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Caldwell JM, Meredith PJ, Whittingham K, Ziviani J, Wilson T. Women pregnant after previous perinatal loss: relationships between adult attachment, shame, and prenatal psychological outcomes. J Reprod Infant Psychol 2024; 42:653-667. [PMID: 36800926 DOI: 10.1080/02646838.2023.2180142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/07/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Insecure adult attachment, shame, self-blame, and isolation following perinatal loss place bereaved women at risk of adverse psychological outcomes, which can impact child and family outcomes. To date, no research has considered how these variables continue to influence women's psychological health in pregnancy subsequent to loss. OBJECTIVE This study explored associations between prenatal psychological adjustment (less grief and distress) and adult attachment, shame, and social connectedness, in women pregnant after loss. METHOD Twenty-nine pregnant Australian women accessing a Pregnancy After Loss Clinic (PALC) completed measures of attachment styles, shame, self-blame, social connectedness, perinatal grief, and psychological distress. RESULTS Four 2-step hierarchical multiple regression analyses revealed adult attachment (secure/avoidant/anxious; Step 1), shame, self-blame, and social connectedness (Step 2) explained 74% difficulty coping, 74% total grief, 65% despair, and 57% active grief. Avoidant attachment predicted more difficulty coping and higher levels of despair. Self-blame predicted more active grief, difficulty coping, and despair. Social connectedness predicted lower active grief, and significantly mediated relationships between perinatal grief and all three attachment patterns (secure/avoidant/anxious). CONCLUSIONS Although avoidant attachment and self-blame can heighten grief in pregnancy after loss, focusing on social connectedness may be a helpful way for prenatal clinicians to support pregnant women during their subsequent pregnancy - and in grief.
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Affiliation(s)
| | - Pamela J Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Trish Wilson
- Bereavement Support Service, Mater Mothers Hospital, South Brisbane, QLD, Australia
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2
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Carvalho SA, Carvalho F, Fonseca L, Santos G, Castilho P. Beyond the Centrality of Shame: How Self-Concealment and Fear of Receiving Compassion From Others Impact Psychological Suffering in Transgender Adults. JOURNAL OF HOMOSEXUALITY 2024; 71:1373-1391. [PMID: 36043899 DOI: 10.1080/00918369.2022.2114398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Shame-based social interactions are a minority social stressor commonly experienced by transgender individuals. However, few studies have explored the centrality of shame experiences in transgender identity and mental health. Also, the ability to receive care and soothing support may be influenced by intrapersonal shame- and fear-related factors, which may hinder openness, and support and care seeking, thus contributing to psychological distress. This study aims to examine the relationship between central shame experiences, fear of receiving compassion from others, self-concealment, and psychological distress (depression, anxiety, and stress symptoms) in a sample of Portuguese transgender adults. Following a cross-sectional design, data from a convenience sample of 70 self-identified transgender individuals undergoing gender-affirming medical interventions (GAMIs) were analyzed, using SPSS PROCESS, to determine whether the relationship between central shame experiences and psychological suffering occurred indirectly through fear of receiving compassion from others, and self-concealment. Results suggest that fear of receiving compassion from others, but not self-concealment, was the underlying factor between central shame experiences, and depression and anxiety. Results suggest that the centrality of shame experiences and stress symptomatology associate sequentially through fear of compassion and, in turn, through self-concealment. Clinical implications for mental health interventions with transgender individuals undergoing GAMI are discussed.
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Affiliation(s)
- Sérgio A Carvalho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, School of Psychology and Life Sciences (EPCV), Lusófona University, Lisbon, Portugal
| | - Frederica Carvalho
- Faculty of Medicine, Institute of Psychological Medicine (IPM), University of Coimbra, Coimbra, Portugal
| | - Lígia Fonseca
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Graça Santos
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
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3
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Kalhovde AM, Kitzmüller G. Family Caregivers' Trajectories of Distress While Caring for a Person With Serious Mental Illness. QUALITATIVE HEALTH RESEARCH 2024; 34:154-165. [PMID: 37905732 PMCID: PMC10714708 DOI: 10.1177/10497323231203627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Serious mental illness (SMI) can significantly impact the lives of individuals and their families. These families often experience great emotional distress over time due to the early onset of SMI, which in turn leads to long-term trajectories and only partial recovery. However, we do not fully understand the emotional distress of family caregivers. Thus, our aim was to enrich the understanding of the lived experiences of family caregivers' emotional trajectories of distress while caring for persons with SMI. We conducted a secondary analysis using a hermeneutic approach to the narratives of seven family caregivers from a study on living with voices unheard by others. Participants' trajectories of emotional distress came forth as being thrust on an unpredictable, intensely worrisome, and indefinite journey. The following themes highlighted this tumultuous journey: fumbling in the dark trying to grasp the incomprehensible, "on your toes"-enduring unpredictability, facing different forms of fear, and battling waves of sadness and regret. Caregivers face multiple threats to their well-being and sometimes even to their health. Their distress appeared to vary according to their relationship with the person with SMI, whether they lived with the ill person, illness trajectory, and amount of violent or suicidal behavior. The results underscore the need for individualized and timely information, opportunities for dialogue with healthcare providers with and without the person with SMI, and inclusion in care planning. Caregivers who have experienced trauma, threats of violence, and rejection require special attention.
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Silberberg A, Castro Méndez J, Torres SF, Fraire R, Siaba Serrate A, Kreutzer C, López Daneri M, Iolster T. Experiences of parents of children with hypoplastic left heart syndrome during their treatment: a qualitative study. Cardiol Young 2023; 33:2553-2558. [PMID: 37009758 DOI: 10.1017/s1047951123000677] [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] [Indexed: 04/04/2023]
Abstract
AIM To investigate the opinion and personal experience of parents of children born with Hypoplastic Left Heart Syndrome and what advice they would give to other parents who have to decide between treatment options. METHODS We conducted a qualitative, descriptive and retrospective study by means of a survey directed to parents of children born with Hypoplastic Left Heart Syndrome in a tertiary hospital in Buenos Aires (Argentina). Their answers and data regarding medical procedures were analysed. RESULTS Parents of thirteen out of sixteen patients with Hypoplastic Left Heart Syndrome were surveyed. Norwood surgery had been performed in all the patients, many had received other procedures, and five had died. In relation to the decision-making process, sixty-one percent of parents would recommend other parents to remain at peace after having done everything possible and 54% would suggest to not feel guilt despite the final result. None of the parents would recommend rejecting surgical treatment and choosing comfort care. CONCLUSION The majority of parents of children with Hypoplastic Left Heart Syndrome would recommend continuing with the therapeutic effort in order to feel at peace and reduce feelings of guilt.
