Penny, Alison; (2023) Refinement of the Child Bereavement Service Questionnaires and preliminary exploration of their measurement properties and utility: a mixed methods study. Doctoral thesis (Ph.D), UCL (University College London).

Text Alison Penny PhD thesis FINAL.pdf - Other Access restricted to UCL open access staff until 1 November 2024. Download (7MB)

Abstract

UK services for bereaved children and young people typically offer a range of flexible, community-based support to help them adjust to the seismic event of the death of someone important in their lives. These services have lacked appropriate measures to demonstrate the difference they make in line with their specific aims. This thesis describes a pragmatic two-stage, mixed methods study, which first piloted a set of three Child Bereavement Service Questionnaires (CBSQs) for children, young people and parents in 11 services and refined the measures in light of the findings. The second stage explored the CBSQs’ properties of reliability, validity, responsiveness, and interpretability by analysing secondary data originally collected in routine practice in two services. Interviews with 11 practitioners and managers complemented this quantitative data with qualitative insights into the measures’ utility in routine practice, and strategies to maximise this. The structural validity of the measures was disappointing, especially that of the younger children’s measure, but aspects of measurement properties were comparable to other recent measures in the field identified in a systematic review and quality appraisal. The CBSQs were valued by practitioners and managers, with their utility lying in their capacity to meet multiple and different needs at the same time: building a relationship while getting a baseline picture, normalising grief while introducing the service, capturing changes while supporting families to move forwards, revealing benefits while suggesting mechanisms for change, and reporting to funders while running the service. This thesis makes recommendations for the implementation of outcome measures in child bereavement services, and for further research to build on the limitations and findings of this study.

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