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Duffner LA, Janssen N, Deckers K, Schroyen S, de Vugt ME, Köhler S, Adam S, Verhey FRJ, Veenstra MY. Facing the Next "Geriatric Giant"-A Systematic Literature Review and Meta-Analysis of Interventions Tackling Loneliness and Social Isolation Among Older Adults. J Am Med Dir Assoc 2024; 25:105110. [PMID: 38945174 DOI: 10.1016/j.jamda.2024.105110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES Loneliness and social isolation are associated with adverse health outcomes, especially within the older adult population, underlining the need for effective interventions. This systematic review and meta-analysis aims to summarize all available evidence regarding the effectiveness of interventions for loneliness and social isolation, to map out their working mechanisms, and to give implications for policy and practice. DESIGN Systematic literature review and meta-analysis. SETTING AND PARTICIPANTS Older adults (≥65 years). METHODS A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression. RESULTS Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: "promoting social contact," "transferring knowledge and skills," and "addressing social cognition". CONCLUSIONS AND IMPLICATIONS Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.
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Affiliation(s)
- Lukas A Duffner
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Niels Janssen
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Kay Deckers
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sarah Schroyen
- Psychology of Aging Unit (UPsySen), Faculty of Psychology, University of Liege, Liege, Belgium
| | - Marjolein E de Vugt
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Stéphane Adam
- Psychology of Aging Unit (UPsySen), Faculty of Psychology, University of Liege, Liege, Belgium
| | - Frans R J Verhey
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Marja Y Veenstra
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Casarez RL, Johnson CM, Soares JC, Meyer TD. Use of a virtual environment to promote self-management and lifestyle changes in persons with bipolar disorder. Arch Psychiatr Nurs 2024; 49:73-82. [PMID: 38734458 DOI: 10.1016/j.apnu.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/08/2023] [Accepted: 02/09/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE Self-management and lifestyle interventions are a key factor in treatment outcomes for persons with bipolar disorder (BD). A virtual environment (VE), due to it's ability to provide flexibility of involvement in its platform, may be an alternative to face-to-face treatment to provide support for self-management. The purpose of this study is to explore how a VE, developed for chronic illness self-management, may be modified to promote self-management and lifestyle changes in those with BD. METHOD This study used a qualitative description design with focus groups. Data were collected via minimally structured interviews and analyzed using thematic content analysis. A total of seven focus groups were conducted, and the sample consisted of 30 adults with BD. Age range was 21-77 years with 21 females, seven males, and two non-binary individuals. RESULTS Five themes emerged from the findings: Self-management and lifestyle interventions with regards to (1) mental health; (2) holistic health; (3) role of peers; (4) involvement of the family; (5) technological aspects of the VE. CONCLUSIONS Focus group participants suggested that the VE may be an efficacious way to enhance self-management and promote lifestyle interventions in those with BD. Research is needed to adapt such platforms to the need of the patients and examine its' effect on health outcomes.
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Affiliation(s)
- Rebecca L Casarez
- The University of Texas Health Science Center, Cizik School of Nursing, USA; Department of Graduate Studies, 6901 Bertner Ave., Houston, TX 77030, USA.
| | - Constance M Johnson
- The University of Texas Health Science Center, Cizik School of Nursing, USA; Department of Research, 6901 Bertner Ave., Houston, TX 77030, USA.
| | - Jair C Soares
- McGovern Medical School, The University of Texas Health Science Center at Houston, USA; Faillace Department of Psychiatry and Behavioral Sciences, 1941 East Road, Houston, TX 77054, USA.
| | - Thomas D Meyer
- McGovern Medical School, The University of Texas Health Science Center at Houston, USA; Faillace Department of Psychiatry and Behavioral Sciences, 1941 East Road, Houston, TX 77054, USA.
