Parental Loss and Grief in the Neonatal Intensive Care Unit: A Systematic Review of Qualitative Evidence

Abstract

Premature and ill infants are admitted to neonatal intensive care units (NICU) for specialized medical and nursing care. Infants admitted to NICUs require the use of life sustaining technology and care from a multidisciplinary health care team. While in hospital, an infant’s prognosis and expected outcomes can dramatically change. Depending on the circumstances of their infant’s health, parents may choose to withdraw life sustaining treatment, or alternatively, face a future reality with the potential of long-term impact related to their infant’s diagnosis. Parents with an infant in the NICU experience many different types of losses which can generate a grief response. The purpose of this thesis is to explore parental loss and grief in the NICU. A systematic review of qualitative evidence modelled on the Joanna Briggs Institute method (2014) was completed. This approach included a systematic and rigorous approach to the searching, critical appraisal, and aggregation procedures. Four databases (CINAHL, Medline, PsycINFO, Nursing and Allied Health) were systematically searched using pre-identified search criteria. Two reviewers were involved in the search and screening, and three additional reviewers were used to identify included articles. This search process resulted in five studies being included in the review. Five themes were identified from the original research studies: support, not knowing what to expect, hospital practices, communication, and coming through grief. The results of this systematic review of qualitative evidence demonstrate that loss and grief have been described by parents in the NICU, both in the presence and absence of neonatal death.