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Lee SA, Neimeyer RA, Ng C, Veglahn L, Tucci AS. When does disruption of meaning in bereavement become debilitating? Screening for deleterious outcomes with the ISLES-SF. DEATH STUDIES 2024:1-7. [PMID: 38907953 DOI: 10.1080/07481187.2024.2364495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Meaning reconstruction is a central process in bereavement adaptation. However, clinical measures or means for identifying individuals whose struggles with meaning making have become dysfunctional have yet to be developed for clinicians to readily use in practice. Therefore, the objective of this study was to evaluate the diagnostic effectiveness of the Integration of Stressful Life Experiences Scale-Short Form (ISLES-SF) for measuring clinically significant struggles with meaning making of loss. The results of this study of 118 bereaved adults support the diagnostic use of the ISLES-SF (sensitivity of 83% and specificity of 73%), as well as an identified cut-score (≥ 14) that researchers and clinicians can employ to accurately and efficiently identify those whose difficulties with making meaning of loss have become debilitating. The results also showed that those who scored in the clinical range of the ISLES-SF displayed higher levels of anxiety, depression and prolonged grief than those not struggling with meaning making.
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Affiliation(s)
| | | | - Carolyn Ng
- Portland Institute for Loss and Transition, Portland, Oregon, USA
| | - Lisa Veglahn
- Hospice Foundation of America, Washington, DC, USA
| | - Amy S Tucci
- Hospice Foundation of America, Washington, DC, USA
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Albuquerque S, Henriques M, Rosa PJ, Delalibera M, Neimeyer RA, Coelho A, Batista J. Validation of the Portuguese version of the Integration of Stressful Life Experiences Scale (ISLES) in a sample of bereaved individuals. DEATH STUDIES 2024:1-10. [PMID: 38597741 DOI: 10.1080/07481187.2024.2334098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The Integration of Stressful Life Experiences Scale (ISLES) evaluates the ability to integrate stressful experiences into one's meaning system. The present study developed and validated a version of this scale for a bereaved Portuguese-speaking population, utilizing a sample of 242 adults who had lost a significant other to diverse causes of death. The sample was predominantly female, educated, married, or in consensual unions, and actively employed. Confirmatory factor analysis revealed a two-factor structure, consisting of 13 items, showing adequate local and global goodness-of-fit and supporting the proposed original structure. Convergent evidence based on internal structure was found for the two dimensions (Comprehensibility and Footing in the World). Regarding reliability, Cronbach's alpha and McDonald's omega computed for each factor showed good internal consistency and the average inter-item correlation was considered satisfactory. This psychometric support for ISLES underscores its relevance in enhancing the knowledge of meaning-making processes in the Portuguese context.
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Affiliation(s)
- Sara Albuquerque
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
| | | | - Pedro Joel Rosa
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
- Instituto Superior Manuel Teixeira Gomes (ISMAT), Portimão, Portugal
| | | | | | - Alexandra Coelho
- Social and Life Sciences, ISPA - University Institute of Psychological, Lisbon, Portugal
- Instituto IPIR Duelo y Pérdidas, Barcelona, Spain
| | - João Batista
- Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
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Kustanti CY, Chu H, Kang XL, Pien LC, Chen R, Tsai HT, Chou KR. Anticipatory grief prevalence among caregivers of persons with a life-threatening illness: A meta-analysis. BMJ Support Palliat Care 2024; 13:e1074-e1083. [PMID: 35149523 DOI: 10.1136/bmjspcare-2021-003338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/24/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Caring for a family member with a life-threatening illness may lead to increased levels of psychological morbidity. Given the lack of recognition of caregivers' grief, this study aimed to determine the prevalence of anticipatory grief disorders in caregivers of persons with a life-threatening illness for better intervention and management. METHODS CINAHL, Cochrane, Embase, Medline, PubMed, Scopus, PsycINFO and Web of Science were searched up to 21 March 2021 without language and time restrictions. The quality of the included studies was assessed with Hoy's criteria. A random-effects model was applied to calculate pooled prevalence rates, and multi-regression was performed to examine heterogeneity among studies. RESULTS A total of 3278 citations were retrieved, and 18 studies met the eligibility criteria involving 5470 caregivers. The pooled prevalence of anticipatory grief was 24.78% (95% CI 19.04% to 30.99%). The prevalence rates were significantly higher in female caregivers (16.64%; 95% CI 12.24% to 21.53%) compared with male caregivers (6.11%; 95% CI 4.55% to 7.87%). The married group also had a higher risk (14.66%; 95% CI 10.66% to 19.16%) than single group (5.47%; 95% CI 4.31% to 6.76%). CONCLUSIONS The overall pooled prevalence is substantially higher compared with after-loss grief in the general population and supported the presumptions that preloss grief has a greater magnitude compared with after-loss grief. Bereavement support, educational programmes and relevant resources should be delivered even before the actual loss to address the burden of caregivers.
