Psychosocial work stress in female funeral service practitioners

Ignored and distressed: a cross-sectional study of the impact of COVID-19 on last responders

BACKGROUND

Last responders constitute an occupational category that includes all those that are involved in the postmortem care of deceased persons and their families. Last responders are exposed to several categories of work-related stressors that affect their health and well-being. COVID-19 exacerbated these stressors. Research to understand the consequences of COVID-19 on the health and wellbeing of last responders is nascent. This study aimed to assess COVID-19 related stress, coping and wellbeing among last responders in the United States.

METHODS

We conducted a national cross-sectional survey of last responders in July through September of 2020. The survey measured wellbeing, stress, coping, and stigma; COVID-19 experiences, and socio-demographics. A ridge regression model was fit for the outcome variables.

RESULTS

Analysis was conducted on 366 respondents from 43 states. Respondents were male (55.4%), age 50 + (57.4%), and White non-Hispanic (90.3%); 54% reported moderate-high stress and 41% endorsed mild-severe anxiety. Seventy-seven percent had experienced at least one form of stigma related to their occupation. Variables associated with higher perceived stress and anxiety included gender (female), shorter length of employment, perceiving a higher impact from COVID-19 on everyday life, and increased perceived stigma.

CONCLUSIONS

Last responders are a critical part of the health care system. Throughout this pandemic, last responders have been frequently ignored and not prioritized for protection and support. Interventions to support last responders cope with stress, and to decrease anxiety are urgently needed. There is also a critical need to challenge community stigma towards last responders.

Secondary traumatic stress and work ability in death care workers: The moderating role of vicarious posttraumatic growth

Death care work consists of dealing with traumatic events frequently, if not daily. This type of exposure is considered characteristic of the profession and can lead to significant negative consequences such as secondary traumatic stress. However, sometimes positive changes can occur as a result of experiencing trauma, which is referred to as vicarious posttraumatic growth. The aim of the present study is to investigate the role of vicarious posttraumatic growth (VPTG) in the relationship between secondary traumatic stress (STS) and work ability (WA) in a sample of 231 death care workers in northern Italy. Regression analysis with interaction was performed using PROCESS. The results showed a negative association between STS and WA and a positive association between VPTG and WA. The interaction between STS and VPTG was also statistically significant. The moderating role of VPTG was partially confirmed by the analysis: at low and moderate VPTG levels, the conditional effect was negative and statistically significant, while at high VPTG, STS exposure had no significant and negative effect on WA, as if VPTG had some kind of protective role against STS. These results provide new insights into the role of VPTG in work environments with daily trauma exposure, such as death care.

Exposure to Death and Bereavement: An Analysis of the Occupational and Psychological Wellbeing of Funeral and Mortuary Operators

Confronting death and suffering represent central work-related contents in the funeral industry occupations. Despite past research evidence on the role of psychosocial risks, a positive side of the relationship with death exposure has also been highlighted. To expand research on these topics, the aim of the present study was to analyze the role of death exposure in affecting funeral and mortuary operators' wellbeing. Analysis of variance was performed on 201 questionnaires to analyze differences between work exposure. Workers always/very often exposed to death through sight or manipulation of bodies showed better psychological and occupational wellbeing compared to those not at all/very rarely committed with these tasks. Those who interacted very frequently with the bereaved showed better psychological and occupational wellbeing, compared to those who were never/very rarely committed with these relational tasks. Insights on the role of death and suffering exposure and information for occupational health practitioners are discussed.

Post-Traumatic Stress Disorder among Funeral Directors after the First Wave of COVID-19 in Belgium

(1) Background: Studies have shown that healthcare workers have an increased chance of developing post-traumatic stress symptoms (PTSS) during the COVID-19 pandemic. However, funeral directors have not yet been studied, despite facing many of the same possible causes of PTSS as healthcare workers. (2) Methods: An online survey was spread to directors of funeral home organization DELA in Belgium (n = 287). The validated scale PCL-5 was used to assess PTSS. Additionally, fear of being infected, fear of infecting family or friends and demographic factors (age, gender, living situations, work experience) were asked. Respondents were asked to indicate if they thought of the COVID-19 period when completing the PCL-5. In addition, with a self-made question, respondents were also asked to compare their current stress-levels with those before COVID-19. (3) Results: 107 respondents were included in the study. Thirteen respondents were above the threshold for possible PTSD-diagnosis, but only four fulfilled the criteria of completing the PCL-5 with COVID-19 in mind. PTSS-scores were significantly associated with a fear of being infected (p = 0.006). Almost a majority (49.5%) of the respondents felt more stress during the period of completing the survey than the period before COVID-19, though 33.6% felt no change. (4) Conclusions: Though the PTSS-symptom rates were lower than for healthcare workers, this study does show that there should be attention for the mental health of funeral directors in the aftermath of COVID-19.

