Protecting mental health and well-being after parental loss: a review of the literature on how children and adolescents cope with cancer bereavement

Public Health Dissertation Prize Winner

Abstract

The death of a parent to cancer during childhood or adolescence can be a life- altering event that can deeply affect a child or adolescent’s mental health, well-being and development. This dissertation explores how bereaved children (0 to 12 years) or adolescents (13 to 18 years) who experience parental loss process grief, the coping strategies they use, and the long-term impact on their mental health. A scoping search was conducted using the Liverpool John Moores University’s Discover Library, PsycINFO, Web of Science, and CINAHL Ultimate. Search terms followed the population, exposure and outcome (PEO) framework, combining keywords such as “childhood bereavement” and “mental health” with Boolean operators. Of 215 initial records, 26 studies met inclusion criteria after duplicate removal, title and abstract screening, and full-text review. Most studies included focused exclusively on cancer-related parental loss, with data extracted and thematically analysed using a study characteristic table. The findings of this dissertation show that children and adolescents experience grief differently depending on their age. Younger children struggle with death’s permanence, while adolescents experience intense sadness and confusion while navigating independence. Anticipatory grief can provide emotional preparation but also exposes children to traumatic decline. Although family, school and community support help to cope, services in the United Kingdom (UK) remain insufficient, where only 13.8% of hospices offer specific bereavement care. Key recommendations are enhanced pre-bereaved support, cancer-specific bereavement programs, and professional grief training for healthcare professionals.