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Affiliation(s)
| | | | - Silvio F Torres
- Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
| | - Rafael Fraire
- Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
| | | | | | | | - Thomas Iolster
- Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
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5
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Klebanov B, Tsur N, Katz C. "Many bad things had been happening to me": Children's perceptions and experiences of polyvictimization in the context of child physical abuse. CHILD ABUSE & NEGLECT 2023; 145:106429. [PMID: 37683405 DOI: 10.1016/j.chiabu.2023.106429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND The association between child maltreatment and polyvictimization has received growing attention since being identified by Finkelhor and colleagues in 2005. OBJECTIVE The current study was designed to explore the experiences and perceptions of children who reported polyvictimization during forensic interviews. METHODS This mixed-methods study sample comprised 117 children aged 5-14, referred for the first time to forensic interviews following suspected physical abuse by a parent. More than one-third of the children reported polyvictimization. A thematic analysis was carried out to spotlight these children's experiences. RESULTS The analysis identified three main themes: the way children comprehend the polyvictimization, the consequences of the polyvictimization regarding the children's negative self-attribution, and the way the polyvictimization was constructed through the dynamic with the forensic interviewers. CONCLUSIONS The findings pointed to the importance of the forensic interview platform in assessing children's maltreatment burden. The current study also provided a glance into the possible involvement of the mechanics of self-blame among maltreated children. These findings have the potential to enhance our understanding of the excessive psychological toll taken on polyvictimized children.
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Affiliation(s)
- Bella Klebanov
- Bob Shapell Scool of Social Work, Tel Abib university, Israel
| | - Noga Tsur
- Bob Shapell Scool of Social Work, Tel Abib university, Israel
| | - Carmit Katz
- Bob Shapell Scool of Social Work, Tel Abib university, Israel.
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6
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Levi-Belz Y. Interpersonal facilitators of complicated grief and depression in the aftermath of suicide loss: The mediated roles of suicide-related shame and guilt. Suicide Life Threat Behav 2023; 53:680-691. [PMID: 37439284 DOI: 10.1111/sltb.12973] [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: 07/15/2022] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Suicide-loss survivors (SLSs) are recognized as an at-risk population for several mental health complications, including complicated grief (CG) and depression. Recent studies have emphasized the contribution of interpersonal factors as well as suicide-related shame and guilt as facilitators of CG and depression among SLSs. In this 6 year longitudinal design study, we examined interpersonal variables as predictors of CG and depression, with suicide-related guilt and shame as mediators. METHOD Participants were 152 SLSs aged 18-70 who completed questionnaires assessing thwarted belongingness, self-disclosure, and social support at index measurement (T1); suicide-related shame and guilt and CG and depression were assessed 6 years later (T2). RESULTS The integrated model revealed that the interpersonal factors of social support and self-disclosure at T1 significantly and negatively predict CG and depression (respectively) at T2. Thwarted belongingness was found to significantly and positively predict both CG and depression through the mediation of suicide-related shame levels. CONCLUSION The findings highlight the critical role of interpersonal factors in facilitating CG and depression among SLSs. Theoretical implications relating to healing processes are discussed, as well as focused clinical recommendations, including psychoeducational interventions for addressing interpersonal difficulties and suicide-related shame in the aftermath of suicide loss.
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Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
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7
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Champion MJ, Kilcullen M. Complicated Grief Following the Traumatic Loss of a Child: A Systematic Review. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231170417. [PMID: 37169347 DOI: 10.1177/00302228231170417] [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: 05/13/2023]
Abstract
Complicated grief is a disabling condition that occurs when the natural grief process is disturbed or prolonged. Research demonstrates that complicated grief is more prevalent following the sudden or violent loss of a child. Despite the high incidence of accidental death worldwide, little research has focused on parental grief trajectories following this form of traumatic loss. A systematic review was conducted to explore parental bereavement outcomes following accidental death. Studies were included if they specifically examined complicated grief in parents bereaved by the accidental death of their child. A total of 767 articles were identified and seven studies met the eligibility criteria for review. Poorer outcomes were identified in relation to the mode of death, relationship type, time post-loss, perceived support, perceived justice and comorbidities. Results of the current study may be used to inform the development of clinical practice guidelines for the treatment of complicated grief.
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Affiliation(s)
| | - Meegan Kilcullen
- College of Healthcare Sciences, James Cook University, Townsville, QLD Australia
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Bourque C, Dumont E, Martisella M, Daoust L, Cantin S, Levasseur MC, de Steur Q, Duval M, Marquis MA, Sultan S. L’expérience à long terme des parents endeuillés en oncologie pédiatrique : une étude rétrospective de 2 à 18 ans après le décès d’un enfant. PSYCHO-ONCOLOGIE 2023. [DOI: 10.3166/pson-2022-0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Objectifs : Cette étude rétrospective et transversale vise à comprendre l’expérience à long terme des parents endeuillés en oncologie pédiatrique et les différences du deuil parental en fonction du genre.
Matériel et méthodes : Un questionnaire multisectionnel coconstruit avec des cliniciens et intervenants en suivi de deuil a été tenu en ligne en 2018 et 2019. Les participants au sondage étaient des parents dont l’enfant était décédé au service d’hématologie-oncologie du CHU Sainte-Justine 2 à 18 ans auparavant. Des sections spécifiques sur les réactions, les changements et les souvenirs ont fait l’objet d’analyses descriptives.
Résultats : Les réponses de 48 parents ont été analysées. Les résultats indiquent que les mères ont tendance à modifier certaines de leurs activités sociales, alors que les pères cherchent plutôt à retrouver leurs habitudes. Les réactions initialement fortes des parents s’atténuent au fil du temps sans disparaître, en particulier la tristesse et les troubles du sommeil. Les parents ont des souvenirs apaisants des interactions et des soins reçus des intervenants en milieux clinique et communautaire même plusieurs années après le décès de leur enfant.
Conclusion : L’offre de soutien psychosocial communautaire et professionnel à long terme est pertinente, de même aux besoins des couples et aux besoins individuels des parents en fonction du genre.
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9
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Hoppen TH, Schlechter P, Arntz A, Rameckers SA, Ehring T, Morina N. A brief measure of guilt and shame: validation of the Guilt and Shame Questionnaire (GSQ-8). Eur J Psychotraumatol 2022; 13:2146720. [PMID: 38872599 PMCID: PMC9766484 DOI: 10.1080/20008066.2022.2146720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Guilt and shame regulate basic human processes such as social cognition and relations. Both emotions are also involved in the aetiology and maintenance of trauma-related mental disorders such as posttraumatic stress disorder (PTSD). However, a concise scale that adequately captures these constructs is currently lacking, impeding research efforts to understand them more thoroughly.Objective: To this end, we developed the eight-item Guilt and Shame Questionnaire (GSQ-8) in English, German, and Dutch.Method: We examined the reliability and validity of the GSQ-8 in a clinical sample of adults seeking treatment for childhood-trauma-related posttraumatic stress disorder (n = 209), a sample of adults who had suffered at least one traumatic life event reporting different levels of PTSD symptoms (n = 556), and a non-clinical sample of adults (n = 156).Results: Theory-driven confirmatory factor analyses confirmed two correlated latent factors guilt and shame with four items for each factor. Across all samples, two-factor models yielded better model fit than one-factor solutions. Measurement invariance across the three samples, gender, and Dutch and German language was mostly established. Guilt and shame composite scores were associated with PTSD symptoms, depressive symptoms, life satisfaction, mental health-related quality of life, and self-blame, thus supporting scale validity. Importantly, both subscales predicted PTSD symptoms, depression, life satisfaction, and mental health-related quality of life over and above cognitions of self-blame.Conclusions: The GSQ-8 is a parsimonious, reliable, and valid tool to assess guilt and shame in clinical, sub-clinical, and non-clinical populations, allowing applications across a broad range of research questions.
