Resilience among Rural Public Health Leaders during the COVID-19 Pandemic: A Hermeneutic Phenomenological Study.

Approximately 82,000 children experience the serious illness of a parent annually in Denmark; of these, 10,000 children experience a parent being diagnosed with cancer, and almost 50,000 children live with a mother or father who is sick with cancer []. Patients who have cancer are the most common to receive specialized palliative care in a hospice in Denmark []. Additionally, an average of five children under the age of 18 lose a parent every day, amounting to around 1,800 bereaved children and young people []. Losing a parent or another close family member early in life is one of the most painful experiences for a child or a young person, and it can change their lives forever [, , ]. Living with the impact of life-threatening illness and impending or imminent death affects not only the patient but the entire family []. It significantly disrupts their everyday lives due to, for example, changes in parental behavior and functioning, changes in routines and roles, as well as an overwhelming amount of psychological pain, which children and young people may not yet be equipped to handle. The loss of a close family member early in life is particularly impactful compared to losses later in life, as children and young people are highly dependent on the adults in their family and their immediate surroundings, and require security and stability to develop and mature. Advancements in treatments and palliative care initiatives have extended the lives of both adult and young patients []. Consequently, young relatives live with the effects of serious illness for prolonged periods, sometimes across multiple stages of the illness [, , , ]. A recent Danish systematic review highlights that children and adolescents confronted with maternal cancer require guidance to manage emotions such as fear, loneliness, and uncertainty about the future. They also need support in adapting to changes in their personal lives and family dynamics []. During the course of a parent’s illness, children and young people often perceive that something is amiss. This awareness may lead to speculation, feelings of insecurity, and a desire for more information about the nature and cause of the illness []. Experiencing a parent’s cancer diagnosis can lead to feelings of isolation, as young relatives often lack peers who are facing similar challenges and emotional burdens []. Efforts to protect children by withholding information—particularly to avoid discussions about death—may inadvertently increase their distress, with the highest levels of distress typically occurring in the period leading up to a parent’s death []. Existing studies have explored how young relatives navigate the tension between managing , emphasizing the experience of coping with an ‘Ill World’ and a ‘Well World’, and how they exercise agency in coping with a parent’s life-threatening illness and impending death. However, these studies do not address the existential dimensions of such [, ]. As the average age of parenthood continues to rise, an increasing number of children and adolescents are likely to experience the death of a grandparent during their formative years []. For many children and young people, the death of a grandparent represents their first encounter with death and loss. In Denmark, as in many other countries, grandparents are increasingly involved in child-rearing and play a significant role in the lives of younger generations. Consequently, the loss of a beloved and influential grandparent can have a profound emotional impact [, ].