"As Long as I Live, My Sweet Boy You'll Be:" Parents' Continuing Bonds in Early Bereavement

Bereaved parents seek ways to maintain connections with their deceased child throughout their lifelong grief. These continuing bonds may bolster parental social functioning, yet limited research has explored continuing bonds early in bereavement.

To explore how parents maintain connection with their child within the first 2 years following death.

Parents of children who died from cancer 6-24 months prior completed the 11-item Continuing Bonds Scale (CBS) and an open-ended question querying ongoing connections. CBS scores ranged from 11 to 55, with higher scores indicating stronger continuing bonds. We examined associations between CBS scores and parent/child factors and qualitatively analyzed free-text responses.

Among 128 parents who completed the CBS, 103 (80%) provided free-text responses. Most respondents identified as non-Hispanic (91%), white (81%), and female (63%). Surveys were completed a mean of 15 (range 8-26) months after the child's death. The mean CBS score was 45.6 (SD = 7.8), indicating strong continuing bonds. Mothers reported higher scores than fathers (mean 46.9, SD = 7.2 vs. 43.4 SD = 8.2, p = 0.023). Free-text responses fell into five thematic domains: (1) physical connection; (2) symbolic and spiritual connection; (3) emotional and relational connection; (4) continuing shared experiences; and (5) legacy and action. Most parents described ongoing connections across multiple domains.

Bereaved parents exhibit strong and complex continuing bonds in early bereavement. Improved understanding of these continuing bonds may help to develop supportive interventions focused on strengthening bonds that facilitate grief integration and potentially mitigate long-term psychosocial sequelae.