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Tang S, Peng W, Qian X, Chen Y. Healing grief - an online self-help intervention programme for bereaved Chinese with prolonged grief: study protocol for a randomised controlled trial. Eur J Psychotraumatol 2024; 15:2323422. [PMID: 38507226 PMCID: PMC10956920 DOI: 10.1080/20008066.2024.2323422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/11/2024] [Indexed: 03/22/2024] Open
Abstract
Background: In China, mental health services do not currently meet the needs of bereaved people with symptoms of prolonged grief disorder (PGD). Internet-based grief interventions may help fill this gap, but such programmes have not yet been developed or evaluated in China. The proposed study aims to investigate the effectiveness, acceptability, and feasibility of an online self-help intervention programme named Healing Grief for bereaved Chinese with prolonged grief, and to explore the psychological mechanisms of potential improvements.Methods: We designed a two-arm randomised controlled trial. At least 128 participants will be randomly assigned to either an Internet-based intervention group or a waitlist-control group. The Internet-based intervention will be developed based on the dual process model, integrating techniques of psychoeducation, behavioural activation, cognitive reappraisal, and meaning reconstruction, and will be delivered via expressive writing. The intervention comprises six modules, with two sessions in each module, and requires participants to complete two sessions per week and complete the intervention in 6 weeks. The primary outcomes include effectiveness, acceptability, and feasibility. The effectiveness will be assessed by measures of prolonged grief, posttraumatic stress, anxiety, and depressive symptoms. Acceptability and feasibility will be evaluated using survey and interview on user experience characteristics. Secondary outcomes include moderators and mediators, such as dual process coping, grief rumination, mindfulness, and continuing bond, to explore the psychological mechanisms of potential improvement. Assessments will take place at pre-intervention, post-intervention, and 3-month follow-up.Conclusion: The proposed study will determine the effectiveness, acceptability, and feasibility of the newly developed online self-help intervention for bereaved Chinese with prolonged grief and clarify how the intervention helps with symptom improvements. Such an intervention may play an important role in easing the imbalance between the delivery and receipt of bereavement psychological services in China.
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Affiliation(s)
- Suqin Tang
- School of Psychology, Shenzhen University, Shenzhen, People’s Republic of China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, People’s Republic of China
| | - Wenjie Peng
- Department of Sociology, School of Government, Shenzhen University, Shenzhen, People’s Republic of China
| | - Xueying Qian
- Department of Sociology, School of Government, Shenzhen University, Shenzhen, People’s Republic of China
| | - Yulin Chen
- School of Psychology, Shenzhen University, Shenzhen, People’s Republic of China
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Maria Pizzoli SF, Vergani L, Monzani D, Scotto L, Cincidda C, Pravettoni G. The Sound of Grief: A Critical Discussion on the Experience of Creating and Listening to the Digitally Reproduced Voice of the Deceived. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228231225273. [PMID: 38176688 DOI: 10.1177/00302228231225273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Technological tools allow for the reproduction and control of peculiar stimuli, such as the possibility of producing audio clips with the voices of deceased people. Artificial intelligence allows to create at-home vocal messages from an audioclip. Recently, some videos and documentaries depicting people interacting with artificial intelligence content related to the deceased have been released to the general public. However, the possibility of interacting with realistic stimuli related to deceased loved ones can create peculiar and delicate experiences and should gain the attention of the scientific community and mental health professionals. Listening and searching for experiences related to the deceived ones might indicate a natural way to elaborate and live the experience of grieving or the presence of symptoms related to more severe conditions. Moreover, such powerful stimuli might be potentially harmful to users, if not appropriately used. To the best of our knowledge, no scientific literature exists on the topic of listening to audio clips with the voice of the deceased yet, although various people shared thoughts and feelings about these habits on social networks and forums. Given the relevant psychological impact that grief can have on a person, an open discussion on the possibility and risks of the availability of digital stimuli related to grief should be taken into account by the scientific community.
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Affiliation(s)
- Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Psychology, Univeristà Cattolica Del Sacro Cuore di Milano, Milan, Italy
| | - Laura Vergani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Dario Monzani
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Ludovica Scotto
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Clizia Cincidda
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
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Kenyon K, Kinakh V, Harrison J. Social virtual reality helps to reduce feelings of loneliness and social anxiety during the Covid-19 pandemic. Sci Rep 2023; 13:19282. [PMID: 37935718 PMCID: PMC10630518 DOI: 10.1038/s41598-023-46494-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023] Open
Abstract
Evidence shows that the Covid-19 pandemic caused increased loneliness, anxiety and greater social isolation due to social distancing policies. Virtual reality (VR) provides users with an easy way to become engaged in social activities without leaving the house. This study focused on adults, who were socialising in Altspace VR, a social VR platform, during the Covid-19 pandemic and it explored whether social VR could alleviate feelings of loneliness and social anxiety. A mixed-methods research design was applied. Participants (n = 74), aged 18-75, completed a questionnaire inside the social VR platform to measure levels of loneliness (UCLA 20-item scale) and social anxiety (17-item SPIN scale) in the social VR platform (online condition) and real world (offline condition). Subsequently, a focus group (n = 9) was conducted to gather insights into how and why participants were using the social VR platform. Findings from the questionnaire revealed significantly lower levels of loneliness and social anxiety when in the social VR platform. Lower levels of loneliness and social anxiety were also associated with participants who socialised with a regular group of friends. In addition, findings from the focus group suggested that being part of an online group facilitates stronger feelings of belonging. Social VR can be used as a valuable intervention to reduce feelings of loneliness and social anxiety. Future studies should continue to establish whether social VR can help to encourage group formation and provide people with enhanced social opportunities beyond the COVID-19 pandemic.