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Affiliation(s)
- Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Xiao Linda Kang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Nursing, University of Pennsylvania, PA, Pennsylvania, USA
| | - Li-Chung Pien
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Hsiu-Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Hsiao CC, Hsieh SI, Kao CY, Chu TP. Factors affecting nurses' willingness and competency to provide anticipatory grief counseling for family caregivers of patients with terminal cancer. J Clin Nurs 2023; 32:1053-1064. [PMID: 35437821 DOI: 10.1111/jocn.16335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/20/2022] [Accepted: 03/30/2022] [Indexed: 01/17/2023]
Abstract
AIM AND OBJECTIVES To explore factors associated with nurses' willingness and competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer. BACKGROUND Family caregivers often experience anticipatory grief due to the imminence of a loved one's death. However, few studies have identified factors associated with nurses' willingness or competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer. METHODS This descriptive correlational study recruited a convenience sample of nurses from cancer-related wards at a regional teaching hospital in Taiwan. The Anticipatory Grief Counseling Willingness Scale and Anticipatory Grief Counseling Competency Scale were employed. This cross-sectional study followed the STROBE checklist. RESULTS The nurses' average scores for willingness and competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer were 44.28 ± 8.36 and 171.84 ± 30.83, respectively. Multivariate linear regression revealed that interest in participating in anticipatory grief counselling for the family caregivers of patients with terminal cancer was significantly associated with the nurses' willingness to provide such counselling. Similarly, their willingness to provide such counselling was significantly associated with their counselling competency. CONCLUSIONS Nurses' willingness and competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer can be enhanced through in-service education programmes, including bedside teaching and scenario simulation. RELEVANCE TO CLINICAL PRACTICE To improve nurses' competency in anticipatory grief counselling for the family caregivers of patients with terminal cancer, factors related to nurses' willingness to provide such grief counselling must be addressed. Diverse strategies of in-service education can be adopted to promote nurses' competency in anticipatory grief counselling.
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Affiliation(s)
- Chia-Chi Hsiao
- Department of Nursing, Chiayi Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Puzi City, Taiwan.,College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Suh-Ing Hsieh
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.,Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Taoyuan City, Taiwan
| | - Chen-Yi Kao
- Hospice Care Ward, Nursing Home, Taoyuan Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Taoyuan City, Taiwan
| | - Tsui-Ping Chu
- Department of Nursing, Chiayi Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Puzi City, Taiwan
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Anticipatory grief and experience of providing at-home palliative care among informal caregivers of spouses in Croatia: a qualitative study. BMC Palliat Care 2022; 21:199. [PMID: 36397096 PMCID: PMC9672539 DOI: 10.1186/s12904-022-01093-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background In palliative care, caring for spouses suffering from incurable diseases can provoke a range of reactions in informal caregivers that are part of the grieving process, as well as other reactions and ways of coping with a current role, which is often challenging. Anticipatory grief occurs before death and is often present in people who face the eventual loss of a loved one or their own death. This study aimed to gain insight into the anticipatory grief of informal caregivers who are providing at-home palliative care for their ill spouse. Our research questions focus on investigating the meanings caregivers ascribe to the experience of providing palliative care and the impending loss of a spouse. Methods A qualitative study was conducted in Zagreb, Croatia, from April to June of 2021. Eight participants took part in the study. Participants in the study were informal caregivers of a spouse suffering from an incurable, terminal disease that receives at-home palliative care. Data were collected through semi-structured face-to-face interviews. Transcripts were analyzed by interpretive phenomenological analysis. Results The analysis provided several meanings that represent caregivers’ experiences and coping strategies. The caregivers bravely face the challenges of “living with an illness” by maintaining optimism, strong cohesion with their partner and a sense of joint destiny. They tend to repress their own personal needs and feelings while carrying the burden of care. Caregivers tend to stay positive and focus on living in the present by taking an active role in providing care for the ill spouse and family. Conclusions Anticipatory grief presents emotional, cognitive, and spiritual challenges to spouse caregivers in palliative care. The contribution of this study was to gain insight into the meaning that caregivers ascribe to the experience and challenges they face while providing everyday care for their ill spouse. Confirming prior results, the experiences are generally similar to all caregivers, pointing to the need for substantial improvement in the quality of the support and help from the healthcare workers and other experts who provide palliative care and support for the patients’ family members. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01093-1.
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Moriconi V, Menéndez A, Neimeyer RA, Moggia D. Adaptation of the Spanish Grief and Meaning Reconstruction Inventory: An Initial Validation and Network Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221118169. [PMID: 35938629 DOI: 10.1177/00302228221118169] [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: 12/22/2023]
Abstract
The current study was conducted to adapt the Grief and Meaning Reconstruction Inventory (GMRI) into Spanish and to establish its psychometric properties in a group of 202 mourners seeking treatment in Spain. A confirmatory factor analysis established that the Spanish GMRI yielded eight factors, displaying strong reliability and convergent validity, through the scale's inverse correlation with the Inventory of Complicated Grief and various measures of psychological distress, explaining a 48% of the variance of the former measure. A network analysis suggested that sense-making could play a central role in meaning-making during bereavement.
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Affiliation(s)
- Valeria Moriconi
- Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
- Fundación Aladina, Hospital Universitario Infantil "Niño Jesús", Madrid, Spain
| | - Amparo Menéndez
- Fundació Hospital de Sant Jaume I Santa Magdalena, Mataró, Spain
| | - Robert A Neimeyer
- Department of Psychology, University of Memphis, Memphis, TN, USA
- Portland Institute for Loss and Transition, Portland, OR, USA
| | - Danilo Moggia
- Fundació Hospital de Sant Jaume I Santa Magdalena, Mataró, Spain
- Department of Clinical Psychology and Psychotherapy, University of Trier, Trier, Germany
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Singer J, Roberts KE, McLean E, Fadalla C, Coats T, Rogers M, Wilson MK, Godwin K, Lichtenthal WG. An examination and proposed definitions of family members' grief prior to the death of individuals with a life-limiting illness: A systematic review. Palliat Med 2022; 36:581-608. [PMID: 35196915 PMCID: PMC10098140 DOI: 10.1177/02692163221074540] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Research has extensively examined family members' grief prior to the death of an individual with a life-limiting illness but several inconsistencies in its conceptualization of related constructs, yet significant conceptualization issues exist. AIM This study aimed to identify and characterize studies published on family members grief before the death of an individual with a life-limiting illness, and propose definitions based on past studies in order to initiate conceptual clarity. DESIGN A mixed-method systematic review utilized six databases and was last conducted July 10, 2021. The search strategy was developed using Medical Subject Headings. This study was prospectively registered on PROSPERO (CRD42020166254). RESULTS One hundred thirty-four full-text articles met inclusion criteria. This review revealed across studies a wide variation in terminology, conceptualization, and characterization of grief before the death. More than 18 terms and 30 definitions have been used. In many cases, the same term (e.g. anticipatory grief) was defined differently across studies. CONCLUSIONS We found grief occurring before the death of a person with a life-limiting illness, which we termed pre-death grief, is comprised of two distinct constructs: anticipatory grief and illness-related grief. Anticipatory grief is future-oriented and is characterized by separation distress and worry about a future without the person with the life-limiting illness being physically present. Illness-related grief is present-oriented and is characterized by grief over current and ongoing losses experienced during the illness trajectory. These definitions provide the field with uniform constructs to advance the study of grief before the death of an individual with a life-limiting illness.
