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Mateus MJ, Simões L, Ali AM, Laranjeira C. Family Experiences of Loss and Bereavement in Palliative Care Units during the COVID-19 Pandemic: An Interpretative Phenomenological Study. Healthcare (Basel) 2024; 12:1763. [PMID: 39273788 PMCID: PMC11395245 DOI: 10.3390/healthcare12171763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 08/30/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024] Open
Abstract
The COVID-19 pandemic significantly interrupted the grieving experiences of bereaved families and drastically changed their ways of dealing with loss. Our study aims to gain an in-depth understanding of the experience of bereaved relatives of patients who died in palliative care units during the COVID-19 pandemic. The phenomenological research design included sixteen family members of hospitalized palliative patients who died from November 2021 to June 2022. The study involved conducting qualitative in-depth semi-structured interviews with family members 12-24 months after the death of their loved ones. The interviews aimed to gather information about the experiences of the families both before and after the death. The COREQ guidelines were applied in the study. Participants were mainly female (n = 13) with a mean age of 47.25 (SD = 12.58). Data were analysed using the Interpretative Phenomenology Analysis (IPA). The following three categories were identified: (1) navigating loved ones' final weeks and days (troubled deaths); (2) the last farewell was robbed; (3) looking for adjustment after loss. One overall main theme emerged, which was as follows: "Struggling between stolen moments and painful losses to get back into the flow of life". This study provides novel insights into end-of-life care and bereavement from the perspectives of family. Our findings suggest that developing and promoting family-centred culture can lead to compassionate palliative care focused on a myriad ways of affirming that their loved one matters.
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Affiliation(s)
- Maria João Mateus
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Palliative Care Inpatient Unit, Local Health Unit of the Aveiro Region, Visconde Salreu Hospital, Rua da Agra 23, 3865-206 Salreu, Portugal
| | - Luís Simões
- Department of Psychology, Local Health Unit of Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Smouha, Alexandria 21527, Egypt
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Vandersman P, Chakraborty A, Rowley G, Tieman J. The matter of grief, loss and bereavement in families of those living and dying in residential aged care setting: A systematic review. Arch Gerontol Geriatr 2024; 124:105473. [PMID: 38728822 DOI: 10.1016/j.archger.2024.105473] [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: 03/15/2024] [Revised: 04/23/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024]
Abstract
The grief, loss and bereavement needs of the families of those living and dying in residential aged care setting is not very well understood. This systematic review examines grief, loss, and bereavement experience of, and interventions relating to, family caregivers of those entering, living and dying in residential aged care. Out of 2023 papers that were identified, 35 met the inclusion criteria which included (n=28) qualitative and (n=7) quantitative intervention studies. The qualitative findings indicated quality of care provided to the resident at the end of their life, and after death care influenced family caregivers' grief reactions. The intervention studies revealed that educational interventions have the potential to lead to some benefits in the context of grief loss and bereavement outcomes. Recognizing the emotional experiences and support needs of families and carers may enhance the understanding of the ageing, caring, dying, grieving pathway for older people and their families.
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Affiliation(s)
- Priyanka Vandersman
- Research Centre for Palliative Care, Death, and Dying, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
| | - Amal Chakraborty
- Faculty of Medicine and Health, University Centre for Rural Health, The University of Sydney, Sydney, Australia
| | - Georgia Rowley
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Jennifer Tieman
- Research Centre for Palliative Care, Death, and Dying, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Forte K, Larkin D. Applying Lessons From Ars Moriendi to Foster Dying Well in Acute Care Settings. J Hosp Palliat Nurs 2024; 26:172-177. [PMID: 38478852 DOI: 10.1097/njh.0000000000001024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Medical and technological advances have made it possible to keep people alive well beyond what was once possible, leading health care providers to focus on life-sustaining measures rather than questioning the futility of such measures and considering quality of life. In the midst of the struggle to foster dying well in a medicalized environment, acute care nurses may be challenged with shifting the focus to providing optimal end-of-life care because of lack of training, time, and resources. A remedy for the current western societal approach to medicalized dying is to look back in history to a time during the late Middle Ages, when death was an accepted part of medieval life. A literary genre called Ars Moriendi (translated "the art of dying") was written and illustrated to provide instruction on how to die well and how to care for the dying. Nurses can apply lessons from this text to fulfill the ethical obligation to practice with dignity and provide compassionate end-of-life care. These lessons include helping patients and families identify goals of care and accept finitude, encouraging the participation of loved ones at the bedside, and fostering reconciliation at the end of life.
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Figueiredo CDS, Giacomin KC, Gual RF, de Almeida SC, Assis MG. Death and Other Losses in the COVID-19 Pandemic in Long-Term Care Facilities for Older Adults in the Perception of Occupational Therapists: A Qualitative Study. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:795-811. [PMID: 35354414 PMCID: PMC8971964 DOI: 10.1177/00302228221086169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Long-term care facilities for older adults (LTCFs) were directly affected by the COVID-19 pandemic. This study aimed to discuss the perceptions of occupational therapists about deaths and other losses in LTCFs during the pandemic. This qualitative study is anchored in social phenomenology, and conducted in-depth interviews with eight occupational therapists who worked in LTCFs. Thus, two themes were generated after the Thematic Analyses: "The proximity of death" and "Losses associated with living and dying in a LTCF." In the first theme, the interviewees addressed the feeling of imminent death in the daily life of the LTCF, and feelings related to their own death, that of their family members and other older adults. In the second, the professionals highlighted three groups of losses: social, functional, and psychological/cognitive. These results highlighted the challenges faced by occupational therapists and can contribute to improve behavior and care for institutionalized older adults during the pandemic.
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Affiliation(s)
- Carolina de S. Figueiredo
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Karla C. Giacomin
- Geriatrician, Center for Studies in Public Health and Aging – NESPE, Fiocruz Minas - Municipal Health Department, Belo Horizonte, Brazil
| | - Ramon F. Gual
- Geriatrician, Conviver Complexo de Atenção ao Idoso, Belo Horizonte, Brazil
| | - Simone C. de Almeida
- Occupational Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marcella G. Assis
- Occupational Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Finkelstein-Fox L, Park CL, Eigsti IM, Awao S, Mancini AD. Disruptions in self-regulatory processes predict depression and sleep disturbance in bereaved young adults. Stress Health 2024; 40:e3310. [PMID: 37658785 DOI: 10.1002/smi.3310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/05/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
Losing a loved one is both common and profoundly stressful for young adults. Little research has examined the longitudinal course of post-loss cognitive processing, depression, and sleep difficulties. Further, little is known about the context of other stressors or the role of individual regulatory resources, such as attentional regulation, that might determine whether loss-related cognitive processing reduces distress. This prospective study examined changes in depression and sleep disturbance over 9 weeks as a function of within- and between-person variation in stress exposure, loss-related cognitive processing, and attention regulation. Participants were 108 recently bereaved college students completing a lab-based assessment of attention regulation and four self-report surveys, spaced three weeks apart. Results revealed that most participants gradually reduced loss-related processing over the study period, with corresponding improvements in depression and sleep. Stress exposure was associated with increased processing, depression, and sleep disturbance. In exploratory analyses, high attentional alertness and slow re-orienting strengthened the association of within-person loss processing with sleep disturbance. Both within- and between-person variation in stress appear to engender risk for a prolonged course of bereavement. Future research should integrate objective attention measures with self-reported adjustment to stress to illuminate reciprocal links between depression, sleep, and loss-related cognitive processing.
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Affiliation(s)
- Lucy Finkelstein-Fox
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Sayaka Awao
- Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Anthony D Mancini
- Department of Psychology, Pace University, Pleasantville, New York, USA
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Aliyaki H, Momeni F, Dolatshahi B, Hosseinzadeh S, Yousefi S, Abdoli F. Mourning in the time of coronavirus: Examining how grief differs in those who lost loved ones to COVID-19 vs. natural causes in Iran. Palliat Support Care 2024:1-10. [PMID: 38533611 DOI: 10.1017/s1478951524000348] [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: 03/28/2024]
Abstract
OBJECTIVES Our study aimed to analyze and compare the grief experiences of individuals in Iran who lost family members to COVID-19 and those who lost loved ones to other natural causes. METHODS In this study, telephone interviews were conducted with 640 first-degree relatives, and finally, a total of 395 people remained in the research. Participants answered the Prolonged Grief Questionnaire (PG-13-R) and Grief Experience Questionnaire. RESULTS The results showed that the most common symptoms and features of grief were feeling guilt, searching for an explanation, somatic reactions, and rejection, with no significant difference observed between the 2 death groups. However, the average scores for these symptoms were higher in the COVID-19 death group. Moreover, the majority of bereaved reported signs and symptoms of prolonged grief, with a higher percentage in the COVID-19 death group, although there was no significant difference between the 2 death groups in terms of the distribution of symptoms and signs of prolonged grief. These findings suggest that the bereavement process can be challenging, and losing a loved one to COVID-19 may lead to more intense experiences of grief. SIGNIFICANCE OF RESULTS The study reveals high levels of guilt, searching for meaning, somatic reactions, and rejection among COVID-19 grievers. Losing loved ones to the pandemic appears linked to more intense, prolonged grief symptoms.