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Affiliation(s)
- Keith Kenyon
- School of Psychology, Faculty of Health and Wellbeing, University of Bolton, Deane Road, Bolton, BL3 5AB, UK.
| | - Vitalia Kinakh
- Faculty of Biology, Medicine and Health, The University of Manchester, Coupland Building 3, Oxford Road, Manchester, M13 9PL, UK.
| | - Jacqui Harrison
- School of Psychology, Faculty of Health and Wellbeing, University of Bolton, Deane Road, Bolton, BL3 5AB, UK.
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Li J, Li Y, Wang Y, Jishi W, Fang J. What we know about grief intervention: a bibliometric analysis. Front Psychiatry 2023; 14:1152660. [PMID: 37608997 PMCID: PMC10442158 DOI: 10.3389/fpsyt.2023.1152660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
Background Grief is a natural and individualized response to different losses, but if grief persists or becomes pathological, professional interventions are required. Grief and corresponding interventions have received increasing attention, as the related concepts have been incorporated into the DSM-5 and ICD-11. Therefore, we conducted a bibliometric analysis to explore the developments in the field of grief intervention research. Methods Articles on grief interventions were systematically searched and screened from the Web of Science Core Collection. The retrieved data were analyzed and visualized using VOSviewer and Bibliometrix software for journals, authors, institutions, countries, references, and keywords. Results A total of 9,754 articles were included. The number of articles on grief interventions has increased significantly each year since 1990. Death Studies was the journal that published the most articles in this field. We identified 25,140 authors contributed to this research area and these authors were from 123 countries and 6,630 institutions. Boelen PA secured the first position in article production, Columbia University emerged as the most productive affiliation and the United States was the foremost leading in grief intervention research. The prevalent keywords utilized in this field comprised bereavement, grief, death, depression, and palliative care. Conclusion The quantity of publications regarding grief interventions is increasing. Although most prior studies have focused on mortality, grief, and health, emerging themes such as COVID-19, grief among workers, and disfranchised grief have drawn increasing attention in recent years. Future studies may focus on investigating the complexities and challenges of grief, including its underlying mechanisms and impact on mental well-being.
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Affiliation(s)
- Jie Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yuan Li
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Nursing, West China Second University Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yali Wang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
- Department of Cardiology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Wuga Jishi
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Jinbo Fang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
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Uneno Y, Kotera Y, Fujisawa D, Kataoka Y, Kosugi K, Murata N, Kessoku T, Ozaki A, Miyatake H, Muto M. Development of a novel COMPAssion focused online psyChoTherapy for bereaved informal caregivers: the COMPACT feasibility trial protocol. BMJ Open 2022; 12:e067187. [PMID: 36549732 PMCID: PMC9772635 DOI: 10.1136/bmjopen-2022-067187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION An easy-to-access and effective psychotherapy for bereaved informal caregivers has not been established. People with higher self-compassion status tend to have lower bereavement related grief, psychotherapy focused on self-compassion can be promising for this population. This study aimed to examine the feasibility of online self-compassion focused psychotherapy for bereaved informal caregivers. METHOD AND ANALYSIS A total of 60 study participants will undergo an intervention programme comprising online sessions of 2 hours per week for five consecutive weeks and undertake postsession work. The intervention personnel will comprise psychologists who have received more than 10 hours of structured training. The primary endpoint will be assessed on the intervention completion rate, with secondary endpoints consisting of the Complicated Grief Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Brief Resilience Scale and Self-Compassion Scale. Evaluations will be conducted preintervention, immediately after intervention, and 4 and 12 weeks after intervention. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, Japan (Approved ID: C1565). The results of this study will be disseminated through publication in a peer-reviewed journal and conference presentations. TRIAL REGISTRATION NUMBER UMIN000048554.
