• Anat Peles Bortz, Ruth Malkinson, and Tamar Krulik.
• Department of Nursing, Tel Aviv University, Tel Aviv, Israel. anat_pb@bezeqint.net
• Cancer Nurs. 2013 Sep 1;36(5):E1-8.

BackgroundCoping with grief after a child's death is a complex and dynamic process. The Two-Track Model of Bereavement, which served as the theoretical framework for this study, examines biopsychosocial reactions to bereavement (track I) and attachment to the deceased (track II).ObjectivesThe objectives of this study were to identify differences in mothers' perceived functioning between bereaved mothers and mothers of children with cancer, describe mother-child relationships and relationship development over the course of illness and death, and describe the association between the 2 tracks.MethodsA quantitative cross-sectional study of 50 Jewish bereaved mothers and a matched comparison group of 50 Jewish mothers to children with cancer aged 6 to 18 years completed structured questionnaires.ResultsNo difference was found between the groups in overall maternal functioning. Bereaved mothers keep a relationship with their deceased child. Among mothers of currently ill children, there was a difference in the mean score of the mother-child relationship with the child before and after the cancer diagnosis. A negative correlation was found between the bereaved mother's relationship with the deceased child and her functioning; this was not found in the comparison group.ConclusionsMother-child relationships become closer following the cancer diagnosis and change further following the child's death. The relationship with the deceased child is an integral part of the bereaved mother's life and influences her functioning.Implications For PracticeTraining programs for nurses need to be developed to help nurses be sensitive to maternal loss and grief and to incorporate the bereaved mother's relationship with her deceased child into interventions.

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