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Affiliation(s)
- Thole H Hoppen
- Institute of Psychology, Division of Clinical Psychology and Psychotherapy, University of Münster, Münster, Germany
| | | | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Sophie A Rameckers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Thomas Ehring
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Nexhmedin Morina
- Institute of Psychology, Division of Clinical Psychology and Psychotherapy, University of Münster, Münster, Germany
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10
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Liang Y, Xu H, Chen F, Liang H, Wu B. Which wound cuts deeper: loss of an only child or loss of a spouse? An examination of bereavement in older adults within a Chinese cultural context. Aging Ment Health 2022; 26:1217-1225. [PMID: 33896295 DOI: 10.1080/13607863.2021.1913473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed to examine whether the loss of spouse had similar impacts on psychological well-being as the loss of the only child, and whether the presence of one mitigated the absence of the other. METHODS We used data from a 2013 survey conducted in Shanghai, China. The sample included 1,200 older adults aged 60+, and 200 adults aged 45+ who lost their only child. Psychological well-being consisted of three dimensions: depression, loneliness, and life satisfaction. We applied logistic regression models to assess the impact of loss of spouse or children on psychological well-being. We further tested whether the impact differed by gender and whether social support mediated the relationship. RESULTS Participants who have at least one living child but lost their spouse had less psychological distress than those who have a living spouse but lost their only child. This effect appeared to be stronger in women than in men. Social support mediated the relationship between bereavement and loneliness among women. CONCLUSION The findings suggested the loss of the only child is a more devastating event than the loss of spouse in Chinese adults. The loss of the only child is a major chronic stressor that has cumulative negative effect on psychological well-being.
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Affiliation(s)
- Yan Liang
- School of Nursing, Fudan University, Shanghai, China
| | - Hanzhang Xu
- Medical Center, Duke University, Durham, NC, USA
| | - Feinian Chen
- Department of Sociology, University of Maryland, College Park, MD, USA
| | - Hong Liang
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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11
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Jaeb MA. Concept analysis of shame in nursing. Int J Ment Health Nurs 2022; 31:295-304. [PMID: 34750954 DOI: 10.1111/inm.12948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/07/2021] [Accepted: 10/15/2021] [Indexed: 11/28/2022]
Abstract
Nurses can facilitate opportunities for patients who feel shame to experience healing in their mental health. Disciplines such as psychology have extensive shame research, yet nursing may provide a unique perspective to bolster research on shame. The objective of this analysis is to examine the use of shame as a concept in nursing literature. This review was guided by Beth Rodgers' Evolutionary approach to concept analysis. Rodgers' approach entails investigating attributes, related terms, surrogate terms, antecedents, and consequences of shame; and examining the use of the concept shame over time to determine if its use changed. Sampled literature came from Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, PubMed, Web of Science, and Health Source: Nursing/Academic Edition. The final sample used for analysis included 334 sources published between 1993 and 2020. The use of shame did not change during these years. Attributes were negative sense of self, feeling worthless, and feeling vulnerable. There were no surrogate terms and three related terms: guilt, humiliation, and embarrassment. Antecedents were trauma, stigma, and perception of moral wrongdoing. Consequences included healthcare avoidance, social withdrawal or isolation, negative coping mechanisms, resilience, lifestyle changes, and healthy coping. There is a discrepancy between the conceptualization and use of shame in nursing and other disciplines. Other disciplines, such as psychology, provide more direction about how interpersonal interactions can elicit or alleviate feelings of shame. Nurses can apply this conceptualization in their clinical practice to support patients experiencing shame.
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Affiliation(s)
- Michael A Jaeb
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
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12
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Bietsch B. Second Time Overlooked in Crisis: Examining How HIV/AID Health Policies in the USA Connect with Policy Implications Today for Aging LGBTQ Adults During the COVID-19 Pandemic. JOURNAL OF HUMAN RIGHTS AND SOCIAL WORK 2022; 7:246-255. [PMID: 35309519 PMCID: PMC8922067 DOI: 10.1007/s41134-021-00208-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
U.S. policy has, once again, overlooked the health care needs of older adults who are lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ). This population is estimated to more than double in the USA (Fredriksen-Goldsen, in Generations 38(4), 86-92, 2015), with estimates of approximately 3 million LGBTQ adults over 50 currently and 7 million by 2030 (Services and Advocacy for GBLT Elders in SAGE, New York, 2018). The healthcare model for addressing the needs of LGBTQ persons has historically been that of a disease model of care, particularly during the HIV/AIDS crisis, and has recently moved to that of a health equity model in the past 20 years. The LGBTQ community, social work profession, and general medical community worked to create the health care equity model we have today and this paper will discuss how this evolved. The health care equity model addresses the health needs for older adult LGBTQ populations. Older LGBTQ adults are more likely to experience elevated rates of chronic conditions (such as HIV, cancer, diabetes), higher prevalence of anxiety/depression, greater substance abuse, higher economic insecurities, limited community resources, and limited access to health care services compared to heterosexual/cisgender counterparts. This paper discusses how health disparities among this minority population and heterosexual/cisgender individuals have been exacerbated during the COVID-19 pandemic. Further, this paper will address policy, research, and practice implications to understand how to assist this vulnerable subpopulation of LGBTQ persons.
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Affiliation(s)
- Breana Bietsch
- University of Connecticut, Social Work, Hartford, CT USA
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13
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Greenmyer JR, Montgomery M, Hosford C, Burd M, Miller V, Storandt MH, Lakpa KL, Tiongson C. Guilt and Burnout in Medical Students. TEACHING AND LEARNING IN MEDICINE 2022; 34:69-77. [PMID: 33722144 DOI: 10.1080/10401334.2021.1891544] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
THEORY Burnout is prevalent among medical students and is correlated with negative feelings, behaviors, and outcomes. Empathy is a desired trait for medical students that has been correlated with reduced burnout. The concept of guilt is closely related to concern about the well-being of others; therefore, feelings of guilt may be associated with empathy. Excessive guilt poses an increased risk for internalized distress, symptoms such as anhedonia, and may be related to burnout. The relationship between pathogenic guilt and burnout in medical students is unknown. HYPOTHESIS We hypothesize that pathogenic guilt is present and related to both burnout and empathy in medical students. METHODS We conducted a cross-sectional survey study of all students in one medical school. Data were collected in February 2020. The Oldenburg Burnout Inventory (OBLI), Toronto Empathy Questionnaire (TEQ), and Interpersonal Guilt Questionaire-67 (IGQ-67) were used. A modified version of IGQ-67 was used to measure four subscales of pathogenic guilt: survival guilt, separation guilt, omnipotence guilt, and self-hate guilt. Data analyses for this study including screening, evaluation of assumptions, descriptive statistics, reliabilities, one-way ANOVA, and correlation coefficients, were conducted using SPSS version 26. RESULTS Of 300, 168 (56.0%) students participated in the study. Survival, omnipotence, and self-hate classes of pathogenic guilt were positively correlated with burnout. Empathy was correlated with two classes of pathogenic guilt: survival and omnipotence. Empathy was inversely related to burnout (disengagement). CONCLUSIONS Pathogenic guilt may be a contributor to burnout in medical students. Guilt should be a target of prevention and treatment in burnout in medical students. UNLABELLED Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.1891544.