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Affiliation(s)
- Jonathan Singer
- Department of Psychological Science, Texas Tech University, Lubbock, TX, USA
| | - Kailey E Roberts
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Elisabeth McLean
- Department of Psychological Science, Texas Tech University, Lubbock, TX, USA
| | - Carol Fadalla
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Taylor Coats
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Madeline Rogers
- Center for Research on End-of-Life Care, Weill Cornell Medicine, New York, NY, USA
| | | | - Kendra Godwin
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Wendy G Lichtenthal
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Li J, Sun D, Zhang X, Zhao L, Zhang Y, Wang H, Ni N, Jiang G. The relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer: a cross-sectional study. Palliat Care 2022; 21:30. [PMID: 35255876 PMCID: PMC8902770 DOI: 10.1186/s12904-022-00925-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 03/03/2022] [Indexed: 11/29/2022] Open
Abstract
Background Anticipatory grief has been shown to be highly prevalent among family caregivers of patients with advanced illness. Qualitative study suggests that illness uncertainty may be one of the core characteristics of anticipatory grief, but it has not been confirmed in quantitative studies. Therefore, the purpose of this study was to explore the relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer and to determine the factors influencing anticipatory grief. Methods This descriptive cross-sectional study used a convenience sampling method and recruited 254 inpatient family caregivers from the thoracic medicine ward of Liaoning Cancer Hospital & Institute in Shenyang, mainland China. Anticipatory grief (Anticipatory Grief Scale (AGS), illness uncertainty (Uncertainty in Illness Scale Family Caregiver Version) and sociodemographic information (Self-compiled general information questionnaire) were measured using validated self-report measures. Results Chinese family caregivers of patients with advanced lung cancer had high levels of anticipatory grief (73.5 ± 16.1). The results of the correlation analysis showed a positive association between anticipatory grief and illness uncertainty (r = 0.580, P < 0.001). The final linear regression model with anticipatory grief as the dependent variable included four variables: illness uncertainty (β = 0.674, P < 0.001), lack of informativeness (β = − 0.168, P = 0.08), monthly income (β = 0.139, P = 0.006), and caregiving burden (β = − 0.196, P < 0.001). Conclusions Illness uncertainty is probably an important factor affecting anticipatory grief. Excessive caregiving burden is associated with high levels of anticipatory grief. Improving illness uncertainty and caregiving burden may effectively reduce anticipatory grief among Chinese family caregivers.
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Sun D, Mao Z, Zhang X, Li J, Zhang L. Relationship Between Post-traumatic Stress Symptoms and Anticipatory Grief in Family Caregivers of Patients With Advanced Lung Cancer: The Mediation Role of Illness Uncertainty. Front Psychiatry 2022; 13:914862. [PMID: 35757209 PMCID: PMC9218190 DOI: 10.3389/fpsyt.2022.914862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore the interrelationship between post-traumatic stress symptoms (PTSS), illness uncertainty (IU), and anticipatory grief (AG). METHODS Structural equation modeling with bootstrapping estimation was conducted using data from a convenience sample of 254 family caregivers of patients with advanced lung cancer in China. Participants were recruited from a public cancer hospital in Shenyang, China. The family caregivers completed the Impact of Events Scale-Revised, Uncertainty in Illness Scale Family Caregiver Version, and Anticipatory Grief Scale. RESULTS The measurement model has good reliability and validity, and the final model fit the data well. PTSS positively influenced AG (direct effect estimate = 0.391, p = 0.002). Moreover, IU was found to mediate the relationship between PTSS and AG (Indirect effects estimate = 0.168, p = 0.005). The mediating effect of IU accounted for up to 30.1% of the total effect. CONCLUSION IU mediated the relationship between PTSS and AG. Healthcare professionals should continuously assess PTSS, IU and AG levels in FCs and provide effective intervention options for mitigation.
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Affiliation(s)
- Di Sun
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Zhihui Mao
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Xu Zhang
- School of Nursing, China Medical University, Shenyang, China
| | - Jiaojiao Li
- Department of Thoracic Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Lijuan Zhang
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, China
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Fee A, Hanna J, Hasson F. Pre-loss grief experiences of adults when someone important to them is at end-of-life: A qualitative systematic review. DEATH STUDIES 2021; 47:1-15. [PMID: 34751635 DOI: 10.1080/07481187.2021.1998935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Pre-loss grief can be experienced by relatives before impending death; however, limited understanding exists about the impact of pre-loss grief on bereavement. This systematic review aimed to synthesize qualitative research evidence reporting adults' experiences of pre-loss grief within cancer care. Thirteen studies were selected, and three key themes identified. Findings indicate that relatives transitioned through lived experiences during end-stage cancer, and that meanings attached to these experiences influenced how they experienced pre-loss grief. Limited formal support was identified to navigate these experiences; however, context was seen as important, and skilled healthcare practitioners and physical environment were key to facilitating preparedness.
