Evaluation of the performance of instruments to diagnose grief disorders: A diagnostic meta-analysis

The influence of culture and spirituality on maternal grief following stillbirth in China: A qualitative study

BACKGROUND

Stillbirth is a unique phenomenon with various manifestations influenced by cultural contexts and spiritual beliefs. Chinese cultural and spiritual practices produce different post-stillbirth grief experiences for bereaved mothers in China. However, the majority of research on perinatal loss and grief has been conducted in Western cultures. In the Chinese cultural context, the post-stillbirth grief experience of bereaved mothers may differ from the types of Western bereavement examined in the dominant research.

OBJECTIVE

This study investigated the influence of culture and spirituality on grieving mothers who had experienced a stillbirth in China.

METHODS

This qualitative study was grounded in an interpretivist constructionist epistemology. In-depth interviews were conducted with mothers who had experienced a stillbirth within the previous year. Thematic analysis was used to analyse the data.

FINDINGS

A total of 28 women were interviewed by trained interviewers. Three key themes were identified: 1) The influence of culture on grief expression, with four subthemes: restrained expressions of grief, unattainable mourning ceremonies, hospital policy as a barrier to grieving, and others-oriented self; 2) Cultural characteristics of post-stillbirth experiences, with four subthemes: paternalistic medical culture, "Kong yuezi", embarrassment during postpartum visits, and cultural taboos on dealing with deceased babies' possessions; and 3) Finding significance in spiritual healing process, with four subthemes: seeking meaning in the event, accepting and reconciling with the event, reshaping beliefs and views about life and death, and achieving personal growth.

CONCLUSION

Chinese culture and spirituality have different influences on bereaved mothers' expressions of grief and post-stillbirth healing. This research demonstrates specific aspects of spirituality that contribute to or hinder the grieving process and the different roles of Chinese culture and spirituality for individuals. The findings suggest the need for the development of culturally sensitive interventions and support systems to assist mothers in navigating grief and healing. Future studies could explore the roles of Chinese culture and spirituality over time in the different stages of grief and healing after stillbirth.

A scoping review of theories and models applied for grief and bereavement projects

This scoping review aimed to identify the theory-based studies related to grief and bereavement in palliative care. The investigation was carried out by searching seven databases and conducting manual searches. The search procedure yielded 51 scholarly papers, which revealed 33 theories or models and 37 instruments. The theories and models can be classified into distinct categories, namely grief patterns and coping mechanisms. This study can be a valuable reference for future research endeavors, particularly those employing deductive methodologies. It offers guidance in selecting appropriate theories or models that can be applied to further studies.

Anticipatory grief prevalence among caregivers of persons with a life-threatening illness: A meta-analysis

OBJECTIVES

Caring for a family member with a life-threatening illness may lead to increased levels of psychological morbidity. Given the lack of recognition of caregivers' grief, this study aimed to determine the prevalence of anticipatory grief disorders in caregivers of persons with a life-threatening illness for better intervention and management.

METHODS

CINAHL, Cochrane, Embase, Medline, PubMed, Scopus, PsycINFO and Web of Science were searched up to 21 March 2021 without language and time restrictions. The quality of the included studies was assessed with Hoy's criteria. A random-effects model was applied to calculate pooled prevalence rates, and multi-regression was performed to examine heterogeneity among studies.

RESULTS

A total of 3278 citations were retrieved, and 18 studies met the eligibility criteria involving 5470 caregivers. The pooled prevalence of anticipatory grief was 24.78% (95% CI 19.04% to 30.99%). The prevalence rates were significantly higher in female caregivers (16.64%; 95% CI 12.24% to 21.53%) compared with male caregivers (6.11%; 95% CI 4.55% to 7.87%). The married group also had a higher risk (14.66%; 95% CI 10.66% to 19.16%) than single group (5.47%; 95% CI 4.31% to 6.76%).

CONCLUSIONS

The overall pooled prevalence is substantially higher compared with after-loss grief in the general population and supported the presumptions that preloss grief has a greater magnitude compared with after-loss grief. Bereavement support, educational programmes and relevant resources should be delivered even before the actual loss to address the burden of caregivers.

