The bereavement experiences of children following sibling death: An integrative review.

PROBLEM: Sibling bereavement is one of the most distressing adverse life events during childhood but has received less attention in research than other forms of childhood bereavement. This integrative review identifies potential risk and protective factors for maladaptive coping following sibling bereavement and the influence of these factors on adjustment to loss. ELIGIBILITY CRITERIA: Articles were limited to peer-reviewed studies, published in English in 2000 and beyond. Target population was bereaved siblings 0-18 years, and outcomes examined grief experiences by child self-report or parent-proxy report. SAMPLE: The Whittemore and Knafl integrative framework was applied. Multidimensional Grief Theory guided the review with twenty-five studies synthesized across its domains: Separation Distress, Existential/Identity Crisis, and Circumstance-Related Distress. RESULTS: Adjustment following sibling death is a complex process associated with a host of risk and protective factors that contribute to the bereavement process for this population. Age, sex, circumstance-related factors, continuing bonds, parental distress, and limited social support were critical influencing factors. CONCLUSION: Definitive predictor variables were not identified but a combination of variables that influence the adjustment of bereaved siblings are discussed. IMPLICATIONS: Future research is needed to explore the risk and protective factors of maladaptive coping to inform intervention development to promote individual and family adjustment following sibling death.

Changing Student Outcomes Without Sacrificing Student Satisfaction.

BACKGROUND: Faculty teaching a large class size implemented evidence-based teaching strategies (EBTS) to improve mastery of core concepts in an accelerated undergraduate pediatric nursing course. METHOD: Pre- and poststudent outcomes were analyzed using data from course assessments and American Technologies Institute (ATI) concept mastery testing to evaluate the effectiveness of course revisions. ATI designates three proficiency levels to determine mastery. A proficiency of level two exceeds the minimum expectations for mastery, whereas a proficiency level of three suggests students exceed NCLEX-RN standards of content. RESULTS: Data indicated implementation of new EBTS facilitated improvement in student content mastery. Students exceeded the minimum expectations for NCLEX-RN standards of pediatric content. Course revisions resulted in all students achieving benchmark on ATI concept mastery testing with a three-fold increase in students achieving the highest level of proficiency. CONCLUSION: EBTS can be adapted for a large class size learning environment with improved learning outcomes. [J Nurs Educ. 2021;60(3):169-171.].