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Affiliation(s)
- Hajar Aliyaki
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Fereshteh Momeni
- Department of Psychology, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Behrouz Dolatshahi
- Department of Psychology, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Samaneh Hosseinzadeh
- Department of Biostatistics, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Shahab Yousefi
- Department of Clinical Psychology, School of Behavioral Science and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Science, Tehran, Iran
| | - Fatemeh Abdoli
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Sarper E, Rodrigues DL. The Role of Perceived Social Support in the Grief Experiences of More Anxious and Self-Compassionate People. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241229484. [PMID: 38265046 DOI: 10.1177/00302228241229484] [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: 01/25/2024]
Abstract
Past research showed that high trait anxiety and low self-compassion, along with lack of perceived social support, have been associated with experiencing stronger grief symptoms. However, research is yet to understand if and how these factors interact among grieving individuals. Results of a cross-sectional study (N = 539) showed that perceived social support interacted differently with trait anxiety and self-compassion to shape grief experiences. Unexpectedly, perceived social support did not buffer the association between higher trait anxiety and stronger grief symptoms. Instead, participants with higher trait anxiety reported stronger symptoms only when they perceived to have less social support. In contrast, participants with higher self-compassion reported less symptoms when they perceived to have more social support. These findings show that social support can emphasize the detrimental role of anxiety and the protective role of self-compassion when people are coping with a loss. Implications and suggestions for future research are discussed.
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Affiliation(s)
- Ecem Sarper
- Centro de Investigação e Intervenção Social (CIS), Iscte-Instituto Universitário de Lisboa, Lisboa, Portugal
| | - David L Rodrigues
- Centro de Investigação e Intervenção Social (CIS), Iscte-Instituto Universitário de Lisboa, Lisboa, Portugal
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Siddiqua A, Ahmad S, Nawaz I, Zeeshan M, Rao A. The smoldering pandemic: Prevalence of prolonged grief disorder. A cross-sectional study of bereaving adults during the COVID pandemic in Pakistan. Asian J Psychiatr 2024; 91:103870. [PMID: 38154352 DOI: 10.1016/j.ajp.2023.103870] [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: 07/04/2023] [Revised: 08/29/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023]
Abstract
The world continues to face unprecedented psycho-social challenges after the COVID-19 pandemic. Prolonged Grief Disorder (PGD) is a young psychiatric condition describing grief exceeding standard cultural, social, and religious norms. We assessed the prevalence of PGD in Pakistan along with its correlation to anxiety, depression, and psychological distress. The prevalence of PGD was estimated to be 15 % with grief intensity correlating with depression, anxiety, and serious mental illness. People who were closely related to the deceased were more likely to experience severe PGD symptoms. Discussions about grief and measures to curb its psychological effects are crucial in the post-pandemic world.
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Affiliation(s)
| | - Shaaf Ahmad
- University College of Medicine and Dentistry, Lahore, Pakistan
| | - Iqra Nawaz
- Quaid-e-Azam Medical College, Bahawalpur, Pakistan.
| | | | - Amina Rao
- Quaid-e-Azam Medical College, Bahawalpur, Pakistan.
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9
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Escobar-Agreda S, Romero Albino Z, Contreras PJ, Cuba-Fuentes MS. Complicated grief and its relationship with anxiety, depression, and suicidal ideation in older adults in the context of the COVID-19 pandemic in Peru: a cross-sectional analysis. BMC Psychiatry 2023; 23:908. [PMID: 38053085 PMCID: PMC10696725 DOI: 10.1186/s12888-023-05412-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Complicated grief (CG) resulting from poor adaptation to the death of a close person may have been related with the presence of other mental health problems in older adults in Peru during the COVID-19 pandemic. Our study aimed to assess the association between CG and anxiety, depression, and suicidal ideation in older adults in Peru in the context of the COVID-19 pandemic. METHODS We conducted a cross-sectional analysis using data from the "Socioemotional evaluation form" applied in 2020 to mental health problems in older adults attending the Peruvian Social Security (EsSalud). For our study, we included older adults who reported the death of a close person during the last six months when this assessment was performed. CG, depression, anxiety, and suicidal ideation were initially evaluated using validated questionnaires. The association between CG and the presence of mental health problems was calculated through multivariate analysis, where prevalence ratios (PR) were estimated with 95% confidence intervals (CI). RESULTS Of the 249 older adults included, 175 (70.3%) were female with a median age of 71 years (interquartile range: 9), and 35 (14.1%) reported the presence of CG. It was found that CG in this population was associated with the presence of anxiety (PR: 1.35, 95% CI: 0.98 to 1.85), depression (PR: 1.44, 95% CI: 1.06 to 1.95), and suicidal ideation (PR: 2.84, 95% CI: 1.06 to 7.59). CONCLUSIONS CG is related to the presence of mental health problems in older adults in Peru. It is essential to implement measures that facilitate the prevention and proper management of this condition in this population, especially in the context of high population mortality such as the COVID-19 pandemic.
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Affiliation(s)
| | | | - Pavel J Contreras
- Padomi Children, Flexible Offer Management, Essalud, Lima, Peru
- Centro de Investigación en Atención Primaria de Salud, Universidad Peruana Cayetano Heredia, 775 Jose Gonzales Street, Apt. 604, Miraflores, Lima, Perú
| | - María Sofía Cuba-Fuentes
- Centro de Investigación en Atención Primaria de Salud, Universidad Peruana Cayetano Heredia, 775 Jose Gonzales Street, Apt. 604, Miraflores, Lima, Perú.
- Juan Jose Rodriguez Lazo Polyclinic, EsSalud, Lima, Perú.
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Lammon M. The Ashes of Tragedy: Parental Death and Child Character Development in Bambi and The Lion King. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231202884. [PMID: 37713269 DOI: 10.1177/00302228231202884] [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: 09/16/2023]
Abstract
The Walt Disney company has been the topic of extensive research for decades; among the explored subjects and identified themes is Disney's fixation on death. Disney has capitalized on the incredibly traumatic childhood experience of the death of a parent by featuring parental death as a major narrative component. Speculation remains regarding the accuracy of not only death presentations in media, but death influence on characters. Using textual analysis, this paper explores the role of parental death on child character development within two Disney animated films. Analysis demonstrates an inaccurate depiction of parental death influence on children in a positive light - essentially overlooking the trauma associated with loss during childhood and the mediating factors of long-term bereavement outcomes. Conversations remain to be had regarding how these inaccurate depictions of death and dying in popular culture influence the children consuming them.
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Affiliation(s)
- Marissa Lammon
- Department of Media Studies, University of Colorado Boulder, Boulder, CO, USA
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Bird MJ, Li G, MacNeil A, Jiang Y, de Groh M, Fuller-Thomson E. Pandemic-Induced Depression Among Older Adults with a History of Cancer During the COVID-19 Pandemic: Findings from the Canadian Longitudinal Study on Aging. Cancer Manag Res 2023; 15:937-955. [PMID: 37700810 PMCID: PMC10493151 DOI: 10.2147/cmar.s421675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/08/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose The objectives of this study were to identify the prevalence of, and factors associated with, incident and recurrent depression in a sample of older adults with a history of cancer during the COVID-19 pandemic. Materials and Methods Data were drawn from four waves of the Canadian Longitudinal Study on Aging Comprehensive Cohort (n=2486 with cancer). The outcome of interest was a positive screen for depression based on the CES-D-10 during the autumn of 2020. Results Among older adults with cancer and no pre-pandemic history of depression (n=1765), 1 in 8 developed first onset depression during the pandemic. Among respondents with cancer and a history of depression (n=721), 1 in 2 experienced a recurrence of depression. The risk of both incident and recurrent depression was higher among those who were lonely, those with functional limitations, and those who experienced an increase in family conflict during the pandemic. The risk of incident depression only was higher among older women, those who did not engage in church or religious activities, those who experienced a loss of income during the pandemic, and those who became ill or had a loved one become ill or die during the pandemic. The risk of recurrent depression only was higher among those who felt isolated from others and those whose income did not satisfy their basic needs. Conclusion Health care providers should continue to screen and provide mental health support to their cancer patients and those with a lifetime history of cancer, with consideration for those with the aforementioned vulnerabilities.