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Affiliation(s)
- Jacob R Greenmyer
- Department of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Michelle Montgomery
- Department of Psychiatry and Behavioral Sciences, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Charles Hosford
- Educational Resources, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Michael Burd
- Public Health Program, University of North Dakota, Grand Forks, North Dakota, USA
| | - Vanessa Miller
- Department of Family Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Michael H Storandt
- Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Koffi L Lakpa
- Department of Biomedical Sciences, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Christopher Tiongson
- Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
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14
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Ismail A. Arab Muslim Mothers’ Struggle Attributing Meaning to Child Loss in Home Accidents. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.2013673] [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)
- Akhlas Ismail
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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15
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Plews-Ogan E, Keywan C, Morris SE, Goldstein RD. The parental role before and after SIDS. DEATH STUDIES 2021; 46:2316-2326. [PMID: 34101544 DOI: 10.1080/07481187.2021.1936296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Role confusion is a prominent constituent symptom of Prolonged Grief Disorder in parents after their infants die from sudden infant death syndrome (SIDS). We interviewed 31 parents of SIDS infants 2-5 years post-loss examining the parental role before death, at the time of loss, and in bereavement. Thematic analysis found disruption of the role and re-imagined responsibilities for their child's physical security, emotional security, and meaning. Tasks within these domains changed from concrete and apparent to representational and self-generated. Parents in bereavement locate ongoing, imperative parental responsibilities, particularly asserting their child's meaningful place in the world and in their family.
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Affiliation(s)
- Erin Plews-Ogan
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Christine Keywan
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sue E Morris
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Richard D Goldstein
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
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Grauerholz KR, Berry SN, Capuano RM, Early JM. Uncovering Prolonged Grief Reactions Subsequent to a Reproductive Loss: Implications for the Primary Care Provider. Front Psychol 2021; 12:673050. [PMID: 34054675 PMCID: PMC8149623 DOI: 10.3389/fpsyg.2021.673050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction There is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss. Materials and Methods A summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not. Results More than a third (39.6%) of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double (136.9% vs. 63.6%) for those who reported that a year or more had passed since the loss of the pregnancy. Discussion Grief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance.
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Affiliation(s)
| | - Shandeigh N Berry
- Life Perspectives, San Diego, CA, United States.,Department of Nursing, College of Arts and Sciences, St. Martin's University, Lacey, WA, United States
| | - Rebecca M Capuano
- Life Perspectives, San Diego, CA, United States.,Blue Ridge Women's Center, Roanoke, VA, United States
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Martin CJH, Patterson J, Paterson C, Welsh N, Dougall N, Karatzias T, Williams B. ICD-11 complex Post Traumatic Stress Disorder (CPTSD) in parents with perinatal bereavement: Implications for treatment and care. Midwifery 2021; 96:102947. [PMID: 33610906 DOI: 10.1016/j.midw.2021.102947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 12/21/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The 11th revision of the WHO International Classification of Diseases (ICD-11) has identified Complex PTSD (CPTSD) as a new condition. AIM To explore whether the new diagnosis of CPTSD (ICD11) is relevant to women who have experienced perinatal bereavement and to advance knowledge about the acceptability, feasibility and perceived impact of delivering an innovative flexible Compassionate Focused Therapy (CFT) informed treatment package to alleviate symptoms of this condition. METHODS A mixed methods study using survey and interviews was conducted. Participants first completed the International Trauma Questionnaire (ITQ) to assess if they met the criteria for PTSD or CPTSD (n=72), and subsequent semi-structured interviews (n=12) identified participants' views about different treatment approaches. PARTICIPANTS A convenience sample of women who had experienced perinatal bereavement were recruited from one geographical region in Scotland. DATA COLLECTION Information was gathered about trauma experiences related to perinatal bereavement; participants' levels of PTSD or CPTSD using the ITQ; and views regarding the features of treatment options. In-depth interviews with women (n=12) and a focus group with staff (n=5) were also conducted. FINDINGS Of 74 participants (n=74) who fully completed the ITQ, 10.8% (n=8) met the criteria for PTSD and 29.7% (n=22) for CPTSD, equating to a total of 40.5% of participants experiencing traumatic stress. Results suggest that CPTSD is a more common condition than PTSD in people with perinatal bereavement, with qualitative data suggesting that CFT and EMDR can be useful and acceptable interventions for this population group. CONCLUSION A feasibility study is recommended next to evaluate acceptability of trial processes in preparation for a definitive randomised controlled trial of a new flexible CFT informed treatment package to address PTSD and CPTSD in people with perinatal bereavement. RECOMMENDATIONS FOR PRACTICE Routine assessment of ICD-11 CPTSD is recommended in this population group.
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Affiliation(s)
- Caroline J Hollins Martin
- Maternal Health, School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK, EH11 4BN.
| | - Jenny Patterson
- School of Health and Social Care, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN.
| | | | - Nicola Welsh
- 'Held in Our Hearts', 177, Colinton Road, Edinburgh, EH14 1BZ, UK.
| | - Nadine Dougall
- School of Health and Social Care, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN, UK.
| | - Thanos Karatzias
- School of Health and Social Care, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN.
| | - Brian Williams
- School of Health and Social Care, 4B06, Sighthill Campus, Edinburgh Napier University, 9 Sighthill Court, UK, EH11 4BN.
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18
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Luck T, Luck-Sikorski C. Feelings of guilt in the general adult population: prevalence, intensity and association with depression. PSYCHOL HEALTH MED 2020; 26:1143-1153. [PMID: 33295786 DOI: 10.1080/13548506.2020.1859558] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To feel guilty can motivate for prosocial behavior but may also lead to negative health-related outcomes. The aim of this study was to provide epidemiological information on guilt feelings in the German general adult population. Based on findings from a nation-wide telephone survey (n=1,003 adultsaged 18+ years), we calculated weighted point prevalence rates for guilt feelings and used multivariable logistic regression analyses to evaluate the association between the guilt feelings and covariates. Prevalence of current guilt feelings was 10.6% (95%-CI=8.7-12.6). About one fourth of the adults with current guilt feelings rated the intensity of their feelings as 'rather strong' or 'very strong'. To feel guilty was unrelated to age, sex and education, but significantly associated with depression. The weighted prevalence of guilt feelings in adults with major depression was 37.4% (95%-CI=26.2-48.7) compared to 8.1% (95%-CI=6.4-9.9) in adults without. A substantial part of the German adult population is confronted with guilt feelings. Feeling guilty seems to be less dependent on rather global socio-demographic characteristics than on others factors like depression. More efforts have to be made to identify those specific circumstances, under which feelings of guilt lead to adverse health-related outcomes and to provide corresponding treatment approaches.