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Affiliation(s)
- Anne Fee
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, UK
| | - Jeff Hanna
- School of Nursing and Midwifery, Queen's University Belfast, Northern Ireland, UK
| | - Felicity Hasson
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, UK
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Mallon A. Compassionate community structure and function: a standardised micro-model for end-of-life doulas and community members supporting those who wish to die at home. Palliat Care Soc Pract 2021; 15:26323524211052569. [PMID: 34708210 PMCID: PMC8543731 DOI: 10.1177/26323524211052569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background: End-of-life doulas are an emerging, non-medical support and advocacy role for
the dying and their caregivers. As more and more people are dying at home,
research shows end-of-life doulas are increasingly in demand as non-medical
advocates and companions for the dying, and their friends and families.
Compassionate communities are essential to those who wish to die at home by
helping to avoid carer stress and burnout associated with physical and
emotional labour when a person is at end of life. However, compassionate
community models are top-down in nature as they focus on public policy,
missing a domestic-scale, standardised design applicable when someone wishes
to die at home. This gap affects care networks and communications and
arguably hinders the work of end-of-life doulas. Aim: Findings from original qualitative research with end-of-life doulas in four
countries demonstrated the importance of compassionate communities for death
literacy and support for a person at end of life and their networks and that
all practitioners were using ad hoc, variable approaches to compassionate
community formation and maintenance. A micro-level standardised and
replicable model for organising and maintaining compassionate communities
for end-of-life doulas which completes the established compassionate
community model was developed to fill this gap and provide a vital tool for
end-of-life doulas and training programmes internationally. Methods: Thematic analysis of research data from qualitative semi-structured
interviews with end-of-life doulas in four countries was undertaken and
considered as a cohort as well as by country. Conclusions: A model was developed that addresses a gap in international approaches to
practice, offering a standardised way to discuss, teach, and implement
compassionate communities for end-of-life doulas in a variety of countries
and languages. This article discusses the research and model in detail.
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Yu W, Lu Q, Lu Y, Yang H, Zhang L, Guo R, Hou X. Anticipatory Grief among Chinese Family Caregivers of Patients with Advanced Cancer: A Cross-Sectional Study. Asia Pac J Oncol Nurs 2021; 8:369-376. [PMID: 34159229 PMCID: PMC8186392 DOI: 10.4103/apjon.apjon-214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/10/2021] [Indexed: 11/04/2022] Open
Abstract
Objective The objective of this study was to explore the interrelationship between anticipatory grief (AG), caregiver burden, communication, preparation for death, and coping style. Methods A convenience sample of 256 Chinese family caregivers of patients with advanced cancer were recruited from an academic cancer hospital between April 2018 and May 2019. This cross-sectional survey included the AG Scale, caregiver burden (Caregiver Reaction Assessment), communication (Caregivers' Communication with Patients about Illness and Death Scale), preparation for death, and coping style (Simplified Coping Style Questionnaire). Structural equation modeling tested the interrelation between them. Results The final model fitted the data acceptably (χ2 = 25.79, degrees of freedom = 17, P = 0.08, root mean square error of approximation = 0.05, goodness-of-fit index [GFI] = 0.98, adjusted GFI [AGFI] = 0.95, parsimony GFI [PGFI] = 0.46, normed fit index = 0.94, comparative fit index = 0.98). Poor communication contributed to less preparation for death and caregiver burden, which further aggravate AG. Communication was positively associated with AG. In addition, communication and positive coping style interacted to further influence caregiver burden. Conclusions Preliminary results supported the model and showed that poor communication, less preparation for death, and caregiver burden contributed to AG while positive coping alleviated AG. Findings suggest the need for further studies to explore effective intervention for communication, preparation for death, burden, and coping style of caregivers to ultimately alleviate AG.
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Affiliation(s)
- Wenhua Yu
- Department of Thoracic Surgical Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Qian Lu
- School of Nursing, Peking University, Beijing, China
| | - Yuhan Lu
- Department of Nursing, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Hong Yang
- Department of Nursing, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Lichuan Zhang
- School of Nursing, Peking University, Beijing, China
| | - Renxiu Guo
- Department of Digestive Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiaoting Hou
- Department of Thoracic Medical Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
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Supiano KP, Andersen T, Luptak M, Beynon C, Iacob E, Levitt SE. Pre-loss group therapy for dementia family care partners at risk for complicated grief. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12167. [PMID: 34027022 PMCID: PMC8116857 DOI: 10.1002/trc2.12167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Dementia family caregiving may span more than a decade and places many family care partners (CPs) at risk for poor bereavement outcomes; estimates of complicated grief in bereaved dementia family CPs range from 10% to 20%. We adapted our efficacious complicated grief group therapy intervention for bereaved dementia caregivers for soon-to-be bereaved dementia CPs at risk for complicated grief to facilitate healthy death preparedness and eventual bereavement-pre-loss group therapy (PLGT). METHODS In this Stage IB pilot intervention study, we implemented and evaluated PLGT in three psychotherapy group cohorts with family CPs at-risk for complicated grief whose person living with dementia (PLWD) had a life expectancy of 6 months or less and resided in a nursing home. PLGT is a 10-session multi-modal psychotherapy administered by social workers. RESULTS Participants in PLGT realized significant improvement in their pre-loss grief and in reported preparedness for the death of their family member, and participants evidenced lowered pre-loss grief severity and improvement, as measured by facilitators. Participants also realized significant improvement in meaning making, particularly as a sense of peace and a reduction of loneliness. DISCUSSION The process and treatment elements of the PLGT intervention affirm the value of specialized care for those dementia family CPs at risk for complicated grief, as the PLGT groups demonstrated a steady progression toward improvement collectively and individually. PLGT participants realized statistical and clinical improvement across pre-loss grief measures suggesting that their risk for complicated grief risk was mitigated, and they were better prepared for the death of their PLWD.