Prevalence of grief symptoms and disorders in the time of COVID-19 pandemic: A meta-analysis

Millions of people worldwide are mourning the loss of loved ones due to the COVID-19 epidemic, which may adversely impact their mental health. This meta-analysis aimed to investigate pandemic grief symptoms and disorders for developing policy, practice, and research priorities. The databases of Cochrane, Embase, Ovid-MEDLINE, WHO COVID-19, NCBI SARS-CoV-2, Scopus, Web of Science, CINAHL, and Science Direct were comprehensively searched until July 31, 2022. The Joanna Briggs Institute's and Hoy's criteria were used to evaluate the studies. A pooled prevalence was presented in a forest plot figure with a corresponding 95% confidence interval (CI) and prediction interval. Between-study heterogeneity was measured using the I² and Q statistics. Variations in the prevalence estimates in different subgroups were examined by moderator meta-analysis. The search identified 3677 citations, of which 15 studies involving 9289 participants were included in the meta-analysis. The pooled prevalence rate of grief symptoms was 45.1% (95%CI: 32.6%-57.5%), and grief disorder was 46.4% (95%CI: 37.4%-55.5%). Grief symptoms were significantly higher in <6 months (45.8%; 95%CI: 26.3%-65.3%) compared to the period of more than 6 months. Unfortunately, moderator analyses for grief disorders could not be performed due to limited studies. The prevalence of grief problems during the pandemic was substantially higher than in non-pandemic conditions; therefore, it is crucial to strengthen bereavement support to reduce psychological distress. The results provide a foundation for nurses and healthcare workers to anticipate a heightened need for support and provision of bereavement care in the post-pandemic era.

Professional grief among nurses in Spanish public health centers after caring for COVID-19 patients

AIMS AND OBJECTIVES

The aim of the present study is to investigate the professional grief suffered by nurses in various medical units, after coping with the COVID-19 pandemic for the last 18 months.

BACKGROUND

Addressing and acknowledging the reality of professional grief is of fundamental importance to nurses' mental health, as this condition has both professional and personal consequences.

DESIGN

A qualitative, content analysis approach was taken.

METHODS

Based on 25 interviews with nursing professionals working in different health centers units were performed. The following sampling schemes were used: first, convenience sampling, then nominated sampling, and finally theoretical sampling.

RESULTS

From our analysis of the data obtained, three main themes were identified: the impact on nurses of COVID-19 outcomes; the symptoms of professional grief; and cognitive reactions. These core elements interacted with 12 subtopics, including symptoms of grief and the cognitive impact produced.

CONCLUSIONS

A large proportion of the nurses consulted in this study have suffered and suffered professional grief and report many related symptoms. In response to the present pandemic and any future occurrence, the question of professional grief needs to be addressed.

RELEVANCE TO CLINICAL PRACTICE

To help them cope better with this type of situation, nurses should receive appropriate training. Moreover, healthcare institutions should be made aware of the problem and be encouraged to offer assistance to address the impact produced on nurses by the deaths of their patients.

CLINICAL RELEVANCE

This study shows the impact of professional grief on nurses in the context of the COVID-19 pandemic. Nurses are affected personally by the deaths of patients and by alterations to their working conditions. In many cases, this grief remains unresolved and its various symptoms persist.

Prevalence of grief disorders in bereaved families of cancer patients: A meta-analysis

BACKGROUND

Cancer caregiving is a distressing experience and loss of a loved one can lead to intense grief and other adverse effects. However, the prevalence of grief disorders among families associated with cancer-related deaths remains unknown.

AIM

This study aimed to determine the prevalence of grief disorders among families of patients with cancer to better inform clinicians, researchers, and policymakers.

DESIGN

Meta-analysis, PROSPERO number CRD42020209392.

DATA SOURCES

The databases of CINAHL, Embase, MEDLINE, PubMed, Scopus, PsycINFO, and Web of Science were comprehensively searched with no language restrictions. The quality of included studies was assessed with Hoy's criteria.

RESULTS

Among the 3046 records screened, 19 studies were eligible for meta-analysis, with a total of 14,971 participants. The pooled prevalence rate of grief disorders was estimated at 14.2% (95% CI, 11.7%-16.7%), ranging from 7% to 39%. The prevalence was higher in females (10%; 95% CI, 8.2%-12.1%), those who are religious (9.55%; 95% CI, 8.97%-10.16%), spouses of the deceased (7.78%; 95% CI, 6.08%-9.69%), and families of patients with neurological cancers (6.4%; 95% CI, 0.10%-19.9%). Educational levels, study locations, diagnosis tools, time post-after loss, and study methods seemed not to affect the prevalence of grief disorders in families of patients with cancer.

CONCLUSIONS

As the prevalence of grief disorders in cancer-related bereavement is substantial, therefore, support including palliative care is important to reduce the burden of caregiving. In addition, future studies are needed to identify and explore effective strategies that can help reduce the burden caused by grief disorders after the death of the patient.