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Affiliation(s)
- Tobias Luck
- University of Applied Sciences Erfurt, Faculty of Applied Social Sciences, Erfurt, Germany.,University of Applied Sciences Nordhausen, Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), Nordhausen, Germany
| | - Claudia Luck-Sikorski
- Research Group COPE - Chronic Diseases and Psychological Health, SRH University of Applied Health Sciences, Gera, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Hospital Leipzig, Leipzig, Germany
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19
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Luck T, Luck-Sikorski C. [Lifetime Prevalence of Feelings of Guilt in the German Adult Population - Results of a Nation-Wide Telephone Survey]. PSYCHIATRISCHE PRAXIS 2020; 48:208-215. [PMID: 33271621 DOI: 10.1055/a-1310-1860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To provide information on lifetime prevalence of feelings of guilt in the German adult population based on data from a nation-wide telephone survey (n = 1.003; 18+ years; May-June 2019). METHODS We calculated weighted lifetime prevalence rates with confidence intervals (95 %-CI) and used multivariable logistic regression analyses to evaluate the association of guilt feelings with covariates. RESULTS We identified a weighted lifetime prevalence of experienced feelings of guilt of 68.5 % (95 %-CI = 65.6-71.3). Younger age, higher education and current depressive symptoms were associated with higher prevalence rates. No association was found with regard to gender and major depression. CONCLUSION A substantial part of the adult population experienced some sort of guilt feelings in their lives. Further research efforts are required to answer the question whether feelings of guilt are only a criterion of depression or whether they may contribute to an increased risk of the disorder.
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Affiliation(s)
- Tobias Luck
- Fakultät Angewandte Sozialwissenschaften, Fachhochschule Erfurt.,Fachbereich Wirtschafts- und Sozialwissenschaften und Institut für Sozialmedizin, Rehabilitationswissenschaften und Versorgungsforschung (ISRV), Hochschule Nordhausen
| | - Claudia Luck-Sikorski
- SRH Hochschule für Gesundheit, Forschungsgruppe COPE Chronische Erkrankungen und Psychische Gesundheit, Gera.,Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Universitätsmedizin Leipzig
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20
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Dumont É, Bourque CJ, Duval M, Payot A, Sultan S. A Portrait of Self-Reported Health and Distress in Parents Whose Child Died of Cancer. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:958-973. [DOI: 10.1177/0030222820959943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Grieving a child following cancer is a substantially difficult task. The objectives of this research were: 1) to describe current quality of life (QoL), psychological distress and symptoms of grief of bereaved parents, and 2) to explore the role of possible contributors of QoL and psychological distress. Forty-six parents (32 mothers) of children who died of cancer were surveyed on their QoL, distress, and complicated grief. Data were analyzed using multiple linear regression. Parents had a high frequency of grieving symptoms (58%). Mothers reported more retrospective grief symptoms than fathers when describing the year after child death. Current lower mental well-being was associated with experiencing higher retrospective grief symptoms, a shorter period since child death, and being a father. Hence, parents experienced disturbances even long after child death. Mothers and fathers may present specificities that should be considered when developing supportive activities for this vulnerable population.
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Affiliation(s)
- Émilie Dumont
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Claude Julie Bourque
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Michel Duval
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Antoine Payot
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
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21
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Scheer JR, Harney P, Esposito J, Woulfe JM. Self-Reported Mental and Physical Health Symptoms and Potentially Traumatic Events Among Lesbian, Gay, Bisexual, Transgender, and Queer Individuals: The Role of Shame. PSYCHOLOGY OF VIOLENCE 2020; 10:131-142. [PMID: 33062388 PMCID: PMC7556696 DOI: 10.1037/vio0000241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals disproportionately face exposure to potentially traumatic events-adverse experiences that may have a traumatizing effect-and experience shame as a common consequence. Previous research demonstrates associations between shame and psychological and physical health issues among those with exposure to potentially traumatic events in general, with limited attention among LGBTQ individuals specifically. This study determined whether shame partially mediated the relationship between potentially traumatic events exposure and self-reported mental and physical health symptoms among LGBTQ individuals. METHOD Participants were 218 self-identified LGBTQ individuals who reported experiencing at least one potentially traumatic event (e.g., childhood sexual abuse). Online surveys assessed the type and frequency of potentially traumatic events exposure, shame, self-reported mental health (depression symptoms, posttraumatic stress disorder symptoms, and substance use), and physical health symptoms (sexual risk behavior, somatic symptoms, and chronic health conditions). RESULTS Greater potentially traumatic events exposure was associated with greater shame, and greater shame was associated with worse self-reported mental and physical health. Potentially traumatic events exposure had a direct effect on self-reported mental and physical health, and shame partially mediated this relationship. CONCLUSION Shame represents an important and modifiable factor that relates to poor health and may be amenable to change through psychosocial interventions. Given the prevalence of negative self-attribution stemming from potentially traumatic events exposure, in addition to the internalization of stigma among this population, practitioners need to uncover interventions specifically targeting shame when working with LGBTQ individuals.
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Affiliation(s)
| | | | - Jessica Esposito
- Brooklyn Campus of the Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
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22
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LeBlanc NJ, Toner ER, O’Day EB, Moore CW, Marques L, Robinaugh DJ, McNally RJ. Shame, guilt, and pride after loss: Exploring the relationship between moral emotions and psychopathology in bereaved adults. J Affect Disord 2020; 263:405-412. [PMID: 31969271 PMCID: PMC7307182 DOI: 10.1016/j.jad.2019.11.164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/20/2019] [Accepted: 11/30/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Self-blame following bereavement has been implicated in the development of post-loss psychopathology. However, prior studies have not distinguished between the emotions of shame versus guilt. This study examined the cross-sectional associations among bereavement-related shame, bereavement-related guilt, and two mental disorders that commonly arise after bereavement: complicated grief and depression. In addition, exploratory analyses examined the associations between bereavement-related pride and post-loss psychopathology. METHODS Participants included 92 bereaved adults who experienced the death of a family member at least one year prior to the study. Participants completed self-report measures of complicated grief symptoms, depression symptoms, shame, guilt, and pride. RESULTS Shame and guilt were positively correlated with complicated grief and depression symptoms. When controlling for their shared variance, only shame remained a significant predictor of post-loss psychopathology. Follow-up analyses indicated that the effect of guilt on psychopathology depended on the level of shame, and vice versa. At low shame, guilt predicted psychopathology; however guilt did not predict psychopathology at moderate to high shame. At low to moderate guilt, shame predicted psychopathology; however shame did not predict psychopathology at high guilt. Pride negatively predicted depression symptoms, but not complicated grief symptoms, when we controlled for shame and guilt. LIMITATIONS Limitations include the cross-sectional design and modest sample size. CONCLUSIONS Our analyses identify shame as the more pathogenic moral emotion for bereaved adults. However, whereas guilt in the absence of shame is often considered adaptive, we found that guilt predicted greater psychological distress at low levels of shame in this sample.
