Empathy in Dialogue: Overcoming Fear of Death and Building Bridges of Understanding for Bereaved Parents

Background:

Pregnancy loss can be a devastating experience for bereaved parents, but their grief is often unacknowledged. In Chinese communities, many danced around the issue of death for the fear of invoking misfortune. Influenced by cultural attitudes that perceives death apprehensively, many struggles to respond appropriately and empathetically. Commonly used expressions like "It was probably for the best" can undermine the experiences of bereaved parents, resulting in empathic failure as their friends or family members invalidate their feelings. Our study hypothesized that empathy has a mediating effect between fear of death and expressions towards bereaved parents.

Methods:

Data and sample: A cross-sectional study was conducted from April to June 2022. 913 participants were predominately female (73.5%), single (60.1%), with 18.8% having experienced miscarriage(s) and a mean age of 31.7 (SD = 11.2).

Measures: Expressions towards bereaved parents were measured with grief communication scale, which consisted of two subscales: interpretative responses (“It was probably for the best”, M = 2.24, SD = 0.86) and intuitive responses (“I am sorry”, M = 3.32, SD = 0.82). Attitudes towards death were examined with the fear of death subscale from the Death Attitude Profile-Revised, fear of death (M = -0.05, SD = 1.20). Empathy bridging was operationalized with the basic empathy scale, which consisted of cognitive empathy (M = 3.80, SD = 0.58) and affective empathy (M = 3.53, SD = 0.60).

Findings:

Correlational analysis indicated that a mediation involving fear of death as independent variable, cognitive empathy as mediator, and interpretative responses as dependent variable was viable. Additionally, gender, age, marital status, and miscarriage history were included as covariates. Regression analysis was used to investigate the hypothesis that cognitive empathy mediates the effect of fear of death on interpretative responses. Results indicated that the total effect between fear of death and interpretative responses was significant, B = 0.08, SE = 0.03, p = 0.002. Fear of death was a significant predictor of cognitive empathy, B = -0.05, SE = 0.02, p =.003, and cognitive empathy was a significant predictor of interpretative responses, B = -0.13, SE = 0.05, p = 0.012. The indirect effect was tested using a percentile bootstrap estimation approach with 5000 samples in PROCESS SPSS. The indirect effect was significant, B = .007, SE = 0.004, 95%CI [0.0006,0.02], which supports the mediational hypothesis. Fear of death was a significant predictor of interpretative responses after controlling for the mediator, cognitive empathy, B = 0.07, SE = 0.03, p = 0.004, suggesting a partial mediation. Female scored higher on cognitive empathy, B = 0.17, SE = .05, p < .001, and participants with miscarriage experience(s) were more likely to respond interpretatively, B = -0.46, SE = 0.09, p <.001.

Conclusion and implications:

When building bridges of understanding for bereaved parents, the findings highlighted the importance of cultivating empathy within our community. We can achieve this by making psychosocial services accessible, enhancing community’s knowledge about pregnancy loss and its emotional impact, and building their capacity to offer bereavement support to bereaved parents.