. Seeing their sibling before or after death and attending the funeral reduced anxiety and depression.
Area of Science:
- Pediatric Psychology
- Child Psychiatry
- Bereavement Studies
Background:
- Sibling loss is a significant adverse childhood experience.
- Children's psychological and behavioral responses to sibling death require thorough investigation.
Purpose of the Study:
- To describe children's anxiety, depression, behaviors, and school performance up to 13 months after a sibling's death in a neonatal/pediatric intensive care unit (NICU/PICU) or emergency department (ED).
- To compare these outcomes based on child demographics and post-death rituals like viewing the sibling or attending the funeral.
Main Methods:
- A longitudinal study involving 132 children from 71 families across multiple hospitals.
- Children self-reported anxiety and depression; parents reported behaviors and school performance at 2, 4, 6, and 13 months post-death.
- Statistical analyses included repeated measures ANOVA, t-tests, and 1-way ANOVA.
Main Results:
- Elevated anxiety was observed in 43% of children, while 6% experienced elevated depression over 13 months.
- Girls and Black children reported higher anxiety. Seeing the deceased sibling and attending the funeral correlated with lower anxiety and depression.
- Teenagers exhibited more withdrawal than school-age children.
Conclusions:
- Anxiety is more prevalent than depression in children following sibling death, with higher rates in girls and Black children.
- Rituals such as viewing the sibling and funeral attendance may mitigate negative psychological outcomes.
- Understanding these factors is crucial for providing targeted support to grieving children.
Objective:
To describe children's anxiety, depression, behaviors, and school performance at 2-13 months after sibling neonatal/pediatric intensive care unit (NICU/PICU) or emergency department (ED) death and compare these outcomes by child age, sex, race/ethnicity, whether the child saw their sibling in the NICU/PICU/ED, and attended the sibling's funeral.
Study Design:
Children in 71 families were recruited for this longitudinal study from 4 children's hospitals and 14 other Florida hospitals. Children rated anxiety (Spence Children's Anxiety Scale) and depression (Children's Depression Inventory); parents rated child behaviors (Child Behavior Checklist) and reported school performance (detentions, suspensions, requested parent-teacher meetings) at 2, 4, 6, and 13 months post-sibling death. Analyses included repeated measures-ANOVA, t-tests, and 1-way ANOVA.
Results:
In total, 132 children and 96 parents participated. More children were female (58%), black (50%), and school-age (72%). Of the children, 43% had elevated anxiety and 6% had elevated depression over 13 months post-sibling death. Child-rated anxiety was higher for girls and black vs white children. Child-rated anxiety and depression were lower if they saw their sibling in the NICU/PICU/ED before and/or after the death, and/or attended the funeral. Teens were more withdrawn than school-age children at all time points. Children who did not see their deceased sibling in the NICU/PICU/ED after death had more requests for parent-teacher conferences.
Conclusions:
Children's anxiety was more common than depression, especially in girls and black children. Children who saw their siblings in the NICU/PICU/ED before/after death and/or attended funeral services had lower anxiety and depression over the first 13 months after sibling death.