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Affiliation(s)
| | - Troy Andersen
- University of Utah College of Social WorkSalt Lake CityUSA
| | - Marilyn Luptak
- University of Utah College of Social WorkSalt Lake CityUSA
| | | | - Eli Iacob
- University of Utah College of NursingSalt Lake CityUSA
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Family Caregiver Suffering in Caring for Patients with Amyotrophic Lateral Sclerosis in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094937. [PMID: 34066364 PMCID: PMC8125242 DOI: 10.3390/ijerph18094937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to describe the meaning of the suffering experience of Korean ALS family caregivers. This is a descriptive phenomenological study that included ten participants using convenience sampling with maximum variation in a tertiary hospital in Seoul, South Korea. Colaizzi's data analysis method was used to inductively determine themes and formulate meanings. The three main themes derived from analysis were: "frustration with seeing a patient suffering", "burnout at the cost of a life of dedication", and "desperate need for help". Caregivers experience high levels of suffering, which can come in various forms depending on the circumstances of the particular patient and family. Especially, distress from seeing a loved one suffering was another aspect of suffering in Korean ALS caregivers, reflecting strong family ties. At the same time, patients are in desperate need of help and support from their families. Thus, it is essential to provide care to lessen the causes of distress and meet the needs of not only patients, but also caregivers through family-centered care to improve overall quality of life for all involved.
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15
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Varilek BM, Isaacson MJ. Female Veteran Use of Palliative and Hospice Care: A Scoping Review. Mil Med 2021; 186:1100-1105. [PMID: 33512462 DOI: 10.1093/milmed/usab005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/11/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The number of female veterans in the USA in the age range of 55-64 years increased 7-fold from 2000 to 2015. Female veterans are more likely to suffer from certain mental health disorders, respiratory diseases, neurologic diseases, and some forms of cancer when compared to their male counterparts. Veterans Affairs (VA) healthcare providers need to be prepared to care for this growth of female veterans with serious illness. These serious illnesses require appropriate medical management, which often includes palliative care. It is imperative to determine how VA healthcare providers integrate palliative and hospice care for this population. The purpose of our scoping review was to explore the palliative and hospice care literature specific to female veterans to learn: (1) what evidence is available regarding female veterans' use of palliative and hospice care? (2) To meet the needs of this growing population, what gaps exist specific to female veterans' use of palliative and hospice care? METHODS A scoping review methodology was employed following the nine-step process described by the Joanna Briggs Institute for conducting scoping reviews. RESULTS Nineteen articles met the inclusion criteria. Fourteen quantitative articles were included which comprised 10 retrospective chart reviews, one randomized controlled trial, one correlation, one quality improvement, and one cross-sectional. The remaining five were qualitative studies. The sample populations within the articles were overwhelmingly male and white. Content analysis of the articles revealed three themes: quality of end of life care, distress, and palliative care consult. CONCLUSIONS The female veteran population is increasing and becoming more ethnically diverse. Female veterans are not well represented in the literature. Our review also uncovered a significant gap in the study methodologies. We found that retrospective chart reviews dominated the palliative and hospice care literature specific to veterans. More prospective study designs are needed that explore the veteran and family experience while receiving end of life care. With the rising number of older female veterans and their risk for serious illness, it is imperative that research studies purposefully recruit, retain, analyze, and report female veteran statistics along with their male counterparts. We can no longer afford to disregard the value of the female veterans' perspective.
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Affiliation(s)
- Brandon M Varilek
- College of Nursing, Graduate Nursing, South Dakota State University, Sioux Falls, SD 57107, USA
| | - Mary J Isaacson
- College of Nursing, Graduate Nursing, South Dakota State University, Rapid City, SD 57701, USA
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16
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Huang M, Schmiedek F, Habermas T. Only some attempts at meaning making are successful: The role of change‐relatedness and positive implications for the self. J Pers 2020. [DOI: 10.1111/jopy.12573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Manxia Huang
- Department of Psychology Goethe University Frankfurt Frankfurt am Main Germany
| | - Florian Schmiedek
- DIPF Leibniz Institute for Research and Information in Education Frankfurt am Main Germany
| | - Tilmann Habermas
- Department of Psychology Goethe University Frankfurt Frankfurt am Main Germany
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Supiano KP, Luptak M, Andersen T, Beynon C, Iacob E, Wong B. If we knew then what we know now: The preparedness experience of pre-loss and post-loss dementia caregivers. DEATH STUDIES 2020; 46:369-380. [PMID: 32093533 PMCID: PMC10400015 DOI: 10.1080/07481187.2020.1731014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We evaluated the relationship between grief preparedness and grief experience in 106 family caregivers anticipating or who had experienced the death of a family member with dementia. Using a phenomenological lens to discern a process of meaning-making in narratives, we found preparation that included positive construction of memories, death as the end of suffering, relationship resolution, and shared construction of meaning were associated with positive grief. Those caregivers who experienced the family member's decline as traumatic, caregiver role loss, unavailable support, and difficulties creating a new life reported inadequate death preparation, and difficulty making meaning of the illness and death.
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Affiliation(s)
| | - Marilyn Luptak
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Troy Andersen
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Cynthia Beynon
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
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18
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Burke LA, Crunk AE, Neimeyer RA, Bai H. Inventory of Complicated Spiritual Grief 2.0 (ICSG 2.0): Validation of a revised measure of spiritual distress in bereavement. DEATH STUDIES 2019; 45:249-265. [PMID: 31215843 DOI: 10.1080/07481187.2019.1627031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Spirituality has long served as a source of solace for many grievers following a loss. For other mourners, whose bereavement experience has been significantly challenged by struggles in their relationship with God and/or their faith community, the opposite is true. Complicated spiritual grief (CSG) is a spiritual crisis following the loss of a loved one. To assess CSG in samples of bereaved adults, a simple-to-use, multidimensional measure of spiritual crisis following loss called the Inventory of Complicated Spiritual Grief (ICSG) was previously developed and validated. However, subsequent research providing greater clarity about the construct of CSG supported the need to revise and update the ICSG. The goal of the present study was to establish the psychometric validity of a revised measure of CSG, called the Inventory of Complicated Spiritual Grief 2.0 (ICSG 2.0), with a large, diverse cohort of bereaved Christian adults (N = 440). Analyses of the bifurcated sample supported a three-factor model measuring insecurity with God, estrangement from the spiritual community, and disruption in religious practices. Further analyses supported the convergent and incremental validity of a 28-item scale relative to other theoretically similar instruments and measures of poor bereavement outcome, indicating the instrument's research and clinical usefulness.
