Grief Symptom Levels in Parents of Children Who Have Died of Cancer

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In a Swedish study reported in the Journal of Clinical Oncology, Pohlkamp et al identified factors associated with levels of prolonged grief symptoms in parents of children who have died of cancer, with factors being found to differ between mothers and fathers.1

As stated by the investigators, “Previous research shows that bereaved parents are at an increased risk for intense and prolonged grief responses. To offer effective support to parents during a child’s cancer treatment and after their child’s death, more knowledge is needed about factors related to the child’s illness trajectory that may contribute to prolonged grief in bereaved parents and about possible sex differences related to such factors.”

Nationwide Survey in Sweden

The study was a population-based nationwide survey among parents with a child who died of cancer in Sweden 1 to 5 years prior to the survey, between August 2010 and July 2015. Parents completed the Prolonged Grief Disorder-13 instrument,2 consisting of 2 items on duration and impairment and 11 items on cognitive, behavioral, and emotional symptoms.

Of a total of 512 parents who were contacted, 133 mothers and 92 fathers completed the survey. The mean ages of the mothers and fathers included in the analysis were 45 and 47 years, respectively. The mean age of the deceased children was 9.9 years at the time of death.

Key Findings

On multiple regression analyses, factors among mothers that were significantly associated with lower levels of prolonged grief symptoms were “being able to talk about feelings within the family” (P = .002) and “trusting that health-care professionals made every possible effort to cure the child” (P = .01). Factors that were significantly associated with lower levels of prolonged grief symptoms among fathers were “having said farewell to the deceased child in the way they wanted” (P < .001) and “feeling that they had received practical support from health-care professionals during the child’s illness trajectory” (= .01).

The investigators concluded, “We found factors during the illness of children with cancer that contributed to prolonged grief for parents; these [factors] were different for mothers and fathers. The results may have implications for design of family bereavement support within pediatric oncology care, including addressing the differing needs of mothers and fathers more effectively.”

Lilian Pohlkamp, MSc, of Ersta Sköndal Bräcke University College, Stockholm, is the corresponding author of the Journal of Clinical Oncology article. 

Disclosure: The study was supported by the Swedish Childhood Cancer Foundation and others. For full disclosures of the study authors, visit


1. Pohlkamp L, Kreicbergs U, Sveen J, et al: Factors during a child’s illness are associated with levels of prolonged grief symptoms in bereaved mothers and fathers. J Clin Oncol. November 14, 2019 (early release online).

2. Prigerson HG, Horowitz MJ, Jacobs SC, et al: Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med 6: e1000121, 2009.