UCSF

Few investigators have focused on grief and bereavement experiences of adolescents themselves, especially from the perspectives of childhood cancer survivors. The purpose of this study using qualitative methods, specifically grounded theory, was to explore grief and bereavement in Korean adolescents who survived cancer following the deaths of friends to the same illness. Specific aims were (a) to explore how the adolescents coped with the death of cancer peers in particular how they interacted with their family and friends, and (b) to identify how culture impacts on their grieving. Data were obtained from Korean adolescents with cancer between the ages of 13 and 23 (N=15) through semi-structured interviews (face-to-face interviews, telephone interviews, and Internet chatting), observations of the social dynamics of participants within self-help groups, and retrieving personal Web journals. Data collection and analysis were conducted simultaneously, and constant comparative methods were used for analysis. Field notes from interviews or observations and memo-writing were integrated into the analytic process. Findings were grouped into three parts. First, participants coped continually with reminders of their grief while interacting with themselves, friends, and their family. To avoid the distress of grieving, participants kept silent, sought solitude, and took care of themselves and others. Second, participants put their grief aside and worked to ease their mother's burden. The conceptual components of filial piety were linked to the ways in which participants made efforts to not show their grief in front of their mothers. They strived to meet parental expectation of carrying on the family lineage, hid their own burden to lessen their mother's worry, reassured their mothers that they will reciprocate the care they received, and attempted to tactfully sense their mothers' feelings and thoughts. Third, cultural considerations such as gate-keeping and multiple strategies to collect data from Korean adolescents were refined based on the understanding of the collectivist culture. The resulting conceptualization of grieving, a theoretical application of filial piety, and methodological reflections will be the basis for future comparative research in grief and bereavement of other cultures, both in Asia and Western countries.