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Affiliation(s)
- Laurie A Burke
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - A Elizabeth Crunk
- Department of Counseling and Human Development, George Washington University, Washington, District of Columbia, USA
| | - Robert A Neimeyer
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Haiyan Bai
- Department of Learning Sciences & Educational Research, University of Central Florida, Orlando, Florida, USA
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Way D, Ersek M, Montagnini M, Nathan S, Perry SA, Dale H, Savage JL, Luhrs CA, Shreve ST, Jones CA. Top Ten Tips Palliative Care Providers Should Know About Caring for Veterans. J Palliat Med 2019; 22:708-713. [DOI: 10.1089/jpm.2019.0190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Deborah Way
- Department of Palliative Care, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Division of Geriatric Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary Ersek
- Division of Geriatric Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Palliative Care, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Marcos Montagnini
- Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, Michigan
- Ann Arbor VA Healthcare System, Ann Arbor, Michigan
| | - Susan Nathan
- VA Boston Healthcare System, Boston, Massachusetts
- Section of Geriatrics and Palliative Care, Department of Internal Medicine, Harvard Medical School, Boston, Massachusetts
- Section of Geriatrics and Palliative Care, Department of Internal Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Sherena A. Perry
- Section of Geriatrics and Palliative Care, Department of Internal Medicine, VA Medical Center, Boise, Idaho
| | - Heather Dale
- Division of Geriatric Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Carol A. Luhrs
- VA New York Harbor Healthcare System, Brooklyn, New York
| | - Scott T. Shreve
- VA Medical Center, Lebanon, Pennsylvania
- Hospice and Palliative Care Program, US Department of Veterans Affairs, Washington, DC
- Penn State College of Medicine, Hershey, Pennsylvania
| | - Christopher A. Jones
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
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20
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Caregiver anticipatory grief: phenomenology, assessment and clinical interventions. Curr Opin Support Palliat Care 2019; 12:52-57. [PMID: 29206700 DOI: 10.1097/spc.0000000000000321] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review aims to synthesize recent findings on anticipatory grief in caregivers, referring to its phenomenology, assessment and clinical interventions. RECENT FINDINGS Recent literature illustrates the wide scope of the current use of the term anticipatory grief, reflecting caregivers' experiences in different end-of-life trajectories. The anticipation of death is the distinctive aspect of anticipatory grief in the predeath grief continuum, encompassing several progressive losses, past and future. Recently developed assessment instruments capture key aspects of this experience, such as separation anxiety, anticipation of death and future absence of the person, denial and relational losses. Recent findings on prevalence of clinically significant predeath symptoms in caregivers range from 12.5 to 38.5%. Beyond personal and relational factors, difficult circumstances of end-of-life care significantly interfere in adjustment to anticipatory grief. Useful therapeutic interventions were identified, such as validation of grief feelings, increased coping and self-care, anticipation of future losses and reframing roles. However, rigorous interventional studies are needed to create guidelines and the manualization of specific therapeutic approaches to caregiver anticipatory grief. SUMMARY Findings suggest that anticipatory grief dynamics in different end-of-life trajectories should be recognized and adequately assessed. Clinical interventions considered useful to support anticipatory grief caregivers are presented, but further research is needed to verify effectiveness.
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Holm M, Alvariza A, Fürst CJ, Öhlen J, Årestedt K. Psychometric evaluation of the anticipatory grief scale in a sample of family caregivers in the context of palliative care. Health Qual Life Outcomes 2019; 17:42. [PMID: 30837000 PMCID: PMC6402133 DOI: 10.1186/s12955-019-1110-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/25/2019] [Indexed: 01/07/2023] Open
Abstract
Introduction In palliative care, family caregivers are often faced with experiences of grief in anticipation of the loss of a close person. An instrument designed to measure this form of grief is the Anticipatory Grief Scale, which includes 27 items and has been used in several studies in various contexts. However, the instrument has not been validated. Aim The aim was to evaluate the psychometric properties, focusing on the factor structure, of the Anticipatory Grief Scale in a sample of family caregivers in palliative care. Methods The study had a cross-sectional design. Data were collected from an intervention study in palliative home care that took place between 2013 and 2014. In total, 270 family caregivers in palliative care completed a baseline questionnaire, including the Anticipatory Grief Scale. The factor structure of the scale was evaluated using exploratory factor analysis. Results The initial factor analysis suggested a four-factor solution, but, due to weak communalities, extensive crossloadings, and item inconsistencies, the model was problematic. Further analysis supported that the scale should be reduced to 13 items and two factors. The two subscales captured the behavioral and emotional reactions of grief in family caregivers in palliative care and were named Behavioral reactions and Emotional reactions. This modified version will hereafter be named AGS-13. Conclusions This validation study of the Anticipatory Grief Scale resulted in a revised two-factor model, AGS-13, that appears to be promising for use in palliative care but needs to be tested further.