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Affiliation(s)
- Meghan J Bird
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
| | - Grace Li
- Department of Sociology, University of Victoria, Victoria, BC, Canada
| | - Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
| | - Ying Jiang
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Margaret de Groh
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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12
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Akbari M, Seydavi M, Babaeifard M, Firoozabadi MA, Nikčević AV, Spada MM. Psychometric properties and psychological correlates of the COVID-19 Anxiety Syndrome Scale: A comprehensive systematic review and meta-analysis. Clin Psychol Psychother 2023; 30:931-949. [PMID: 37166175 DOI: 10.1002/cpp.2861] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/14/2023] [Accepted: 04/25/2023] [Indexed: 05/12/2023]
Abstract
Coronavirus disease-19 (COVID-19) has led to the demise of millions of people worldwide; additionally, it has resulted in a significant economic and mental health burden. Since the onset of the COVID-19 pandemic, various measures have been constructed to evaluate pandemic-related fear and anxiety. The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a promising measure that assesses coping strategies (e.g., avoidance, checking, worrying and threat monitoring), termed 'COVID-19 Anxiety Syndrome', in response to COVID-19 fear and anxiety. The measure has been broadly welcomed, leading to its use in Brazil (Portuguese), China, Greece, Indonesia, the Philippines, Iran (Farsi), Italy, Saudi Arabia (Arabic), Turkey, the United Kingdom and the United States. To gain a better understanding of the relevance of the COVID-19 Anxiety Syndrome, we conducted a systematic review and meta-analysis to explore the psychological correlates and psychometric properties of the C-19ASS. Through the analysis of a total of 17,789 individuals (age range 19-70; female = 33%-85%), the C-19ASS demonstrated a consistent factor structure, measurement invariance across gender and acceptable reliabilities. Furthermore, a significant association with COVID-19 anxiety, depressive symptoms, generalized anxiety, health anxiety, psychological distress and functional impairment (work and social adjustment) during the COVID-19 pandemic was observed. When considering the Big Five personality traits, the C-19ASS and its subscales were only significantly and negatively associated with extraversion; only the total score on the measure was associated with neuroticism. The observed effect sizes ranged from very small to medium. Given that all included studies (K = 24) were cross-sectional, and due to the nature of the COVID-19 Anxiety Syndrome, which may well persist after the pandemic ends, it is recommended to continue screening society for the persistence of this syndrome.
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Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Mohammad Seydavi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Maryam Babaeifard
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Mahsa Akbarian Firoozabadi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Ana V Nikčević
- Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, Kingston, UK
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Morgan T, Gott M, Williams L, Naden J, Wang Y, Smith B, Fanueli E, Budi Setyawati M, Morgan K, Robinson J, Anderson N, Carey M, Moeke-Maxwell T. A bad time to die? Exploring bereaved families/wha-nau experiences of end-of-life care under COVID-19 restrictions: a qualitative interview study. Palliat Care Soc Pract 2023; 17:26323524231189525. [PMID: 37584059 PMCID: PMC10424543 DOI: 10.1177/26323524231189525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/05/2023] [Indexed: 08/17/2023] Open
Abstract
Background There have been international concerns raised that, during the COVID-19 pandemic, there was an absence of good palliative care resulting in poor end-of-life care experiences. To date, there have been few studies considering the pandemic's impact on people dying from non-COVID-19 causes and their families and friends. In particular, there has been very less empirical research in relation to end-of-life care for Indigenous, migrant and minoritised ethnic communities. Objectives To explore bereaved next-of-kin's views and experiences of end-of-life care under COVID-19 pandemic regulations. Design This qualitative study involved in-depth one-off interviews with 30 ethnically diverse next-of-kin who had a family member die in the first year of the pandemic in Aotearoa, New Zealand. Methods Interviews were conducted by ethnically matched interviewers/interviewees. A reflexive thematic analysis was used to explore and conceptualise their accounts. Results A key finding was that dying alone and contracting COVID-19 were seen as equally significant risks by bereaved families. Through this analysis, we identified five key themes: (1) compromised connection; (2) uncertain communication; (3) cultural safety; (4) supported grieving and (5) silver linings. Conclusion This article emphasises the importance of enabling safe and supported access for family/whanau to be with their family/wha-nau member at end-of-life. We identify a need for wider provision of bereavement support. We recommend that policy makers increase resourcing of palliative care services to ensure that patients and their families receive high-quality end-of-life care, both during and post this pandemic. Policy makers could also promote a culturally-diverse end-of-life care work force and the embedding of culturally-safety practices across a range of institutions where people die.
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Affiliation(s)
- Tessa Morgan
- Applied Social Science Group, Department of Public Health and Primary Care, The University of Cambridge, Forvie Site, Cambridge CB2 0SR, UK
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Joe Naden
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Yingmin Wang
- School of Foreign Studies and School of International Culture, South China Normal University, Guangzhou, China
| | - Brianna Smith
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Fanueli
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Martyarini Budi Setyawati
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Kathryn Morgan
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jackie Robinson
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Natalie Anderson
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Melissa Carey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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14
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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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Mucci F, Bouanani S, Cerù A, Mauro A, Diolaiuti F. Navigating the "Mental Health Crisis" in Adolescents in the Aftermath of Covid-19 Pandemic: Experience and Insights from Frontline Psychiatric Service. CLINICAL NEUROPSYCHIATRY 2023; 20:309-315. [PMID: 37791087 PMCID: PMC10544258 DOI: 10.36131/cnfioritieditore20230410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
The COVID-19 pandemic had a great impact on adolescent mental health, with a dramatic rise in psychiatric emergencies that has challenged healthcare systems worldwide. This paper aims at focusing on reporting the authors' experience and their data collected on adolescent emergencies in 2022 in Tuscan, within the context of the "Azienda USL Toscana Nord Ovest", a large department covering about a third of Tuscany's Regional Health Service, in central Italy. The collected findings will be shortly presented and commented on, while providing insights concerning the importance of adapting healthcare systems to adequately respond to this growing crisis and the need for broader strategies to support adolescent mental health in these challenging times.
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Affiliation(s)
- Federico Mucci
- University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Italy
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit
| | - Siham Bouanani
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit
| | - Angelo Cerù
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit
| | - Amelia Mauro
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit
| | - Francesca Diolaiuti
- University of Pisa, Department Translational Research and New Technologies in Medicine and Surgery, Italy
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16
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Drucker A, Levi-Belz Y, Hamdan S. Depression, Complicated Grief, and Suicide Ideation Following Bereavement During the COVID-19 Pandemic. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231186361. [PMID: 37402646 PMCID: PMC10323518 DOI: 10.1177/00302228231186361] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Many people lost a relative during the COVID-19 pandemic. Such a loss may have deleterious implications due to the circumstances of bereavement during lockdowns and social distancing. This study aimed to explore depressive symptoms, complicated grief, and suicidal ideation in the grieving process among 104 bereaved jewish adults who had lost relatives during the COVID-19 pandemic by completing self-reported questionnaires. The results indicate high suicidal ideation, complicated grief, and depression among them. Bereaved with suicidal ideation have an avoidant attachment and a close relationship with the deceased. These results highlight the adverse implication of COVID-19 on the grief process.
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Affiliation(s)
- Adva Drucker
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv- Yaffo, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Sami Hamdan
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv- Yaffo, Israel
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17
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Biagianti B, Lisi I, Di Liberto A, Turtulici N, Foti G, Zito S, Ginex V, Fornoni C, Gallo F, Cantù F, Tombola V, Di Fede V, Rossetti MG, Colombo E, Stocchetti N, Zanier ER, Bellani M, Bressi C, Brambilla P. Feasibility and preliminary efficacy of brief tele-psychotherapy for COVID-19 patients and their first-degree relatives. J Affect Disord 2023; 330:300-308. [PMID: 36934855 PMCID: PMC10022466 DOI: 10.1016/j.jad.2023.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/01/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND The SARS-CoV-2 pandemic compromised the mental health of COVID-19 patients and their family members. Due to social distancing and lockdown measures, a remote, tele-psychotherapy program for former or current COVID-19 patients and their relatives was implemented. OBJECTIVE The primary goal of this project was to evaluate intervention feasibility. The secondary aim was to assess the impact of the intervention by means of pre-post psychological changes. METHODS After a phone-based eligibility screening and remote neuropsychological testing, participants completed online self-reports assessing baseline COVID-related psychopathology. Next, participants attended eight tele-psychotherapy sessions. After treatment, the online self-reports were completed again. RESULTS Of 104 enrolled participants, 88 completed the intervention (84.6 % completion rate). Significant pre-post improvements were observed for generalized anxiety (d = 0.38), depression (d = 0.37), insomnia (d = 0.43), post-traumatic psychopathology (d = 0.54), and general malaise (d = 0.31). Baseline cluster analysis revealed a subgroup of 41 subjects (47.6 %) with no psychopathology, and a second subgroup of 45 subject (52.3 %) with moderate severity. Thirty-three percent of the second group reached full symptom remission, while 66 % remained symptomatic after treatment. CONCLUSIONS Remote brief tele-psychotherapy for COVID-19 patients and their first-degree relatives is feasible and preliminary efficacious at reducing COVID-related psychopathology in a subgroup of patients. Further research is needed to investigate distinct profiles of treatment response.