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Affiliation(s)
- Nicole J. LeBlanc
- Department of Psychology, Harvard University,Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital
| | - Emma R. Toner
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital
| | | | - Cynthia W. Moore
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School
| | - Luana Marques
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School,Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-Based Treatments, Massachusetts General Hospital
| | - Donald J. Robinaugh
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School
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Omar N, Major S, Mohsen M, Al Tamimi H, El Taher F, Kilshaw S. Culpability, blame, and stigma after pregnancy loss in Qatar. BMC Pregnancy Childbirth 2019; 19:215. [PMID: 31242874 PMCID: PMC6595691 DOI: 10.1186/s12884-019-2354-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/05/2019] [Indexed: 11/23/2022] Open
Abstract
Background Following a miscarriage many women report feeling guilty and culpable for what has happened particularly when aspects of societal blame and stigma are involved. This research investigated the impact of cultural context on the experience of miscarriage. In particular, it focused on how elements of stigma and blame are linked to notions of miscarriage etiology and risk among Qatari women. Methods The research used an ethnographic approach. The data was collected over 18 months of fieldwork in Qatar, using semi-structured face to face interviews, and participant observation. A purposive sample of 40 women (primary participants) who had recently miscarried, participated in the study. Potential subjects were initially identified in the Women’s Hospital and were consented, and then interviewed in Arabic either in the hospital or at their preferred location. The interviews were audio recorded, transcribed and translated into English. Additional key interviews were performed with 20 secondary participants related to the miscarriage cohort including family members and husbands. Inductive thematic analysis of content was performed manually to extract themes. Results Two main themes emerged from the material looking specifically at miscarriage aftermaths: rhetorics of blame, self-blame and feelings of guilt; and miscarriage attitudes. Overall society is sympathetic and miscarriage is seen as normal and not particularly worrying, but understood to be upsetting to women. However, findings suggest there is some ambivalence around blame, culpability and stigma applied to miscarriage; some participants perceived miscarriage as a relatively normal and common event, whereas, others felt that miscarriage is resounding stigma and shame. Conclusion Miscarriage aftermaths are embedded in social, cultural and religious frameworks in relation to notions of risk and causation. Attention should be paid to ensure women and those around them are given appropriate and robust information about miscarriage causation to deflect discourses of blame that may be employed and reduce harm to women who suffer miscarriage.
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Affiliation(s)
- Nadia Omar
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Stella Major
- Department of Medical Education, Weill Cornell Medicine-Qatar, Education City, P.O. Box 24144, Doha, Qatar
| | - Mona Mohsen
- Interim Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Halima Al Tamimi
- The Women's Hospital (Hamad Medical Corporation)-Qatar, Doha, Qatar
| | - Faten El Taher
- The Women's Hospital (Hamad Medical Corporation)-Qatar, Doha, Qatar
| | - Susie Kilshaw
- University College London-Department of Anthropology, 14 Taviton Street, London, WC1H 0BW, United Kingdom.
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24
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Sibeoni J, Manolios E, Verneuil L, Chanson P, Revah-Levy A. Patients' perspectives on acromegaly diagnostic delay: a qualitative study. Eur J Endocrinol 2019; 180:339-352. [PMID: 30939451 DOI: 10.1530/eje-18-0925] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/02/2019] [Indexed: 12/27/2022]
Abstract
Context Acromegaly has a substantial diagnostic delay associated with an increased risk of comorbidities and psychosocial deterioration. Qualitative methods which focus on the ways that individuals understand and relate to what they are experiencing are the best methods for exploring patients' perspectives. To the best of our knowledge, they have not been developed in the context of acromegaly. Objectives This study aimed to explore the experience of the diagnostic pathway of patients with acromegaly. Design We conducted a qualitative study, based on 20 face-to-face unstructured interviews in a third referral Endocrinology center. Participants, purposively selected until data saturation, were patients with acromegaly with diverse disease durations, types of treatment or associated comorbidities. The data were examined by thematic analysis. Results Our analysis found four themes: (i) what happened for patients before the diagnosis; (ii) what happened after; (iii) the style or type of doctor involved and (iv) patients' suggestions for limiting diagnostic delay. Our findings underlined the direct associations between diagnostic delay and the doctor-patient encounter, and the truly catastrophic experience of this disease, both before and after the diagnosis. Conclusions Diagnosis of acromegaly requires active medical involvement and awareness. Intervention of patient-experts in medical schools may help to be more aware of this disease. Endocrinologists caring for patients with acromegaly should also address the catastrophic dimension of the patient's experience and initiate the narrative to help them to put it into words for preventing harmful consequences such as social isolation and QoL impairment, but also anxiety or depression.
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Affiliation(s)
- Jordan Sibeoni
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cité, France
| | - Emilie Manolios
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cité, France
- Service de Psychologie et Psychiatrie de Liaison et d'Urgences, Hôpital Européen Georges Pompidou AP-HP, Hôpitaux Universitaires Paris Ouest, Paris, France
| | - Laurence Verneuil
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cité, France
| | - Philipe Chanson
- Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Le Kremlin Bicêtre, France
- UMR S 1185, Fac Med Paris Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cité, France
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Hvidtjørn D, Prinds C, Bliddal M, Henriksen TB, Cacciatore J, O'Connor M. Life after the loss: protocol for a Danish longitudinal follow-up study unfolding life and grief after the death of a child during pregnancy from gestational week 14, during birth or in the first 4 weeks of life. BMJ Open 2018; 8:e024278. [PMID: 30580272 PMCID: PMC6318761 DOI: 10.1136/bmjopen-2018-024278] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION After the death of a child during pregnancy, birth or in the neonatal period, parents often experience feelings of guilt, disenfranchisement, feelings of betrayal by one's own body and envy of others. Such bereavement results in high rates of distress: psychologically, emotionally, physiologically and existentially. These data are collected using a national, longitudinal cohort to assess grief in mothers and their partners after the death of a child during pregnancy, birth or in the neonatal period. Our aim is to achieve a general description of grief, emotional health, and existential values after pregnancy or perinatal death in a Danish population. METHODS AND ANALYSIS The cohort comprises mothers and their partners in Denmark who lost a child during pregnancy from gestational week 14, during birth or in the neonatal period (4 weeks post partum). We began data collection in 2015 and plan to continue until 2024. The aim is to include 5000 participants by 2024, generating the largest cohort in the field to date. Parents are invited to participate at the time of hospital discharge or via the Patient Associations homepage. Data are collected using web-based questionnaires distributed at 1-2, 7 and 13 months after the loss. Sociodemographic and obstetric variables are collected. Validated psychometric measures covering attachment, continuing bonds, post-traumatic stress, prolonged grief, perinatal grief and existential values were chosen to reach our aim. ETHICS AND DISSEMINATION The study was approved by The Danish National Data Protection Agency (no. 18/15684, 7 October 2014). The results will be disseminated in peer-reviewed and professional journals as well as in layman magazines, lectures and radio broadcasts.
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Affiliation(s)
- Dorte Hvidtjørn
- University of Southern Denmark and Odense University Hospital, Research Unit for Gynecology and Obstetrics, Institute of Clinical Research, Odense, Denmark
- Unit for Perinatal Loss, Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Prinds
- University of Southern Denmark and Odense University Hospital, Research Unit for Gynecology and Obstetrics, Institute of Clinical Research, Odense, Denmark
- Midwifery College, University College South Denmark, Esbjerg, Denmark
| | - Mette Bliddal
- OPEN Odense Patient Data Explorative Network, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Tine Brink Henriksen
- Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Joanne Cacciatore
- School of Social Work, Arizona State University, Tempe, Arizona, USA
| | - Maja O'Connor
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
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Camacho D, Pérez-Nieto MÁ, Gordillo F. The role of rumination in the guilt associated with bereavement according to cause of death. Psychiatry Res 2018; 270:1053-1058. [PMID: 30196977 DOI: 10.1016/j.psychres.2018.04.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 02/05/2018] [Accepted: 04/27/2018] [Indexed: 10/16/2022]
Abstract
The purpose of this study was to analyse the role rumination plays in the relationship between cause of death and the guilt present during bereavement. The sample consisted of 90 people that had suffered a loss due to an expected or unexpected natural death, suicide or accident. The results suggest that rumination increases the levels of guilt felt by people that had suffered a loss due to suicide compared to those whose loss was due to an expected natural death. These findings contribute to a better understanding of the mechanisms with an influence on bereavement.
