Losing a child: finding meaning in bereavement

Figures & data

Table 1 Data transformation

Meaning reconstruction themes		Degree of sense-making/benefit-finding (numerical value)
No sense/no benefit	→	None (0)
No sense/no benefit combined with other sense-making or benefit-finding themes	→	Medium (1)
Sense-making or benefit-finding themes other than no sense/no benefit	→	Large (2)

Table 2 Sense-making themes and frequencies (participants often gave multiple answers)

Sense-making theme	Coding definition	% (n)
Purpose of life/death	Fulfillment of purpose of child's presence in the world and/or the consequences following for one's own life.	50.0 (15)
Biological explanation	Biological or medical explanations of the death.	43.3 (13)
Theme of an afterlife	Beliefs in the existence of an afterlife and/or the reunion with the dead child in the future.	40.0 (12)
No sense of meaning	Explicit response of “no” to sense-making question, or stating that such an event cannot be understood.	36.7 (11)
Human existence	Discussion about the imperfection of the world, the inevitability of death, or the fragility of life.	36.7 (11)
Fate	Death of the child attributed to fate, destiny, or a universal plan.	23.3 (7)
Child's behavior	Actions of the child believed to be related to the death.	20.0 (6)
Identity	Understanding the death as an event that cannot destroy the identity of a mother or father as a parent of that child and/or the continuing bonds with the child.	20.0 (6)
End of suffering	Discussion about the end of the child's physical or mental suffering as a result of the death.	13.3 (4)
Probability	Death of the child discussed as a very unlikely event that happened to them nevertheless.	10.0 (3)
Foreshadowing	Descriptions of having foreseen the death of the child.	10.0 (3)
Challenge	Event seen as challenge in life and/or sense could be made in the way to deal with it.	10.0 (3)
Little sense of meaning	Uncertainty about being able to profoundly understand the event in a way that makes sense.	10.0 (3)
Gift	Viewing the time with the child as a gift and/or being deeply thankful for the time spent together.	10.0 (3)
Parent's role	Belief that parent's own actions were related to the death.	6.7 (2)
Belief in a sense of meaning	Strong belief that there is a deeper sense in this event that may or may not be revealed in the future.	6.7 (2)
Information seeking	Discussion about obtaining information concerning the death in the context of understanding why the death occurred.	3.3 (1)
Random	Death seen as a random event.	3.3 (1)
Laws of physics	Laws of physics given as an explanation for the death.	3.3 (1)
God's will	Discussion of the death as an expression of God's will or plan.	–
Other themes	Other sense-making themes only one person mentioned.	10.0 (3)

Note: Italicized themes represent themes developed in the course of this study that were not already included in the themes of Lichtenthal et al. (2010).

Table 3 Benefit-finding themes and frequencies (participants often gave multiple answers)

Benefit-finding theme	Coding definition	% (n)
Personal improvement	Themes of personal growth other than those detailed separately in this table (e.g., increased sensitivity), such as becoming wiser, more tolerant, etc.	46.7 (14)
Changed priorities	Changes in priorities or in the importance of how time is spent, or about what is distressing.	43.3 (13)
Appreciation of life	Heightened appreciation of life and of the moment, not taking anything for granted.	36.7 (11)
Helping others	Description of actions to help others or the desire to help others who have experienced losses or other painful events.	33.3 (10)
Stronger coping	Discussion of ways in which participants feel stronger, are better able to cope with difficult situations, or are generally less afraid, or are less afraid of specific issues, such as dying.	30.0 (9)
No benefit	Explicit response of “no” to benefit-finding question and/or stating that there is no positive implication of such a terrible loss.	26.7 (8)
Appreciation of others	Increased appreciation of others and/or heightened ability to express appreciation to others (also other children).	26.7 (8)
Increased sensitivity	Increase in perceptual sensitivity in general and/or empathy and compassion towards other human beings.	23.3 (7)
Valuable lessons	Lessons learned about life, death, relationships, etc.	23.3 (7)
Experience	Having and being open for new experiences or discoveries.	20.0 (6)
Education	Description of pursuing classes, or a (desired) change in careers.	16.7 (5)
Enhanced spirituality	Increases in spirituality or religiosity.	13.3 (4)
Bitter benefits	Presumed positive, objective changes in life, which cannot really be seen as positive, such as there is nothing worse that could happen now.	13.3 (4)
Increased empathy	Increased empathy for other bereaved parents and/or other suffering people.	10.0 (3)
Relationships developed	Strengthening of relationships and/or formation of new personal relationships.	10.0 (3)
Freedom	Description of a gain in time or freedom in consequence of the loss.	10.0 (3)
Lifestyle improvements	Positive changes in life such as ending a difficult relationship.	6.7 (2)
Support from others	Description of efforts made by family and/or friends following the loss.	3.3 (1)
Benefits to others	Discussion of how consequences of the child's death benefited others (e.g., organ donation) or the society.	–
Relationships to other children	Discussion of giving birth to or adopting other children, or an improvement in relationships with other children (see Appreciation of others).	_
Other themes	Other benefit-finding themes only one person mentioned.	10.0 (3)

Note: Italicized themes represent themes developed in the course of this study that were not already included in the themes of Lichtenthal et al. (2010).

Table 4 Measures of posttraumatic growth and complicated grief

	Total (n=29)	Men (n=9)	Women (n=20)	Gender differences χ ^2/t/u-tests (p)
PGI, M (SD)	68.10 (16.99)	68.78 (17.87)	67.80 (17.05)	t=0.14 (.89)
CGM, M (SD )	28.72 (12.58)	19.00 (9.62)	33.10 (11.37)	t=−3.23 (.00)**
Sense-making				χ ^2=0.99 (.61)
Benefit-finding				χ ^2=0.08 (.96)

** p<0.01. PGI=Posttraumatic Growth Inventory; CGM=Complicated Grief Module.

Table 5 Relations of meaning reconstruction, complicated grief and posttraumatic growth

	PGI	CGM	Sense-making	Benefit-finding
PGI	1	r=0.00 (0.48)	r s=0.54 (0.00)**	r s=0.49 (0.00)**
CGM	r=0.00 (.48)	1	r s=0.08 (0.34)	r s =−0.07 (0.35)
Sense-making	r s=0.54 (.00)**	r s =0.08 (0.34)	1	r s=0.18 (0.35)
Benefit-finding	r s=0.49 (.00)**	r s =−0.07 (0.35)	r s=0.18 (0.35)	1

** p<0.01. PGI=Posttraumatic Growth Inventory; CGM=Complicated Grief Module.

Lichtenthal W. G, Currier J. M, Neimeyer R. A, Keesee N. J. Sense and significance: A mixed methods examination of meaning making after the loss of one's child. Journal of Clinical Psychology. 2010; 66(7): 791–812.

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