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Affiliation(s)
- Bruno Biagianti
- Department of Psychology, University of Milan Bicocca, 20126, Milano, Italy
| | - Ilaria Lisi
- Laboratory of Acute Brain Injury and Therapeutic Strategies, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milano, Italy
| | - Asia Di Liberto
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Nunzio Turtulici
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Giuseppe Foti
- Department of Psychology, University of Milan Bicocca, 20126, Milano, Italy
| | - Silvana Zito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Valeria Ginex
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Chiara Fornoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Francesca Gallo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Filippo Cantù
- Department of Psychology, University of Milan Bicocca, 20126, Milano, Italy
| | - Valentina Tombola
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Viviana Di Fede
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Elisa Colombo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Nino Stocchetti
- Department of Anaesthesia and Critical Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Elisa R Zanier
- Laboratory of Acute Brain Injury and Therapeutic Strategies, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milano, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, 37134 Verona, Italy
| | - Cinzia Bressi
- Department of Psychology, University of Milan Bicocca, 20126, Milano, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Brambilla
- Department of Psychology, University of Milan Bicocca, 20126, Milano, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
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18
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Milner KA. Evolution of Visiting the Intensive Care Unit. Crit Care Clin 2023; 39:541-558. [DOI: 10.1016/j.ccc.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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19
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Mayers PM, Olckers L, Prinsloo EL, Raine J, Zweigenthal V. Reflections of volunteer counselors working remotely during the COVID-19 pandemic-Implications for policy and practice. J Nurs Scholarsh 2023; 55:239-252. [PMID: 36510097 PMCID: PMC9877706 DOI: 10.1111/jnu.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE We reflect on our experience of running a remote volunteer counseling service, known as the Counseling Collective, to support patients and their families during the second wave of the COVID-19 pandemic in Cape Town, South Africa, and the learning and implications for practice and policy regarding the effective utilization of volunteers during a crisis or disaster context. BACKGROUND The Beta SARS-Co-2 variant dominated the second COVID-19 wave which gained momentum in December 2020, as public sector health teams prepared to deescalate services over the South African summer season. The ferocity with which the wave hit the city soon made it clear that volunteers would be needed to assist with counseling services as the Beta variant caused serious disease, resulting in a significant upswing in hospitalisations and deaths. METHODS Four counselors and a colleague with oversight responsibilities of the volunteers reflected on the service we provided. This was done with the benefit of hindsight a year after the activities of the Counseling Collective were wrapped up. LESSONS LEARNED Virtual volunteers are a largely untapped resource in the South African health care system. Much is to be gained by using this underutilized resource to deliver patient-centred services, especially in times of crisis. CONCLUSION Networks of retired and self-employed health professionals, particularly nurses,-skilled volunteers-are a valuable resource and can be deployed for critical work using their versatile skillsets, in public health emergencies. Telephonic consultations are a useful modality for providing quality care and need to be built into the business of health services. Skills to conduct such consultations and for the provision of palliative care services need to be mainstreamed into the skillsets of health professionals. POLICY AND CLINICAL RELEVANCE Public health disaster plans should include a blueprint for the rapid recruitment and deployment of volunteer counselors to assist permanent staff in providing crucial patient-centred care.
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Affiliation(s)
- Pat M. Mayers
- University of Western CapeCape TownSouth Africa
- University of Cape TownCape TownSouth Africa
| | | | | | - Joy Raine
- Private PracticeCape TownSouth Africa
| | - Virginia Zweigenthal
- School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
- Western Cape Department of HealthCape TownSouth Africa
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20
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Hanauer C, Telaar B, Al-Dawaf N, Rosner R, Doering BK. 'Feeling disconnected' - risk factors for PGD and themes in grief counselling during the COVID-19 pandemic. A mixed-method study. Eur J Psychotraumatol 2023; 14:2183006. [PMID: 36912798 PMCID: PMC10013402 DOI: 10.1080/20008066.2023.2183006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Background: Due to its high death toll and measures to curb the pandemic, COVID-19 has affected grieving experiences and may contribute to risk factors for Prolonged Grief Disorder (PGD). Persons at risk for PGD often seek support from grief counselling.Objective: To explore whether pandemic-associated risk factors have become more important topics in counselling in a mixed-method design.Method: German grief counsellors (n = 93) rated whether pre-defined risk factors had become more important in grief counselling and indicated additional important themes in an open format.Results: The counsellors indicated that all pre-defined risk factors had become more important, though differing significantly in their frequency. Most frequently endorsed risk factors were lack of social support, limited possibilities to accompany a dying loved one and absence of traditional grief rituals. Qualitative analysis identified three additional themes: the societal impact of the pandemic, its impact on bereavement support and health care, and a chance for personal growth.Conclusions: The pandemic has affected bereavement experiences and grief counselling. Counsellors should monitor grief processes and specific risk factors to provide the best possible care for bereaved people when needed.
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Affiliation(s)
- Christina Hanauer
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Berit Telaar
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Nadja Al-Dawaf
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Bettina K Doering
- Clinical Psychology, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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21
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Marmo S, Milner KA. From Open to Closed: COVID-19 Restrictions on Previously Unrestricted Visitation Policies in Adult Intensive Care Units. Am J Crit Care 2023; 32:31-41. [PMID: 36175358 DOI: 10.4037/ajcc2023365] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND In March 2020, rising numbers of COVID-19 infections contributed to changes in intensive care unit visitation policies, with some facilities allowing no visitors. OBJECTIVE To compare visitation policies of Magnet and Pathway to Excellence hospitals with prepandemic open visitation in adult intensive care units. METHODS A mixed-methods study was conducted from January through March 2021. Quantitative data on visitation policies were extracted from websites of 96 Magnet and Pathway to Excellence hospitals that had allowed unrestricted visits in adult intensive care units before the pandemic. Qualitative data were collected via semistructured interviews with 9 nurse leaders from these hospitals. RESULTS More than 1 year after the start of the pandemic, all of the hospitals had instituted restricted visitation policies. The policies varied, with little to no evidence-based justification. Restrictions included 83% of hospitals (n = 80) allowing just 1 visitor per day and 69% of hospitals (n = 50 of 72) allowing no visits at all for patients with COVID-19 in the intensive care unit. Five themes were found when nurse leaders' interviews were analyzed: visitors not welcome, doing harm, external decisions at system level, visiting within limits, and changes in critical care nursing work. CONCLUSION Results of the study suggest that despite the vast amount of evidence supporting the benefits of visitation and the harms of restricted visitation and expert recommendations for returning safe visitation to hospitals, Magnet and Pathway to Excellence hospitals continue to enforce restricted visitation policies in intensive care units. Patients, families, and nursing and health care staff must partner to create pandemic-proof visitation policies.
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Affiliation(s)
- Suzanne Marmo
- Suzanne Marmo is an assistant professor of social work at Sacred Heart University, Fairfield, Connecticut
| | - Kerry A Milner
- Kerry A. Milner is a professor of nursing at Sacred Heart University, Fairfield, Connecticut
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22
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Salisbury MR, Harmsen CRW, Muller RT. Help-Seeking Buffers the Impact of Grief on Quality of Life: A Study of Loss During the COVID-19 Pandemic. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221146337. [PMID: 36534615 PMCID: PMC9780555 DOI: 10.1177/00302228221146337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic has presented a global challenge for anticipating the support and treatment needs of bereaved individuals. However, no studies have examined how mourners have been coping with grief and which strategies may buffer negative mental health consequences. We examined the various coping strategies being used and which strategies best support quality of life. Participants completed self-report measures of demographic and loss-related characteristics, grief symptoms, quality of life (QOL), and coping strategies used. Despite help-seeking being one of the least endorsed coping strategies used, help-seeking was the only coping strategy that buffered the impact of grief on QOL for individuals with high grief severity. Results support predictions that grief may become a global mental health concern requiring increased accessibility and availability of grief therapies and professional supports for bereaved individuals during and in the aftermath of the pandemic.