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Affiliation(s)
- Maja Holm
- Department of Nursing Sciences, Sophiahemmet University, Box 5605, 114 86, Stockholm, Sweden.
| | - Anette Alvariza
- Department of Health Care Sciences, Ersta Sköndal University College, Box 11189, 100 61, Stockholm, Sweden.,Capio Geriatrics, Palliative care unit, Dalen hospital, Åstorpsringen 6, 121 87, Stockholm, Sweden
| | - Carl-Johan Fürst
- Department of Clinical Science and the Institute for Palliative Care, Lund University, Scheelevägen 2, 223 81, Lund, Sweden
| | - Joakim Öhlen
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden.,Centre for Person-Centred Care, University of Gothenburg, Arvid Wallgrens backe 1, 413 46, Gothenburg, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, Sweden.,The Reserch Section, Region Kalmar County, Lasarettsvägen 1, 392 44, Kalmar, Sweden
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22
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Smigelsky MA, Bottomley JS, Relyea G, Neimeyer RA. Investigating risk for grief severity: Attachment to the deceased and relationship quality. DEATH STUDIES 2019; 44:402-411. [PMID: 30623750 DOI: 10.1080/07481187.2018.1548539] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Previous research examining the interrelationship between attachment, relationship quality, and bereavement outcomes suffers from a lack of precision and sophistication in the measurement of the core constructs of interest. The present study adapted an existing measure of attachment and employed a novel instrument of relationship quality to examine specific attachment to and relationship quality with the deceased as contributors to grief symptom severity. A sample of 385 bereaved college students completed measures retrospectively assessing relationship quality, attachment to the deceased, and grief symptomatology. Findings indicate that specific attachment to the deceased differs significantly from global attachment style and that relationship quality and attachment anxiety and avoidance interact in significant ways to predict the risk of grief severity. Specifically, individuals with a Preoccupied attachment style (high anxiety, low avoidance) are most at risk for adverse grief reactions in the context of high relationship closeness and conflict. This study is limited by an over-representation of extended family loss, which may have unique implications for attachment and relationship quality. Grief therapists should consider the implications of attachment and relationship quality with the deceased in the selection of relationship-enhancing or relational problem-solving interventions.
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Abstract
The death of a significant person, especially when it comes tragically or prematurely, can shake the foundations of our assumptive and relational world and lead to anguished attempts to find meaning in the loss and in our lives in its aftermath. In this article, I review one program of research focused on this attempt at meaning reconstruction, describe recently developed measures of meaning in mourning, and discuss several therapeutic techniques for helping clients make sense of the death and rework their attachment relationship to the deceased. I conclude by illustrating some of this work in my therapy with a couple grieving the loss of not one but two children to tragic accidents, as they try to adapt to a compound traumatic bereavement.
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Affiliation(s)
- Robert A Neimeyer
- a Department of Psychology , University of Memphis , Memphis , TN , USA
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24
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Bottomley JS, Smigelsky MA, Bellet BW, Flynn L, Price J, Neimeyer RA. Distinguishing the meaning making processes of survivors of suicide loss: An expansion of the meaning of loss codebook. DEATH STUDIES 2018; 43:92-102. [PMID: 30247994 DOI: 10.1080/07481187.2018.1456011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Suicide loss represents particularly a difficult form of bereavement due to the challenges that volitional death poses to survivors. Understanding these challenges requires recognition of the idiosyncratic processes of meaning reconstruction for this specific group of grievers. The current study investigates such processes in survivors of suicide loss (SOSL) by utilizing the Meaning of Loss Codebook (MLC) to analyze the narratives of eight SOSL. The findings contribute to a broader understanding of meaning making following suicide, strengthen the validity of the MLC by demonstrating its appropriateness for SOSL, and illuminate unique challenges faced by SOSL, resulting in the proposal of supplemental MLC codes. Research and clinical implications are discussed.
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Affiliation(s)
- Jamison S Bottomley
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Melissa A Smigelsky
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Benjamin W Bellet
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Lauren Flynn
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Justin Price
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Robert A Neimeyer
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
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25
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Karantzas GC, Romano D, Lee J. Attachment and aged care: a systematic review of current research. Curr Opin Psychol 2018. [PMID: 29529481 DOI: 10.1016/j.copsyc.2018.02.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attachment theory is an important framework from which to examine familial aged care. Despite this, the role of attachment in later-life caregiving remains unclear. The current study presents a systematic review of papers within the last five years on attachment and various outcomes related to familial aged care. For the caregiver, attachment anxiety was associated with poorer mental health, and attachment insecurity with a more controlling manner of caregiving. The few studies conducted with care recipients found that attachment insecurity was associated with greater self-appraisals of dementia symptoms and a lower sense of security. Research continues to suffer from the use of inadequate assessments of individual differences into adult attachment.
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Affiliation(s)
- Gery C Karantzas
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
| | - Daniel Romano
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
| | - Juwon Lee
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
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26
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Breen LJ, Karangoda MD, Kane RT, Howting DA, Aoun SM. Differences in meanings made according to prolonged grief symptomatology. DEATH STUDIES 2018; 42:69-78. [PMID: 28489494 DOI: 10.1080/07481187.2017.1328467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study investigated differences in specific meanings made following bereavement, according to participants' prolonged grief symptomatology. A survey of 580 bereaved adults (Mage = 61.6 years, 70.7% female) showed 13 meanings predicted symptomatology, with the largest differences between the two lower symptomatology groups and the high symptomatology group; the latter was more likely to report no meaning. The results provide further support for empirically distinct groups within the bereaved population, not only in terms of symptoms, etiology, outcomes, courses, and treatment responses, but also in their meanings made, and may assist in advancing meaning reconstruction interventions.