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Affiliation(s)
- Yu Uneno
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Daisuke Fujisawa
- Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nanami Murata
- Medical School, Wakayama Medical University, Wakayama, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
- Department of Palliative Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | | | - Manabu Muto
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
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Tadros E, Salman M, Ramadan A, Daifallah N. Community sadness: Clinical recommendations for working with grieving Arab American families. Int J Soc Psychiatry 2022; 69:602-612. [PMID: 36217776 DOI: 10.1177/00207640221124764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Grief is a universal emotion, both layered and multidimensional. Grief in Arab cultures center around three ideals: culture, family, and religion. This paper examines the multiple different factors that influence Arabs during their grief, broken down into how different religions process and view death, along with the impact of Westernized ideals and other relationships. We explore physiological responses of grief, gender differences in expressing emotions, self-care practice, and utilizing religion as a strength. The rules and traditions surrounding grief and loss in Arab communities need to be acknowledged by clinicians and incorporated into their practice. Recommendations and future directions for clinicians to support Arab grief within the three lenses of culture, family, and religion.
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Affiliation(s)
- Eman Tadros
- Governors State University, University Park, IL, USA
| | - Marram Salman
- Governors State University, University Park, IL, USA
| | - Abrea Ramadan
- Governors State University, University Park, IL, USA
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Carmont H, McIlfatrick S. Using virtual reality in palliative care: a systematic integrative review. Int J Palliat Nurs 2022; 28:132-144. [PMID: 35452268 DOI: 10.12968/ijpn.2022.28.3.132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Recently, healthcare services have witnessed an exponential increase in the use of immersive and non-immersive virtual reality (VR) technology to improve health-related outcomes. However, the use of VR in palliative care remains relatively unexplored. AIMS To review and synthesise evidence regarding the experiences of patients, families and healthcare professionals in palliative care who have engaged with immersive/non-immersive VR technology. METHODS A systematic integrative review using pre-defined MeSH search terms to identify eligible studies from five electronic databases (Cochrane Library, CINAHL, OVID Medline, Pubmed and Scopus) between April 2020 and February 2021. FINDINGS In total, 1066 articles were reviewed, 55 articles were considered eligible and subject to further analysis and a total of 16 articles met the inclusion criteria and were subject to critical appraisal. Rigorous analysis of eligible articles resulted in the identification of five overarching and interconnected themes: connection, VR as an emergent technology, perceptual change, safety, and future research. CONCLUSION This review identified that VR could support patients, families and healthcare professionals in palliative care. As a result of the COVID-19 pandemic, the findings could prove particularly significant for facilitating connection. However, further research is necessary to explore the full scope of VR use in this speciality.
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Affiliation(s)
| | - Sonja McIlfatrick
- Head of School of Nursing and Professor of Nursing and Palliative Care, Ulster University, UK
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Vedder A, Boerner K, Stokes JE, Schut HAW, Boelen PA, Stroebe MS. A systematic review of loneliness in bereavement: Current research and future directions. Curr Opin Psychol 2021; 43:48-64. [PMID: 34293651 DOI: 10.1016/j.copsyc.2021.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022]
Abstract
Bereaved people suffer from loneliness and loneliness is associated with poor mental health. In this study, this topic is reviewed. An agenda is suggested for future research. Research that is theory-driven, addresses measurement consistency, correlates of loneliness in bereaved and non-bereaved, and treatment is necessary for prevention and intervention.
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Affiliation(s)
- Anneke Vedder
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands.
| | - Kathrin Boerner
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Jeffrey E Stokes
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Henk A W Schut
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Paul A Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - Margaret S Stroebe
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
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Dias N, Boring E, Johnson LA, Grossoehme DH, Murphy S, Friebert S. Developing a theoretically grounded, digital, ecological momentary intervention for parental bereavement care using the ORBIT model-Phase 1. DEATH STUDIES 2021:1-10. [PMID: 33913789 DOI: 10.1080/07481187.2021.1914239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Current models of bereavement care do not address all of bereaved parents' unique needs. Diverse challenges limit parents' ability to access certain bereavement services. A web-based intervention prototype for bereaved parents was developed. Using convenience and snowball techniques, 14 participants (pediatric providers, software developers, and bereaved parents) were enrolled in a descriptive, cross-sectional feasibility and usability study. While the intervention was generally considered acceptable, three themes were identified to enhance its usability and acceptability: timing; delivery; and revisions. Further intervention development is needed to improve both short- and long-term physical and psychological outcomes for bereaved parents.