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23
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Pugi D, Ferretti F, Galeazzi M, Gualtieri G, Lorenzi L, Pappalardo N, Macrì PG, Garosi G, Coluccia A, Pozza A. Health-Related Quality of Life in pre-dialysis patients with chronic kidney disease: the role of Big-Five personality traits and illness denial. BMC Psychol 2022; 10:297. [PMID: 36496378 PMCID: PMC9737964 DOI: 10.1186/s40359-022-00992-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Health-Related Quality of Life (HRQoL) in patients with chronic kidney disease (CKD) is significantly affected, regardless of the stage of the disease, as regards the physical, psychological and social functioning dimension. Big-Five personality traits can affect patients' HRQoL and willingness to take treatment options. Illness denial consists of denial of negative emotions, resistance to change and conscious avoidance. Poorer HRQoL can predict a higher risk of hospitalization and mortality, and broadly a worse adjustment to the dialytic therapy. Thus, a clearer knowledge of the psychological variables associated with a worse HRQoL in the predialysis stage might improve the intervention planning. No study investigated illness denial and personality traits simultaneously. We investigated the role of illness denial and Big-Five personality traits in the domains of HRQoL in predialysis patients with CKD. METHODS One hundred adults (mean age: 75.87 years) with CKD participated. The Kidney Disease Quality of Life Short form, the Italian version of Ten Item Personality Inventory Revised, the Illness Denial Questionnaire, and the State-Trait Anxiety Inventory Form-Y were administered. RESULTS Illness denial was associated with increased HRQoL related to symptoms/problems, effect and burden of CKD and cognitive functions domains, and it was a predictor of higher HRQoL in the last three domains mentioned above. Extraversion was related to better work status and sexual function; agreeableness was linked to elevated cognitive function, quality of social interaction and sexual function; conscientiousness was related to better sexual function; neuroticism was linked to improved cognitive and sexual functions; in the end, openness to experience was related to fewer symptoms and problems. CONCLUSIONS This is the first study which simultaneously assessed Big-Five personality traits and illness denial in different domains of HRQoL of CKD patients. Personalised psychological interventions aimed at improving HRQoL in this population might focus on specific illness denial processes and personality traits.
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Affiliation(s)
- Daniele Pugi
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy
| | - Fabio Ferretti
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy
| | - Maddalena Galeazzi
- grid.411474.30000 0004 1760 2630Department of Cardio-Thoraco-Vascular Sciences and Public Health, School of Specialization of Legal Medicine, University Hospital of Padova, Padua, Italy
| | - Giacomo Gualtieri
- grid.411477.00000 0004 1759 0844Santa Maria Alle Scotte University Hospital of Siena, Siena, Italy
| | - Lore Lorenzi
- grid.411477.00000 0004 1759 0844Santa Maria Alle Scotte University Hospital of Siena, Siena, Italy
| | | | | | - Guido Garosi
- grid.411477.00000 0004 1759 0844UOC Nefrologia, Dialisi e Trapianti, Santa Maria alle Scotte University Hospital, Siena, Italy
| | - Anna Coluccia
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy
| | - Andrea Pozza
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy ,grid.411477.00000 0004 1759 0844Psychology Unit Santa Maria Alle Scotte University Hospital, Siena, Italy
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24
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Becker C, Taniyama Y, Kondo-Arita M, Sasaki N, Yamada S, Yamamoto K. How funerals mediate the psycho-social impact of grief: Qualitative analysis of open-ended responses to a national survey in Japan. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Bardideh F, Jarareh J, Mofrad M, Bardideh K. The Effectiveness of Integrated Group Therapy on Prolonged Grief Disorder of Bereaved People from COVID-19 Randomized Controlled Trial. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221141126. [PMID: 38124328 PMCID: PMC9703023 DOI: 10.1177/00302228221141126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
This study aimed to evaluate the integrated cognitive-behavioral group therapy and Gestalt empty chair technique on bereaved individuals with COVID-19-caused PGD (prolonged grief disease). Thirty-six patients with PGD resultant from COVID-19 were randomly assigned intervention and control groups. The intervention group underwent 16 90-minute integrated group therapy sessions twice a week. Both groups completed the BDI II depression, NAI anger, and GASP guilt scale before, after, and 2 months after the study's conclusion. The intervention and control groups significantly differed in the depression, anger, and guilt indices after the therapeutic intervention (p < .001). This difference remained in the follow-up phase. Integrated group therapy in treating could help with some of the symptoms of PGD resulting from the corona-caused loss of loved ones. This reduction in symptoms was also stable over time.
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Affiliation(s)
- Fatemeh Bardideh
- Department of Counselling and Psychology, Islamic Azad University, Kish International, Kish, Iran
| | - Jamshid Jarareh
- Department of Teacher Training, Shahid Rajaee University, Tehran, Iran
| | - Mohammad Mofrad
- Department of Psychology, Khayyam Institute of Higher Education, Mashhad, Iran
| | - Kosar Bardideh
- Department of Counselling and Psychology, Islamic Azad University, Kish International, Kish, Iran
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26
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Qian W, Tang R, Jiao K, Xu X, Zou X, Wang J. Growing in Suffering: The Curvilinear Relationship Between Prolonged Grief and Post-traumatic Growth of Recently Bereaved Individual During the COVID-19 Pandemic. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221141937. [PMID: 36423236 PMCID: PMC9703020 DOI: 10.1177/00302228221141937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
The outbreak of the COVID-19 pandemic brought new challenges to mourning and growth of bereaved. The purpose is to explore the relationship between the prolonged grief (PG) symptoms and the post-traumatic growth (PTG) of recently bereaved people during the COVID-19 period, and the mediating role of meaning making. 305 participants were recruited to complete the Posttraumatic Growth Inventory, Inventory of Complicated Grief, and Integration of Stressful Life Experiences Scale. Hierarchical multiple regression analyses and Medcurve in SPSS were adapted to test the hypotheses. The results revealed that there was a curvilinear relationship between PG and PTG and meaning making had a completely mediating effect on this relationship. Different intervention goals - whether alleviating distress or cultivating growth - should be set up according to the level of grief for recently bereaved individuals during COVID-19. More attention should be paid to the role of meaning making in the future clinical practice.
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Affiliation(s)
- Wenli Qian
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, China
| | - Renzhihui Tang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, China
| | - Keyuan Jiao
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Xin Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, China
| | - Xinyan Zou
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, China
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Zou X, Xu X, Tang R, Jiao K, Qian W, Shen X, Wang J. Potential risk factors for acute grief during the COVID-19 pandemic: The mediating role of avoidance processes. Clin Psychol Psychother 2022; 30:202-212. [PMID: 36303248 PMCID: PMC9874740 DOI: 10.1002/cpp.2794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 02/03/2023]
Abstract
Bereavement during the COVID-19 pandemic may have some unique characteristics that become potential risk factors (e.g., absence of grief rituals, no opportunity to say goodbye to the deceased and loneliness caused by social distancing) for acute grief. Avoidance processes could be significant mediators in the context of the pandemic. The current study aimed to investigate whether and how these COVID-19-related risk factors were related to acute grief severity. Bereaved adults (n = 319) who lost significant others during the COVID-19 pandemic completed a self-report questionnaire package measuring COVID-19-related factors, grief severity and depressive and anxious avoidance. Regression analyses suggested that among the three potential risk factors (loneliness, grief rituals and opportunity to say goodbye), loneliness was significantly associated with acute grief after controlling for basic demographic and loss-related information. Structural equation models suggested that depressive avoidance and anxious avoidance partially mediated the associations of loneliness with acute grief severity. The findings indicate that dealing with loss during the COVID-19 pandemic warrants further exploration concerning how potential environmental risk factors may impede adaptation to loss. Depressive and anxious avoidance processes may play important roles in grief interventions for isolated and lonely bereaved people.
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Affiliation(s)
- Xinyan Zou
- Faculty of PsychologyBeijing Normal UniversityBeijingChina,Mental Health Education and Counselling CenterUniversity of Science and Technology of ChinaHefeiChina
| | - Xin Xu
- Faculty of PsychologyBeijing Normal UniversityBeijingChina
| | - Renzhihui Tang
- Faculty of PsychologyBeijing Normal UniversityBeijingChina
| | - Keyuan Jiao
- Department of Social Work and Social AdministrationUniversity of Hong KongHong Kong
| | - Wenli Qian
- Faculty of PsychologyBeijing Normal UniversityBeijingChina
| | - Xinlan Shen
- Faculty of PsychologyBeijing Normal UniversityBeijingChina
| | - Jianping Wang
- Faculty of PsychologyBeijing Normal UniversityBeijingChina
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28
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Taylor C, Lafarge C, Cahill S, Milani R, Görzig A. Living through lockdown: A qualitative exploration of individuals' experiences in the UK. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:2240-2249. [PMID: 35266223 PMCID: PMC9111840 DOI: 10.1111/hsc.13772] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 01/13/2022] [Accepted: 02/14/2022] [Indexed: 05/04/2023]
Abstract
In response to the COVID-19 outbreak, the British government introduced a lockdown resulting in country wide restrictions on movement and socialisation. This research sought to explore individuals' experience of the first lockdown in the UK. A qualitative online survey was conducted between April and June 2020. Using a convenience sample, 29 individuals participated in the study. Data were analysed using thematic analysis. Four themes were identified: 'health and well-being', 'social connectedness and belonging', 'employment and finances' and 'personal and collective values'. Participants' experiences involved both challenges and opportunities. Participants reported challenges to their physical health, mental health, sense of connection to others as well as their employment and finances. However, they also viewed the lockdown as an opportunity to reassess their goals and values, and define a 'new normal' for society. Lockdown restrictions threatened individuals' well-being on many aspects of their lives. As anxiety, loneliness and a compromised grieving process may lead to severe mental health issues, early interventions are needed to prevent these and promote well-being. Interventions may include traditional therapies (e.g. Acceptance and Commitment Therapy), or focus specifically on developing social networks and social support (e.g. mutual help groups). These interventions may also be conducive to the experience of growth reported by some participants.