Funeral and Mortuary Operators: The Role of Stigma, Incivility, Work Meaningfulness and Work-Family Relation to Explain Occupational Burnout

The funeral and mortuary sector, including funeral homes, cemeteries and crematoria, is a largely neglected sector in regard to the study of occupational factors that can affect the quality of working life. The present study aimed at overcoming this gap by investigating job demands and resources that may affect burnout levels. Data were collected through a self-report questionnaire involving funeral industry employees (N = 229) from cemetery, morgues, crematoria and funeral agencies in a Northern Italian region. The survey was cross-sectional and non-randomized. Results reveal that among job demands, stigma consciousness, supervisor incivility and work-to-family negative spillover significantly affect levels of burnout, whereas meaningfulness of work and family-to-work positive spillover may represent relevant resources to counter the onset of burnout. The results of this study contribute to new insights into the psychosocial working conditions that affect occupational wellbeing among the funeral industry sector by also giving insight into how to promote resources to prevent burnout.

Mental Health Status of Canadian Funeral Service Workers at the Beginning of the COVID-19 Pandemic

OBJECTIVE

To describe the mental health situation and job stress levels of Funeral Service Workers (FSW) during the first months of the pandemic.

METHODS

We conducted a cross-sectional study in Canada between May and July 2020. Funeral service professional organizations were asked to spread a questionnaire to their members including job description, assessment of anxiety (GAD-7), depression (PHQ-8), and job stress (effort-reward imbalance questionnaire).

RESULTS

Fifty-eight FSW completed a questionnaire, 32% reported anxiety symptoms (GAD-7 > 10), 29% reported depressive symptoms (PHQ-8 > 10), 31% reported job stress. Women were more likely to report overcommitment (66.7% vs. 31.8%, P = 0.015).

CONCLUSIONS

Levels of anxiety and depression identified in Canadian FSW were higher than those identified in other occupational groups during the first few months of the pandemic.

Compassion fatigue of funeral directors during and after the first wave of COVID-19

BACKGROUND

Compassion fatigue has not been studied among funeral directors. Yet, funeral directors have been exposed to the same risks for compassion fatigue as other caregivers during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

An online survey was spread two times to 287 employees of funeral home DELA, in Belgium. Once during the height of the first wave of COVID-19 in Belgium, and a second time at the end of the first wave. The professional quality of life-scale 5 (PROQOL-5) was used to measure compassion fatigue, which includes burnout, compassion satisfaction and secondary trauma. Non-parametric tests were performed.

RESULTS

In total, 104 participants answered the first survey, and 107 the second. Burnout increases from survey 1 to survey 2 (P < 0.001), while compassion satisfaction (P = 0.011) and secondary trauma decrease (P < 0.001). In survey 1, only age (P = 0.007) and gender (P = 0.040) were found to be significantly associated with secondary trauma. In survey 2, having more work experience is associated with having a higher burnout (P = 0.008) and secondary trauma (P = 0.001) score. Neither for burnout (P < 0.001), nor for secondary trauma (P < 0.001) are there any respondents in the highest category.

CONCLUSIONS

Although overall funeral directors do not have acute problems with compassion fatigue, burnout scores increase significantly after the first wave.

Predictors of depression among a sample of South African mortuary workers

Mortuary workers are at high risk of developing depression and other psychiatric disorders owing to the nature of their work and exposure to deceased victims of violent deaths. Few studies have investigated mental health among mortuary workers in low- and middle-income countries. Participants (N = 45) were recruited from mortuaries in South Africa and completed a battery of questionnaires measuring depression, physical health, perceived stress, fear of blood/injury/mutilation, and resilience. Participants with self-reported depression and posttraumatic stress disorder (PTSD) comprised 13.3% and 4.4% of the sample, respectively. Inexperienced mortuary workers had a higher prevalence rate of depression (16.7%) compared with experienced workers (9.5%). Prevalence of PTSD did not differ significantly between inexperienced (4.2%) and experienced (4.8%) workers. Physical health, perceived stress, fear of blood/injury/mutilation, and resilience were significant predictors of depression in the combined group (experienced and inexperienced). However, perceived stress was the only significant predictor of depression, in multiple regression, in the combined group. Inexperienced workers had significantly higher levels of blood/injury/mutation fear and depression. Mortuary workers seem to be at increased risk of depression, especially inexperienced workers. Perceived poor health, lower levels of resilience, and blood/injury/mutilation fears may lead to increased perceived stress among mortuary workers, which may, in turn, lead to depression. Interventions focused on promoting mental health may be beneficial to all mortuary workers, and preparatory training related to mental health may be beneficial to inexperienced mortuary workers before occupational uptake.