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Affiliation(s)
- Nancy Dias
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Elizabeth Boring
- Riley Hospital for Children, Indiana University Health, Indianapolis, Indiana, USA
| | - Lee Ann Johnson
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Daniel H Grossoehme
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, Ohio, USA
- Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, Ohio, USA
| | - Savannah Murphy
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Sarah Friebert
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, Ohio, USA
- Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, Ohio, USA
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Hoang P, Whaley C, Thompson K, Ho V, Rehman U, Boluk K, Grindrod KA. Evaluation of an Intergenerational and Technological Intervention for Loneliness: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e23767. [PMID: 33595443 PMCID: PMC7929741 DOI: 10.2196/23767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/02/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social integration and mental health are vital aspects of healthy aging. However, close to half of Canadians older than 80 years report feeling socially isolated. Research has shown that social isolation leads to increased mortality and morbidity, and various interventions have been studied to alleviate loneliness among older adults. This proposal presents an evaluation of an intervention that provides one-on-one coaching, is intergenerational, provides both educational and socialization experiences, and increases technology literacy of older adults to overcome loneliness. OBJECTIVE This paper describes the protocol of a randomized, mixed-methods study that will take place in Ontario, Canada. The purpose of this study is to evaluate if an intergenerational technology literacy program can reduce social isolation and depression in older adults via quantitative and qualitative outcome measures. METHODS This study is a randomized, mixed-methods, feasibility trial with 2 conditions. Older adults in the intervention condition will receive 1 hour of weekly technological assistance to send an email to a family member, for 8 weeks, with the assistance of a volunteer. Participants in the control condition will not receive any intervention. The primary outcomes are loneliness, measured using the University of California, Los Angeles Loneliness Scale, and depression, measured using the Center for Epidemiologic Studies Depression scale, both of which are measured weekly. Secondary outcomes are quality of life, as assessed using the Older People's Quality of Life-Brief version, and technological literacy, evaluated using the Computer Proficiency Questionnaire-12, both of which will be administered before and after the intervention. Semistructured interviews will be completed before and after the intervention to assess participants' social connectedness, familiarity with technology, and their experience with the intervention. The study will be completed in a long-term care facility in Southwestern Ontario, Canada. Significance was set at P<.05. RESULTS This study was funded in April 2019 and ethical approval was obtained in August 2019. Recruitment for the study started in November 2019. The intervention began in February 2020 but was halted due to the COVID-19 pandemic. The trial will be restarted when safe. As of March 2020, 8 participants were recruited. CONCLUSIONS Information and communication technology interventions have shown varying results in reducing loneliness and improving mental health among older adults. Few studies have examined the role of one-on-one coaching for older adults in addition to technology education in such interventions. Data from this study may have the potential to provide evidence for other groups to disseminate similar interventions in their respective communities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/23767.
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Affiliation(s)
- Peter Hoang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,enTECH Computer Club, University of Waterloo, Waterloo, ON, Canada
| | - Colin Whaley
- enTECH Computer Club, University of Waterloo, Waterloo, ON, Canada.,School of Pharmacy, University of Waterloo, Waterloo, ON, Canada.,Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Karen Thompson
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, ON, Canada
| | - Venus Ho
- enTECH Computer Club, University of Waterloo, Waterloo, ON, Canada.,Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Uzma Rehman
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Karla Boluk
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, ON, Canada
| | - Kelly A Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
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13
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Fallon MA, Riem MME, Kunst LE, Kop WJ, Kupper N. Multi-modal responses to the Virtual Reality Trier Social Stress Test: A comparison with standard interpersonal and control conditions. Int J Psychophysiol 2021; 161:27-34. [PMID: 33454320 DOI: 10.1016/j.ijpsycho.2021.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
The Trier Social Stress Test (TSST) is a reliable social-evaluative stressor. To overcome limitations of the in vivo TSST, a standardized virtual reality TSST (VR-TSST) was developed. The present study compares the emotional (anxiety) and physiological (heart period and variability) response to a VR-TSST with an in vivo TSST and a control condition. Participants took part in either an in vivo TSST (N = 106, 64% female), VR-TSST (N = 52, 100% female), or a control TSST (N = 20, 40% female). Mixed linear modeling examined response profile differences related to TSST type. While there was an equivalent anxiety response to the in vivo TSST as the VR-TSST, we found a smaller heart period and heart rate variability response in VR-TSST compared to the in vivo TSST, especially in response to the math part of the test. The present findings demonstrate that social evaluative stress can be successfully induced in a VR setting, producing similar emotional and slightly attenuated cardiovascular responses.