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Affiliation(s)
| | | | | | | | - Anke Görzig
- University of West LondonLondonUK
- Psychology and CounsellingSchool of Human SciencesUniversity of GreenwichRoyal Naval CollegeGreenwich, LondonUK
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Neuroticism and Conscientiousness Moderate the Effect of Oral Medication Beliefs on Adherence of People with Mental Illness during the Pandemic. Brain Sci 2022; 12:brainsci12101315. [PMID: 36291250 PMCID: PMC9599797 DOI: 10.3390/brainsci12101315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/28/2022] Open
Abstract
Background. After the declaration of the pandemic status in several countries, the continuity of face-to-face visits in psychiatric facilities has been delayed or even interrupted to reduce viral spread. Little is known about the personality factors associated with medication beliefs and adherence amongst individuals with mental illness during the COVID-19 pandemic. This brief report describes a preliminary naturalistic longitudinal study that explored whether the Big Five personality traits prospectively moderate the effects of medication beliefs on changes in adherence during the pandemic for a group of outpatients with psychosis or bipolar disorder. Methods. Thirteen outpatients undergoing routine face-to-face follow-up assessments during the pandemic were included (41 observations overall) and completed the Revised Italian Version of the Ten-Item Personality Inventory, the Beliefs about Medicines Questionnaire, the Morisky Medication Adherence Scale—8-item and the Beck Depression Inventory—II. Results. Participants had stronger concerns about their psychiatric medications rather than beliefs about their necessity, and adherence to medications was generally low. Participants who had more necessity beliefs than concerns had better adherence to medications. People scoring higher in Conscientiousness and Neuroticism traits and more concerned about the medication side effects had poorer adherence. Conclusions. These preliminary data suggest the importance of a careful assessment of the adherence to medications amongst people with psychosis/bipolar disorder during the pandemic. Interventions aimed to improve adherence might focus on patients’ medication beliefs and their Conscientiousness and Neuroticism personality traits.
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Marmo S, Hirsch J. Visitors not Welcome: Hospital Visitation Restrictions and Institutional Betrayal. JOURNAL OF POLICY PRACTICE AND RESEARCH 2022. [PMCID: PMC9465650 DOI: 10.1007/s42972-022-00063-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Healthcare organizations’ continued restrictions on hospital visitation during the COVID-19 pandemic can be considered a violation of the rights of hospitalized patients to receive family visitors. Despite expert opinion related to the safety of visitation and low risk of visitor transmission with appropriate monitoring and precautions, hospital visitation restrictions have continued beyond the initial crisis phase of the pandemic, with little transparency or inclusion of key stakeholders in the decision-making process. Particularly on critical care units, blocking access to family visitors can contribute to additional harm and trauma for care-dependent hospitalized patients and their families. Utilizing an institutional betrayal framework, the aim of this commentary on hospital ICU visitation policy is to provide a discussion of how hospitals who serve a care-dependent population have placed critically ill patients, families, and healthcare workers at risk for complex trauma. Hospital social workers should incorporate an integrated social work approach to advocacy efforts which address not only individual hospitalized patient service needs, but also the uneven power differential that can contribute to inequity in visitation, medical mistrust, and long-term community trauma. On the interprofessional ICU team, social workers can function as trauma informed systems experts, coordinating and facilitating supports to help patients and families cope with hospitalization, while also advocating within their institution and with elected officials for policy change to protect patient and family–centered visitation rights.
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Affiliation(s)
- Suzanne Marmo
- Department of Social Work, Sacred Heart University, 3135 Easton Turnpike, Fairfield, CT 06825 USA
| | - Jennifer Hirsch
- School of Social Work, Michigan State University, East Lansing, MI USA
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31
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Guerra-Ramirez M, Rojas-Torres I, Tafur-Castillo J. Significado del duelo frente al COVID en estudiantes y profesores de enfermería. REVISTA CIENCIA Y CUIDADO 2022. [DOI: 10.22463/17949831.3375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objetivo: La pandemia ocasionada por el COVID- 19 y sus consecuencias por el alto índice de mortalidad, afectó a la población mundial a nivel de salud mental, psicológica y emocional. La comunidad académica de la enfermería no fue la excepción; por tanto, el objetivo de este estudio fue describir el significado del duelo frente al COVID - 19 en estudiantes y profesores de enfermería de una institución universitaria. Materiales y métodos: Estudio cualitativo descriptivo con enfoque fenomenológico, a partir de la experiencia de 12 personas que enfrentaron duelo ante la pérdida de un ser querido por COVID -19. La información se obtuvo de septiembre de 2021 a febrero de 2022 mediante entrevistas en profundidad grabadas y transcritas literalmente; posteriormente se identificaron las palabras clave para categorizarla. Resultados: Emergieron cuatro categorías: El último adiós por lo que el COVID nos quitó; seguir viviendo en medio de un duelo por COVID; búsqueda de apoyo para sobrellevar el duelo COVID; lo que cambió después de perder a un ser querido por COVID. Los datos anteriores indican que se debe pensar en el cuidado sobre este tipo de actitudes frente al duelo sobre la desaparición de seres queridos y cercanos por el COVID-19 desde la academia de manera particular. Conclusiones: El estudio concluye que estudiantes y profesores de un programa de enfermería enfrentaron un proceso complejo y diverso, con matices sociales, culturales y que las categorías develadas dan luz a posibles acciones de cuidado orientadas a la población de estudio.
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Downar J, Parsons HA, Cohen L, Besserer E, Adeli S, Gratton V, Murphy R, Warmels G, Bruni A, Bhimji K, Dyason C, Enright P, Desjardins I, Wooller K, Kabir M, Noel C, Heidinger B, Anderson K, Arsenault-Mehta K, Lapenskie J, Webber C, Bedard D, Iyengar A, Bush SH, Isenberg SR, Tanuseputro P, Vanderspank-Wright B, Lawlor P. Bereavement outcomes in family members of those who died in acute care hospitals before and during the first wave of COVID-19: A cohort study. Palliat Med 2022; 36:1305-1312. [PMID: 35786109 PMCID: PMC9446458 DOI: 10.1177/02692163221109711] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The COVID-19 pandemic has caused millions of deaths worldwide, leading to symptoms of grief among the bereaved. Neither the burden of severe grief nor its predictors are fully known within the context of the pandemic. AIM To determine the prevalence and predictors of severe grief in family members who were bereaved early in the COVID-19 pandemic. DESIGN Prospective, matched cohort study. SETTING/PARTICIPANTS Family members of people who died in an acute hospital in Ottawa, Canada between November 1, 2019 and August 31, 2020. We matched relatives of patients who died of COVID (COVID +ve) with those who died of non-COVID illness either during wave 1 of the pandemic (COVID -ve) or immediately prior to its onset (pre-COVID). We abstracted decedents' medical records, contacted family members >6 months post loss, and assessed grief symptoms using the Inventory of Complicated Grief-revised. RESULTS We abstracted data for 425 decedents (85 COVID +ve, 170 COVID -ve, and 170 pre-COVID), and 110 of 165 contacted family members (67%) consented to participate. Pre-COVID family members were physically present more in the last 48 h of life; the COVID +ve cohort were more present virtually. Overall, 35 family members (28.9%) had severe grief symptoms, and the prevalence was similar among the cohorts (p = 0.91). Grief severity was not correlated with demographic factors, physical presence in the final 48 h of life, intubation, or relationship with the deceased. CONCLUSION Severe grief is common among family members bereaved during the COVID-19 pandemic, regardless of the cause or circumstances of death, and even if their loss took place before the onset of the pandemic. This suggests that aspects of the pandemic itself contribute to severe grief, and factors that normally mitigate grief may not be as effective.