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Affiliation(s)
- Dulce Camacho
- Alaia Association. C/ Fernández de los Ríos, 87. 28015 Madrid, Spain.
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27
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Kokou-Kpolou K, Megalakaki O, Nieuviarts N. Persistent depressive and grief symptoms for up to 10 years following perinatal loss: Involvement of negative cognitions. J Affect Disord 2018; 241:360-366. [PMID: 30144719 DOI: 10.1016/j.jad.2018.08.063] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/08/2018] [Accepted: 08/12/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Perinatal loss is known to be associated with a heightened risk of mental health complications. However, the psychological mechanisms underlying the perinatal grief process are less well documented. We hypothesized that negative cognitions are associated with post-perinatal loss symptomatology, and vary according to whether the death occurs before or after birth. METHODS We adopted a cross-sectional design to assess demographics, variables related to the death, five types of negative cognitions (about the self, world, life, future, and self-blame), prolonged grief, and depressive symptoms. The sample included 98 perinatally bereaved mothers with a mean age of 33.9 years. RESULTS When we controlled for demographics and variables related to the death, hierarchical linear regression showed that maladaptive cognitions about life, the future and the world were associated with prolonged grief symptoms, whereas only maladaptive cognitions about the world were associated with depressive symptoms. Significant interaction effects confirmed that cognitions about the world were associated with increased depressive symptoms when the death occurred after the birth, and cognitions about life when it occurred before the birth. LIMITATIONS The cross-sectional design precluded causal conclusions. However, the sample size was relatively representative and limited to perinatally bereaved mothers. CONCLUSIONS Different negative cognitions are involved in persistent depressive versus grief symptoms following perinatal loss, and vary depending on the type of loss. These results will serve to enhance perinatal grief interventions.
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Affiliation(s)
| | - Olga Megalakaki
- Department of Psychology, Picardy Jules Verne University, Amiens, France
| | - Nicolas Nieuviarts
- Department of Psychology, Picardy Jules Verne University, Amiens, France
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Kornhaber R, Childs C, Cleary M. Experiences of guilt, shame and blame in those affected by burns: A qualitative systematic review. Burns 2018; 44:1026-1039. [DOI: 10.1016/j.burns.2017.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 07/17/2017] [Accepted: 11/20/2017] [Indexed: 11/28/2022]
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Trevino KM, Litz B, Papa A, Maciejewski PK, Lichtenthal W, Healy C, Prigerson HG. Bereavement Challenges and Their Relationship to Physical and Psychological Adjustment to Loss. J Palliat Med 2017; 21:479-488. [PMID: 29182478 DOI: 10.1089/jpm.2017.0386] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The psychosocial challenges confronted by bereaved survivors may contribute to poor bereavement adjustment. Measures of the challenges of bereavement are limited. This study is a preliminary examination of the factor structure of a new measure of bereavement challenges and their relationships to quality of life and mental illness in bereaved cancer caregivers. This measure was designed to identify intervention targets to reduce the likelihood of prolonged grief. METHODS Caregivers of advanced cancer patients were administered measures of bereavement challenges (Bereavement Challenges Scale, BCS), quality of life (Medical Outcomes Study Short Form-36), prolonged grief (PG-13), and mental disorders (Structured Clinical Interview for the DSM-IV). Principal component factor analyses identified the underlying factor structure of the BCS. We examined associations between the factors and caregiver quality of life, prolonged grief, and rates of mental disorders. RESULTS A factor analysis identified five factors: "Challenges with Connecting with Others," "Challenges with Change," "Challenges Imagining a Hopeful Future," "Challenges with Accepting the Loss," and "Challenges with Guilt." Greater endorsement of bereavement challenges was associated with worse quality of life, more severe symptoms of prolonged grief, and greater likelihood of meeting criteria for a mental disorder. CONCLUSIONS Assessing the challenges associated with bereavement is important to understanding barriers to bereaved individuals' adjustment. The five factors of the BCS point to potential targets for clinical intervention. Additional research on the BCS is needed, including validation in larger more diverse samples, and confirmation that reduction of these challenges is associated with less psychiatric morbidity and, specifically, symptoms of prolonged grief.
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Affiliation(s)
- Kelly M Trevino
- 1 Cornell Center for Research on End-of-Life Care , Weill Cornell Medicine, New York, New York.,2 Department of Medicine, Weill Cornell Medicine , New York, New York
| | - Brett Litz
- 3 VA Boston Healthcare System , Jamaica Plain, Massachusetts.,4 Department of Psychiatry, Boston University Medical Center , Bosten, Massachusetts
| | - Anthony Papa
- 5 Department of Psychology, University of Nevada , Reno, Reno, Nevada
| | - Paul K Maciejewski
- 1 Cornell Center for Research on End-of-Life Care , Weill Cornell Medicine, New York, New York.,6 Department of Radiology, Weill Cornell Medicine , New York, New York
| | - Wendy Lichtenthal
- 7 Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center , New York, New York
| | - Charlotte Healy
- 8 Department of Professional Studies, Columbia University , New York, New York
| | - Holly G Prigerson
- 1 Cornell Center for Research on End-of-Life Care , Weill Cornell Medicine, New York, New York.,2 Department of Medicine, Weill Cornell Medicine , New York, New York
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30
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Gold KJ, Sen A, Leon I. Whose Fault Is It Anyway? Guilt, Blame, and Death Attribution by Mothers After Stillbirth or Infant Death. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/1054137317740800] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Parents who experience stillbirth or infant death often struggle with postpartum guilt. This may be an adaptive response or can become chronic and maladaptive. We surveyed bereaved mothers in Michigan with perinatal death 15 months after loss to evaluate guilt, blame, and potential covariates. Self-report information was linked with data from State of Michigan vital records of births and deaths. Respondents included 311 mothers. Most reported guilt or self-blame at 15 months. In multinomial logistic analysis, depression and interpersonal violence predicted greater guilt. Nearly half of women blamed their medical team for the loss, and about a fifth reported feeling blamed by others. Both of these attributions were associated with greater guilt. The majority of mothers report persistent guilt after perinatal loss. Depression at either 9 or 15 months was a strong predictor of greater guilt.
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Affiliation(s)
- Katherine J. Gold
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Ananda Sen
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Irving Leon
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
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31
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The Negative Impact of an Uncertain Residence Status: Analysis of Migration-Related Stressors in Outpatients with Turkish Migration Background and Psychiatric Disorders in Germany Over a 10-Year Period (2005-2014). J Immigr Minor Health 2017; 20:317-326. [PMID: 28293898 DOI: 10.1007/s10903-017-0555-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Several studies indicate that immigration is associated with a higher risk for mental disorders, particularly in refugees and asylum seekers. We investigated migration-related distress in outpatients with Turkish migration background and a psychiatric disorder. Asylum applicants (ASA) and migrants with a permanent residency status (PRS) from a specialized German psychiatric outpatient service were compared with respect to clinical variables and stressors related to migration and acculturation. Of n = 620 migrant outpatients (main diagnosis: 3.9% ICD-10 F2, 58.2% F3, 36.5% F4, 1.5% F60), n = 78 (12.6%) were ASA with larger proportions of illiteracy and language difficulties. Communication problems, stress related to migration, shame feelings, homesickness and perceived discrimination occurred more often in ASA whereas family conflicts were more frequent in PRS (P < 0.05). According to our results, adaptation to the new environment of asylum applicants implies more difficulties, especially language problems, feelings of shame, and experience of discrimination. Asylum seeking seems to denote an additional severe psychological stressor.
