PhD in Nursing Science Program
Terrah Foster Akard
A Mixed Method Study of Continuing Bonds: Maintaining Connections after the Death of a Child
Dissertation under the direction of Professor Mary Jo Gilmer
This mixed method study explored continuing bonds in children who lived with advanced cancer, as well as in bereaved families who lost a child to cancer. The study also examined associations among continuing bonds, coping strategies, and grief symptoms. Participants included 107 bereaved parents and siblings (ages 8-18) of 41 children who died from cancer. Survivors separately answered 2 open-ended questions and completed 3 questionnaires. Qualitative content analysis identified major themes related to continuing bonds, and quantitative correlations identified associations among continuing bonds, coping strategies, and grief symptoms. In sum, continuing bonds may be a response to stress for bereaved families and ill children, including both coping strategies and automatic responses, resulting in both positive and negative grief symptoms. This study contributes to the state of the science on continuing bonds within pediatric palliative care.