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Affiliation(s)
- James Downar
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada.,Bruyère Continuing Care, Ottawa, ON, Canada.,Australian Centre for Health Law Research, Queensland University of Technology School of Law, Brisbane, QLD, Australia
| | - Henrique A Parsons
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada
| | - Leila Cohen
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada.,Bruyère Continuing Care, Ottawa, ON, Canada
| | | | - Samantha Adeli
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Valérie Gratton
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Institut du Savoir Montfort, Ottawa, ON, Canada
| | - Rebekah Murphy
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Bruyère Continuing Care, Ottawa, ON, Canada.,Queensway-Carleton Hospital, Ottawa, ON, Canada
| | - Grace Warmels
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada.,Queensway-Carleton Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Adrianna Bruni
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada.,Queensway-Carleton Hospital, Ottawa, ON, Canada
| | - Khadija Bhimji
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada.,Queensway-Carleton Hospital, Ottawa, ON, Canada
| | - Claire Dyason
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada
| | - Paula Enright
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada
| | - Isabelle Desjardins
- The Ottawa Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Krista Wooller
- The Ottawa Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Monisha Kabir
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Chelsea Noel
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Brandon Heidinger
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Koby Anderson
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | | | - Julie Lapenskie
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Colleen Webber
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | | | | | - Shirley H Bush
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Bruyère Continuing Care, Ottawa, ON, Canada
| | - Sarina R Isenberg
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Peter Tanuseputro
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Bruyère Continuing Care, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | | | - Peter Lawlor
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Bruyère Continuing Care, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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Willis KD, Rao SR, Normen M, de Groot J, Calman L, Bahcivan O, Centeno I, Fehon DC. Same storm, different boat: The global impact of COVID-19 on palliative care. Psychooncology 2022; 32:148-154. [PMID: 35793431 PMCID: PMC9350379 DOI: 10.1002/pon.5995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has had a complex and profound impact on the provision of palliative care globally. To support learning from palliative care providers and researchers worldwide, the Education Subcommittee of International Psycho-Oncology Society (IPOS) Palliative Care Special Interest Group developed a webinar with presentations by and discussion with eight international palliative care leaders. METHODS Presentations were content rich; the speakers used both quantitative (e.g., sharing recent statistical findings) and qualitative (e.g., narrative storytelling, anecdotal experiences) approaches to portray the effect of COVID-19 in their region. Subsequent to the webinar, the committee collectively identified five themes conveyed by the presenters through consensus. RESULTS The themes included: (1) altered accessibility to palliative care, with socio-economic status impacting virtual health availability; (2) reduced opportunities to preserve dignity, as survival has been prioritized over preserving the humanity of patients and their loved ones; (3) complicated grief and bereavement arising from social distancing requirements; (4) greater awareness of the importance of sustaining health provider well-being; and (5) the development of valuable innovations across nations, institutions, disciplines, and communities. CONCLUSIONS Overall, the webinar facilitated valuable connection for global learning and identified opportunities for research and clinical interventions. In an ongoing crisis that has exacerbated isolation, we will need to continue to learn and lean on one another as a global community to navigate ongoing challenges of the COVID-19 pandemic.
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Affiliation(s)
- Kelcie D. Willis
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA,Massey Cancer CenterVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Seema Rajesh Rao
- Department of Research & EducationBangalore Hospice Trust—KarunashrayaBangaloreIndia
| | - Michelle Normen
- Department of Research & EducationBangalore Hospice Trust—KarunashrayaBangaloreIndia
| | - Janet de Groot
- Departments of Psychiatry and OncologyCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Lynn Calman
- School of Health SciencesCentre for Psychosocial Research in CancerUniversity of SouthamptonSouthamptonUK
| | - Ozan Bahcivan
- Psiko‐Onkologlar Dernegi (Psycho‐Oncological Association)IzmirTurkiye,Ozel Oz Psikoloji Aile Danisma Merkezi (Oz Psychology Family Counselling Centre)IzmirTurkiye
| | - Isabel Centeno
- Breast Cancer CenterHospital Zambrano HellionMonterreyMexico
| | - Dwain C. Fehon
- Department of PsychiatryYale School of MedicineNew HavenConnecticutUSA,Smilow Cancer HospitalNew HavenConnecticutUSA
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Tur C, Campos D, Suso-Ribera C, Kazlauskas E, Castilla D, Zaragoza I, García-Palacios A, Quero S. An Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Prolonged Grief Disorder (PGD) in adults: A multiple-baseline single-case experimental design study. Internet Interv 2022; 29:100558. [PMID: 35865996 PMCID: PMC9294524 DOI: 10.1016/j.invent.2022.100558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
The death of a loved one has physical, psychological, and social consequences. Between 9.8 and 21.5 % of people who lose a loved one develop Prolonged Grief Disorder (PGD). Internet- and computer-based interventions (i.e., Internet-delivered Cognitive-Behavioral Therapy, iCBT) are cost-effective and scalable alternatives that make it possible to reach more people with PGD. The main goal of the present investigation was to examine the effect and feasibility (usability and satisfaction) of an iCBT (GROw program) for adults with PGD. A secondary objective was to detect adherence to the app (Emotional Monitor) used to measure daily grief symptoms. The study had a single-case multiple-baseline AB design with six participants. The GROw program is organized sequentially in eight modules, and it is based on the dual-process model of coping with bereavement. Evaluations included a pre-to-post treatment assessment of depression, grief symptoms, and typical grief beliefs, along with daily measures of symptom frequency and intensity on the Emotional Monitor App. Treatment opinions and adherence to the App were also collected. Efficacy data were calculated using a Nonoverlap of All Pairs (NAP) analysis and Reliable Change Index (RCI). The mean age of the sample was 29.5 years (SD = 8.19). Two participants dropped out of the study. Adherence to the App varied across patients (4.8 % -77.8 %). Most participants (75 %) showed a clinically significant change (recovered) in depression, and 50 % obtained a clinically significant improvement (recovered) in symptoms of loss and typical beliefs in complicated grief. The participants reported high usability and satisfaction with the treatment content and format. In sum, the GROw program was very well accepted and generally feasible, and it has strong potential for treating PGD. The results support scaling up the treatment by using more complex designs with larger samples (i.e., randomized controlled trials comparing GROw with active conditions).
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Affiliation(s)
- Cintia Tur
- Departmento de Psicología Básica, Clínica y Psicobiología. Universitat Jaume I, Castellón de la Plana, Spain
| | - Daniel Campos
- Departmento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain,Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Carlos Suso-Ribera
- Departmento de Psicología Básica, Clínica y Psicobiología. Universitat Jaume I, Castellón de la Plana, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Lithuania
| | - Diana Castilla
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain,Universitat de València, València, Spain
| | - Irene Zaragoza
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Azucena García-Palacios
- Departmento de Psicología Básica, Clínica y Psicobiología. Universitat Jaume I, Castellón de la Plana, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Soledad Quero
- Departmento de Psicología Básica, Clínica y Psicobiología. Universitat Jaume I, Castellón de la Plana, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain,Corresponding author at: Universitat Jaume I, Av. Vicente Sos Baynat s/n, 12006, Castellón, Spain.
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35
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Righi L, Ramacciani Isemann C, Rosati M, Pallassini M, Pozza A. Coping strategies at the frontline of care: Comparisons between Covid-19 and non-Covid-19 units' nurses and the role of moderator variables. Nurs Forum 2022; 57:545-557. [PMID: 35262941 PMCID: PMC9115366 DOI: 10.1111/nuf.12715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Relatively few studies focused on the coping strategies adopted by the healthcare workers during the second phase of the pandemic. The present study compared the coping strategies between Italian nurses working in Covid-19 and in other units and it explored whether socio-demographic and work-related variables moderate the relation between the type of unit and coping strategies. METHODS A web-based questionnaire that included sociodemographic and work-related questions and the Coping Orientation to Problem Experienced-New Italian Version-25 item was administered. Moderation effects between variables and coping strategies were analyzed using generalized linear models. RESULTS 253 nurses participated. Nurses who worked in a Covid-19 unit had significantly lower scores on Avoidance Strategies subscale and higher scores on Positive Attitude and Social Support subscales than nurses working in other units. DISCUSSION Gender differences emerged only on the social support coping dimension, with women being more likely to adopt social support than men. No association between the type of unit and the other coping strategies was found. CONCLUSION Nurses working in Covid-19 units showed better coping strategies than their colleagues: this suggests that support interventions aimed to promote coping strategies should be offered also to Covid-19-free units' nurses.
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Affiliation(s)
- Lorenzo Righi
- Department of EmergencyUSL Toscana Sud Est Health AgencyArezzoItaly
| | | | - Moris Rosati
- Intensive Care Unit“Santa Maria alle Scotte” University HospitalSienaItaly
| | - Maurilio Pallassini
- Department of Medical Sciences, Surgery and NeurosciencesUniversity of SienaSienaItaly
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and NeurosciencesUniversity of SienaSienaItaly
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A Scoping Review of Interventions for Family Bereavement Care during the COVID-19 Pandemic. Behav Sci (Basel) 2022; 12:bs12050155. [PMID: 35621452 PMCID: PMC9137947 DOI: 10.3390/bs12050155] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 12/24/2022] Open
Abstract
The death of a loved one is a major stressor, and bereaved people are at a higher risk of negative health effects. This risk is higher during the COVID-19 pandemic, which raises the need for understanding existing bereavement support interventions. This scoping review aimed to map and summarize findings from the existing literature regarding bereavement support interventions (i.e., psychosocial and psychotherapeutic interventions) for family carers of people who died of COVID-19. The Arksey and O’Malley methodological framework was used. Five databases—Medline, PubMed, CINAHL, Scopus, and Web of Science—were searched for articles available from the inception of COVID-19 pandemic (March 2020) to January 2022, following the PRISMA guidelines. Among the 990 studies identified, only seven met this study’s inclusion criteria. The analysis comprised three key topics: types of support programmes and bereavement interventions; tools used to measure the outcomes; and evidence of the impacts of the interventions. All studies analysed included interdisciplinary interventions, commonly developed in clinical settings. Support for recently bereaved individuals can entail cognitive behavioural therapy strategies and other tools to educate, guide, support, and promote healthy integration of loss. To mitigate the effects of non-normative family bereavement, we recommend a systematic approach and coordination between organizational settings, including access to informal and professional support, in order to find hope while navigating the aftermath of COVID-19.