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Camacho D, Pérez Nieto M, Gordillo F. Guilt and Bereavement: Effect of the Cause of Death, and Measuring Instruments. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/1054137316686688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Guilt is a common reaction in bereavement. Our aim is to explore the guilt in bereavement depending on the cause of death. The sample involved 73 participants who had lost a family member to a terminal illness, suicide, sudden illness, accident, or perinatal death. Guilt was measured using the items of self-blame and regret in the Tübingen Bereavement Symptoms Questionnaire, the SC-35, and the Bereavement Guilt Scale (BGS). The results reveal significant differences in suicide bereavement on the self-blame subscale compared with unexpected natural death. Further there are significant differences in suicide bereavement in the regret subscale compared with unexpected natural death, and in the BGS as regards both an expected and an unexpected natural death. There are no significant differences in guilt when it is measured through the SC-35. These data suggest that the measurement of guilt in bereavement calls for the use of specific scales for this context.
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Affiliation(s)
| | - M.A. Pérez Nieto
- Department of Psychology. Camilo José Cela University, Madrid, Spain
| | - Fernando Gordillo
- Department of Psychology. Camilo José Cela University, Madrid, Spain
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Bryant RA, Kenny L, Joscelyne A, Rawson N, Maccallum F, Cahill C, Hopwood S. Predictors of treatment response for cognitive behaviour therapy for prolonged grief disorder. Eur J Psychotraumatol 2017; 8:1556551. [PMID: 30815235 PMCID: PMC6383610 DOI: 10.1080/20008198.2018.1556551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/19/2018] [Accepted: 11/23/2018] [Indexed: 10/31/2022] Open
Abstract
Background: Prolonged grief disorder (PGD) causes significant impairment in approximately 7% of bereaved people. Although cognitive behaviour therapy (CBT) has been shown to effectively treat PGD, there is a need to identify predictors of treatment non-response. Methods: PGD patients (N = 80) were randomly allocated to receive 10 weekly two-hour group CBT sessions and (a) four individual sessions of exposure therapy or (b) CBT without exposure. PGD was assessed by self-report measures at baseline, post-treatment (N = 61), and six-months (N = 56) after treatment. Results: Post-treatment assessments indicated that greater reduction in grief severity relative to pretreatment levels was associated with being in the CBT/Exposure condition, and lower baseline levels of self-blame and avoidance. At follow-up, greater grief symptom reduction was associated with being in the CBT/Exposure condition and lower levels of avoidance. Conclusions: These patterns suggest that strategies that target excessive self-blame and avoidance during treatment may enhance response to grief-focused cognitive behaviour therapy.
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Affiliation(s)
- Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Lucy Kenny
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Amy Joscelyne
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Natasha Rawson
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Fiona Maccallum
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Catherine Cahill
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Sally Hopwood
- School of Psychology, University of New South Wales, Sydney, Australia
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Callebaut L, Molyneux P, Alexander T. The Relationship Between Self-Blame for the Onset of a Chronic Physical Health Condition and Emotional Distress: A Systematic Literature Review. Clin Psychol Psychother 2016; 24:965-986. [PMID: 27925335 DOI: 10.1002/cpp.2061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Past literature presents contrasting perspectives regarding the potential influence of self-blame on adjustment to illness. This systematic literature review aimed to summarize findings from all investigations to date that have explored the relationship between self-blame for the onset of a chronic physical health condition and emotional distress. METHOD Between November 2014 and February 2015, electronic databases were searched for relevant literature. Only those studies which assessed self-blame directly and related specifically to illness onset were included within the review. The methodological and reporting quality of all eligible articles was assessed, and themes within the findings were discussed using a narrative synthesis approach. RESULTS The majority of studies found self-blame to be associated with increased distress. However, several concerns with the quality of the reviewed articles may undermine the validity of their conclusions. CONCLUSIONS It is important for professionals supporting people with chronic physical health conditions to have an understanding of how of self-critical causal attributions might relate to emotional distress. Further research is required to understand the concept of self-blame, the factors that may encourage this belief and to develop reliable and valid measures of this experience. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE What does this study add? The review presents an exploration of the role of self-blame in emotional adjustment following the diagnosis of a chronic physical health condition. This is the first review to synthesize findings from studies measuring self-blame beliefs directly and specifically for illness onset and their relationship to indicators of distress and wellbeing. Findings suggest that self-blame for illness onset is often associated with emotional distress for people with cancer, HIV/AIDS and cardiovascular disease. This has implications for how healthcare professionals respond to self-blaming beliefs in the context of illness. Research quality concerns are identified for many of the reviewed studies, highlighting a need for further research on this topic.
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Affiliation(s)
- Leah Callebaut
- Department of Psychological Health and Wellbeing, The University of Hull, Hull, United Kingdom
| | - Philip Molyneux
- Department of Psychological Health and Wellbeing, The University of Hull, Hull, United Kingdom
| | - Tim Alexander
- Department of Psychological Health and Wellbeing, The University of Hull, Hull, United Kingdom
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Currie ER, Roche C, Christian BJ, Bakitas M, Meneses K. Recruiting bereaved parents for research after infant death in the neonatal intensive care unit. Appl Nurs Res 2016; 32:281-285. [PMID: 27969043 DOI: 10.1016/j.apnr.2016.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/22/2016] [Accepted: 08/26/2016] [Indexed: 11/30/2022]
Abstract
Understanding parental experiences following infant death in the neonatal intensive care unit (NICU) is a high research priority and a necessary first step to improving health services. However, recruiting bereaved parents to discuss their experiences on such an extremely sensitive topic can be challenging and research procedures must be planned carefully in order to get an adequate sample. There is little published in the literature detailing specific strategies for recruiting bereaved parents for grief research, especially strategies for contacting parents and identifying factors that might affect participation. The purpose of this paper is to describe the process of recruiting bereaved parents into a qualitative research study exploring parental NICU experiences and grief responses following infant death. We describe a successful recruitment plan that led to the enrollment of difficult to recruit participants such as fathers, and individuals representing minorities and those from lower socioeconomic (SES) groups. Bereaved parents of infants after an NICU hospitalization should continue to be recruited for research studies for their unique perspectives and valuable insights about the devastating experience of infant death. Participants in this study reported more benefits than harm and the results addressed a critical gap in the literature.
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Affiliation(s)
- Erin R Currie
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA.
| | - Cathy Roche
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA.
| | - Becky J Christian
- University of Louisville School of Nursing, Louisville, KY 40292, USA.
| | - Marie Bakitas
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA; University of Alabama at Birmingham, Center for Palliative and Supportive Care, Birmingham, AL 35233, USA.
| | - Karen Meneses
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA.
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