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Affiliation(s)
- Lauren J Breen
- a School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Michelle D Karangoda
- a School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Robert T Kane
- a School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Denise A Howting
- b School of Nursing, Midwifery and Paramedicine , Curtin University , Perth , Australia
| | - Samar M Aoun
- b School of Nursing, Midwifery and Paramedicine , Curtin University , Perth , Australia
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Hirooka K, Otani H, Morita T, Miura T, Fukahori H, Aoyama M, Kizawa Y, Shima Y, Tsuneto S, Miyashita M. End-of-life experiences of family caregivers of deceased patients with cancer: A nation-wide survey. Psychooncology 2017; 27:272-278. [DOI: 10.1002/pon.4504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/26/2017] [Accepted: 07/17/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Kayo Hirooka
- Department of System Management in Nursing, Graduate School of Health Care Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Hiroyuki Otani
- Palliative Care Team, Department of Palliative and Supportive Care; National Kyushu Cancer Center; Fukuoka Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team; Seirei Mikatahara General Hospital; Hamamatsu-shi Japan
| | - Tomofumi Miura
- Department of Palliative Medicine; National Cancer Center Hospital East; Kashiwa Japan
| | - Hiroki Fukahori
- Department of System Management in Nursing, Graduate School of Health Care Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Maho Aoyama
- Department of Community Health, School of Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine; Kobe University Graduate School of Medicine; Kobe Japan
| | - Yasuo Shima
- Tsukuba Medical Center Hospital, Department of Palliative Medicine; Tsukuba Medical Center Foundation; Tsukuba Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Department of Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
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28
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Davis EL, Deane FP, Lyons GCB, Barclay GD, Bourne J, Connolly V. Feasibility randomised controlled trial of a self-help acceptance and commitment therapy intervention for grief and psychological distress in carers of palliative care patients. J Health Psychol 2017; 25:322-339. [DOI: 10.1177/1359105317715091] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We tested the feasibility and preliminary effectiveness of an acceptance and commitment therapy self-help intervention for grief and psychological distress in carers of patients in palliative care. Carers were randomised to the control group, which received treatment as usual, or the intervention group, which received treatment as usual plus an acceptance and commitment therapy–based self-help booklet and telephone support call. Questionnaires were completed at baseline, 1-month post-allocation and 6 months post-loss. Results indicated that the intervention was generally feasible and viewed as acceptable to carers. Preliminary effectiveness analyses showed at least a small effect in acceptance, valued-living, grief and psychological distress.
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Affiliation(s)
| | | | | | - Gregory D Barclay
- University of Wollongong, Australia
- Illawarra Shoalhaven Local Health District, Australia
| | - Joan Bourne
- Illawarra Shoalhaven Local Health District, Australia
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Burke LA, Neimeyer RA, Bottomley JS, Smigelsky MA. Prospective Risk Factors for Intense Grief in Family Members of Veterans Who Died of Terminal Illness. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/1054137317699580] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Laurie A. Burke
- The University of Memphis, TN, USA
- Memphis Veterans Affairs Medical Center, TN, USA
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Spiritual Distress and Depression in Bereavement: A Meaning-Oriented Contribution. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2017. [DOI: 10.1007/s10942-017-0262-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Bellet BW, Neimeyer RA, Berman JS. Event Centrality and Bereavement Symptomatology: The Moderating Role of Meaning Made. OMEGA-JOURNAL OF DEATH AND DYING 2016; 78:3-23. [DOI: 10.1177/0030222816679659] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The centrality of a loss to a bereaved individual’s identity is associated with greater symptomatology, whereas meaning made of a loss is associated with positive outcomes. This article examines meaning made as a moderator of the relationship between event centrality and symptomatology. Our sample consisted of 204 bereaved undergraduate university students. Centrality was assessed using the Centrality of Events Scale, meaning made was assessed using the Integration of Stressful Life Experiences Scale, and symptomatology was assessed using the posttraumatic stress disorder Checklist-Civilian and Inventory of Complicated Grief-Revised. Meaning made had a significant moderating effect on the relationship between centrality and both measures of symptomatology. At lower levels of meaning made, centrality had a strong and positive association with symptomatology; at higher levels of meaning made, this association became weaker. These results suggest that meaning made is the key to understanding how centrality affects bereavement outcomes.
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Abstract
As theories of bereavement have evolved, so too have evidence-based interventions to mitigate complications in post-loss adaptation. This article reviews one line of programmatic research grounded in a conceptualisation of grieving as an attempt to reaffirm or reconstruct a world of meaning challenged by loss. Anchored in therapeutic encounters with the bereaved, a meaning reconstruction approach to loss has grown over the past 15 years to generate an increasingly substantial research base, as well as to develop and refine a wide array of contributions to psychological assessment and therapy. By summarising the major models, measures and methods resulting from this collaborative work, it offers an introduction to meaning reconstruction for those unfamiliar with it, noting its contributions to date, its areas of future development, and its relevance for clinical practice.
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Recent Literature Feature Editor: P.C. Rousseau. J Palliat Med 2016. [DOI: 10.1089/jpm.2015.0554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Toyama H, Honda A. Using Narrative Approach for Anticipatory Grief Among Family Caregivers at Home. Glob Qual Nurs Res 2016; 3:2333393616682549. [PMID: 28462354 PMCID: PMC5342864 DOI: 10.1177/2333393616682549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 10/16/2016] [Accepted: 10/25/2016] [Indexed: 01/01/2023] Open
Abstract
Family caregivers of patients with terminal-stage cancer have numerous roles as caregivers, which can influence their anticipatory grief. The purpose of this study was to clarify how talking to family caregivers of patients with terminal illness using the narrative approach can influence such caregivers' process of anticipatory grief. We conducted the narrative approach as an intervention with two family caregivers several times and qualitatively analyzed their narratives. The results indicated that these family caregivers had two primary roles-family member and caregiver-and that family caregivers felt trapped in their caregiver role. The narrative approach helped them transition into the role needed for coping with the loss.
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Affiliation(s)
- Hiroko Toyama
- The JIKEI University school of Nursing, Tokyo, Japan
- Tokyo Medical and Dental University Graduate School of Health Care Sciences, Tokyo, Japan
| | - Akiko Honda
- Tokyo Medical and Dental University Graduate School of Health Care Sciences, Tokyo, Japan
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