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Delgado MEP, Pérez JJM, García-Moreno M, López CA, Cordón RDA, González-Salvador MT. Estudio descriptivo de un programa de soporte emocional para familiares de pacientes hospitalizados por COVID-19 en el Hospital Puerta de Hierro de Madrid. CLÍNICA CONTEMPORÁNEA 2022. [DOI: 10.5093/cc2022a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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38
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Pompele S, Ghetta V, Veronese S, Bucuță MD, Testoni I. Spirituality and Children's Coping with Representation of Death During the COVID-19 Pandemic: Qualitative Research with Parents. PASTORAL PSYCHOLOGY 2022; 71:257-273. [PMID: 35496075 PMCID: PMC9043098 DOI: 10.1007/s11089-021-00995-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 06/14/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic and the related lockdown measures have had intense negative impacts on the psychological well-being of both adults and children. Among such impacts is a significant increase in mortality salience and changes in how people deal with grief and losses. This qualitative research used semi-structured interviews with 23 Italian parents to draw insights on the impact of the pandemic on children aged 5-15 years with regard to their representation of death and the eventual role that family spirituality/ religiosity played in helping them understand both the concept of dying and possibly the pandemic itself. From the data analysis, four main thematic areas emerged: "Lockdown experience," "Fears and worries related to COVID-19," "Emergence of thoughts on the process of dying," and "Representation of death and the impact of religious beliefs." The participants highlighted how stressful the lockdown measures have been for their children and the anxiety that their children have experienced because of fears related to the pandemic. The interviews also surfaced how living in a religious family has contributed significantly to shaping children's representation and understanding of death and sometimes even helped both the parents and their children to face difficult moments such as those caused by the pandemic.
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Affiliation(s)
- Sara Pompele
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | - Valentina Ghetta
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | - Serena Veronese
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | | | - Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Symptoms of psychological distress among bereaved relatives of deceased patients in the intensive care unit during the first COVID-19 wave. Intensive Care Med 2022; 48:491-492. [PMID: 35089407 PMCID: PMC8795333 DOI: 10.1007/s00134-022-06629-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/05/2022]
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Gibney RN, Blackman C, Gauthier M, Fan E, Fowler R, Johnston C, Jeremy Katulka R, Marcushamer S, Menon K, Miller T, Paunovic B, Tanguay T. COVID-19 pandemic: the impact on Canada’s intensive care units. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 pandemic has exposed the precarious demand-capacity balance in Canadian hospitals, including critical care where there is an urgent need for trained health care professionals to dramatically increase ICU capacity. The impact of the pandemic on ICUs varied significantly across the country with provinces that implemented public health measures later and relaxed them sooner being impacted more severely. Pediatric ICUs routinely admitted adult patients. Non-ICU areas were converted to ICUs and staff were redeployed from other essential service areas. Faced with a lack of critical care capacity, triage plans for ICU admission were developed and nearly implemented in some provinces. Twenty eight percent of patients in Canadian ICUs who required mechanical ventilation died. Surviving patients have required prolonged ICU admission, hospitalization and extensive ongoing rehabilitation. Family members of patients were not permitted to visit, resulting in additional psychological stresses to patients, families, and healthcare teams. ICU professionals also experienced extreme psychological stresses from caring for such large numbers of critically ill patients, often in sub-standard conditions. This resulted in large numbers of health workers leaving their professions. This pandemic is not yet over, and it is likely that new pandemics will follow. A review and recommendations for the future are provided.
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Affiliation(s)
- R.T. Noel Gibney
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Cynthia Blackman
- Dr. Cynthia Blackman and Associates, Edmonton, AB M5R 3R8, Canada
| | - Melanie Gauthier
- Faculty of Nursing, McGill University, Montréal, QC Canada
- President, Canadian Association of Critical Care Nurses, Quebec, QC, Canada
| | - Eddy Fan
- Interdisciplinary Division of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Robert Fowler
- Interdisciplinary Division of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Medicine, Sunnybrook Hospital, Toronto, ON M5S 1A1, Canada
| | - Curtis Johnston
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Intensive Care Unit, Royal Alexandra Hospital, Edmonton, AB T6G 2R3, Canada
| | - R. Jeremy Katulka
- Department of Medicine, Royal University Hospital, Saskatoon, SK S7N 0W8, Canada
| | - Samuel Marcushamer
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Intensive Care Unit, Royal Alexandra Hospital, Edmonton, AB T6G 2R3, Canada
| | - Kusum Menon
- Paediatric Intensive Care Unit, Children’s Hospital of Eastern Ontario, Ottawa, ON K1N 6N5, Canada
- Paediatric Intensive Care Unit, Department of Pediatrics, University of Ottawa, Ottawa, ON T6G 2R3, Canada
| | - Tracey Miller
- Intensive Care Unit, Royal Columbian Hospital, New Westminster, BC V3L 3W7, Canada
| | - Bojan Paunovic
- Department of Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- President, Canadian Critical Care Society, Winnipeg, MB R3T 2N2, Canada
| | - Teddie Tanguay
- Intensive Care Unit, Royal Alexandra Hospital, Edmonton, AB T6G 2R3, Canada
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Fisher JE, Rice AJ, Zuleta RF, Cozza SJ. Bereavement during the COVID-19 Pandemic: Impact on Coping Strategies and Mental Health. Psychiatry 2022; 85:354-372. [PMID: 35404761 DOI: 10.1080/00332747.2022.2051141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The COVID-19 coronavirus has caused 5.4 million deaths worldwide, including over 800,000 deaths in the United States (as of December 2021). In addition to these staggering statistics, an even greater number of individuals have died from other causes during the COVID-19 pandemic. As a result, a large portion of the global population has faced bereavement during the COVID-19 pandemic and resulting quarantine. The often rapid and unexpected nature of COVID-19 deaths and the presence of pandemic-related stressors and living restrictions make it more difficult for individuals bereaved during the pandemic to implement effective strategies for coping with the loss compared to non-pandemic periods. Quarantine-related constraints (e.g., social distancing, availability of and access to resources) impede coping strategies that have been found to be adaptive after a loss, such as supportive (e.g., seeking emotional and instrumental support) and active (e.g., problem-focused and cognitive reframing) coping, and they augment avoidant strategies (e.g., substance use, denial, and isolation) that have been found to be maladaptive. Poorer mental health outcomes (including prolonged grief disorder; PGD) have been associated with less healthy coping. This article reviews research findings regarding bereavement during the COVID-19 pandemic, discusses the effects of pandemic-related stressors on bereavement coping strategies, and proposes how different types of coping during the pandemic may account for the poorer mental health outcomes described in recent reports. Interventions for promoting adaptive coping strategies and minimizing maladaptive coping strategies are also outlined.
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Kira IA, Shuwiekh HA, Alhuwailah A, Balaghi D. Does COVID-19 Type III Continuous Existential Trauma Deplete the Traditional Coping, Diminish Health and Mental Health, and Kindle Spirituality?: An Exploratory Study on Arab Countries. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.2006501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
- Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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Zavras D. Feeling Uncertainty during the Lockdown That Commenced in March 2020 in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5105. [PMID: 34065841 PMCID: PMC8151900 DOI: 10.3390/ijerph18105105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 12/25/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant uncertainty for the global population. However, since not all population groups experience the impacts of the pandemic in the same way, the objective of this study was to identify the individual characteristics associated with the feeling of uncertainty during the lockdown that commenced in March 2020 in Greece. The study used data from the "Public Opinion in the European Union (EU) in Time of Coronavirus Crisis" survey. The sample consisted of 1050 individuals aged between 16 and 54 years. According to the analysis, which was based on a logistic regression model, the emotional status of older individuals, those who experienced income and job losses since the beginning of the pandemic, and middle-class and high-class individuals, is more likely to be described as a feeling of uncertainty. In addition, the emotional status of individuals with less concern for their own health and that of family and friends is less likely to be described as a feeling of uncertainty. Although the results related to age, income, and job losses, as regards concern for health, agree with the international literature, the limited health literacy of lower-class individuals may explain the reduced likelihood of their experiencing feelings of uncertainty. The results confirm the international literature describing several aspects of uncertainty due to the COVID-19 crisis.
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Affiliation(s)
- Dimitris Zavras
- Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens, Greece
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