Avaliação de transtorno de luto prolongado e depressão parental na oncologia pediátrica

Abstract

The death of a child or adolescent due to cancer represents one of the most disruptive experiences for parental identity, with enduring emotional, relational, symbolic, and clinical repercussions. This study aimed to assess the presence of Prolonged Grief Disorder (PGD) and depressive symptoms among bereaved parents in the context of pediatric oncology, integrating quantitative and qualitative methods to achieve a comprehensive understanding of the phenomenon. A mixed-methods design was employed, combining the application of the PG-13 and PHQ-9 instruments with a lexicometric analysis of semi-structured interviews using IRaMuTeQ software, through Descending Hierarchical Classification and Correspondence Factor Analysis. Quantitative findings showed that approximately 29% of participants presented scores indicative of high-intensity prolonged grief symptoms, while 29% exhibited moderate depressive symptoms, with no significant correlation between grief and depression scores, reinforcing their clinical distinction. A marked increase in antidepressant use after the child’s death was also observed, suggesting a tendency toward the medicalization of parental grief. Qualitative analysis revealed a discursive organization structured around two interdependent axes: an emotional-symbolic axis, characterized by pain, longing, faith, and continuing bonds, and a clinical-care axis, related to hospital experiences, treatments, and caregiving trajectories. The integration of findings indicates that parental grief constitutes a multidimensional and oscillatory process in which persistent suffering may coexist with functional adaptation, meaning reconstruction, and the maintenance of bonds with the deceased child, consistent with contemporary grief models. The study concludes that prolonged parental grief should not be automatically pathologized, highlighting the need for sensitive clinical approaches, empathic communication, ongoing psychosocial support, and early integration of palliative care, recognizing grief as a relational and human experience rather than solely a biomedical condition.