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Affiliation(s)
- M A Fallon
- Business School, University of Mannheim, Mannheim, Germany
| | - M M E Riem
- Center of Research on Psychological & Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands; Behavioral Science Institute, Radboud University, the Netherlands; Clinical Child & Family Studies, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - L E Kunst
- Center of Research on Psychological & Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - W J Kop
- Center of Research on Psychological & Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - N Kupper
- Center of Research on Psychological & Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
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Abstract
Purpose of review a)The purpose of this systematic review was to characterize the studies published on grief interventions for bereaved older adults in the last 5 years. Grief intervention studies were included that exclusively focused on older adults as well as those that included older adults in their samples, in order to summarize the most up-to-date treatment options available for bereaved older adults. Recent findings b)Twenty-four articles that investigated grief interventions in older adults were identified. Generally, findings suggest viable treatment approaches for bereaved older adults are those incorporating behavioral activation and guidance on restoration-oriented coping. However, similar to studies of broader adult populations, grief interventions had small effects on grief-related symptoms in older adults. Few studies examined age as a moderator of treatment effects. Studies varied greatly by study design, sample size, and outcomes measured, which all likely impacted the efficacy of results. Summary c)This review suggests that, while there has been a growing focus on older adults, who have unique vulnerabilities in bereavement, the evidence-base of efficacious interventions for this population is limited. Given the need for specialized bereavement support for older adults will increase in the coming years, future research should prioritize rigorous investigations of grief treatment options leveraging technology to increase access and incorporate techniques that enhance engagement in life and connectedness for this vulnerable population.
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Lancel M, Stroebe M, Eisma MC. Sleep disturbances in bereavement: A systematic review. Sleep Med Rev 2020; 53:101331. [PMID: 32505968 DOI: 10.1016/j.smrv.2020.101331] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022]
Abstract
Severe, persistent and disabling grief occurs among a sizable minority experiencing bereavement, with diagnostic manuals newly including complicated grief (CG) disorders. Sleep disturbances/disorders have been established as worsening affective and stress-related conditions. However, the role of sleep difficulties in bereavement and CG has not received similar scientific attention. We therefore conducted a systematic review with narrative syntheses on this topic to clarify the role of sleep in bereavement (PROSPERO: CRD42018093145). We searched PubMed, Web of Science and PsychInfo for peer-reviewed English-language articles including (at least one) bereaved sample and sleep disturbance measure. We identified 85 articles on 12.294 participants. We answered seven pre-defined research questions demonstrating: high prevalence of sleep disturbances in bereavement; positive associations of grief intensity with sleep difficulties; preliminary indications of risk factors of post-loss sleep disturbance; higher prevalence of sleep disturbances in CG, enhanced by psychiatric comorbidity (i.e., depression); and initial evidence of causal relationships between (complicated) grief and sleep. Grief therapy partly improves sleep difficulties, yet no intervention studies have specifically targeted sleep problems in bereaved persons. Causal relationships between sleep and grief require further examination in intensive longitudinal investigations, including randomized trials, thereby clarifying whether treating sleep problems enhances CG treatment effects.
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Affiliation(s)
- Marike Lancel
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Psychiatric Sleep Center Assen, Mental Health Services Drenthe, the Netherlands.
| | - Margaret Stroebe
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Maarten C Eisma
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
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16
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Mason TM, Tofthagen CS, Buck HG. Complicated Grief: Risk Factors, Protective Factors, and Interventions. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2020; 16:151-174. [PMID: 32233740 DOI: 10.1080/15524256.2020.1745726] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Complicated grief (CG) poses significant physical, psychological, and economic risks to bereaved family caregivers. An integrative review of the literature published 2009-2018 on CG associated with caregiving was performed using PubMed, PsychINFO, and Web of Science. The search returned 1428 articles, of which 32 were included in the review. Sixteen studies described risk and protective factors and 16 described interventions for CG. Caregiver-related risk factors included fewer years of education, depression, anxiety, poor physical health, and maladaptive dependency and attachment traits. Additional risk factors included lower perceived social support, family conflict at end-of-life, and family having difficulty accepting death. Care recipient-related risk factors are younger age, fear of death, and place of death. Protective factors included hospice utilization in reducing fear of death, high pre-bereavement spiritualty, and satisfaction with palliative care. Complicated grief treatment was the most widely-studied intervention. Social Workers and other clinicians can use this information to identify family caregivers at increased risk for CG and refer or implement an early intervention to lessen its impact.
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Affiliation(s)
- Tina M Mason
- College of Nursing, University South Florida, Tampa, Florida, USA
| | | | - Harleah G Buck
- College of Nursing, University South Florida, Tampa, Florida, USA
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