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Ivynian SE, Maccallum F, Chang S, Breen LJ, Phillips JL, Agar M, Hosie A, Tieman J, DiGiacomo M, Luckett T, Philip J, Dadich A, Grossman C, Gilmore I, Harlum J, Kinchin I, Glasgow N, Lobb EA. Support needs of Australians bereaved during the COVID-19 pandemic: A cross-sectional survey study. PLoS One 2024; 19:e0304025. [PMID: 38843213 PMCID: PMC11156310 DOI: 10.1371/journal.pone.0304025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 05/05/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND COVID-19 disrupted access to bereavement support. The objective of this study was to identify the bereavement supports used by Australians during the COVID-19 pandemic, perceived helpfulness of supports used, prevalence and areas of unmet support need, and characteristics of those with unmet support needs. METHODS A convenience sample of bereaved adults completed an online questionnaire (April 2021-April 2022) about their bereavement experiences including support use and perceived helpfulness, unmet support needs and mental health. Multiple logistic regression was conducted to determine sociodemographic correlates of unmet needs. Open-ended responses were examined using content analysis to determine key themes. RESULTS 1,878 bereaved Australians completed the questionnaire. Participants were mostly women (94.9%) living in major cities (68%) and reported the death of a parent (45%), with an average age of 55.1 years (SD = 12.2). The five most used supports were family and friends, self-help resources, general practitioners, psychologists, and internet/online community groups. Notably, each was nominated as most helpful and most unhelpful by participants. Two-thirds (66%) reported specific unmet support needs. Those with unmet needs scored lower on mental health measures. Correlates of unmet needs included being of younger age, being a spouse or parent to the deceased; reporting more impacts from public health measures, and not reporting family and friends as supports. The most frequent unmet need was for social support after the death and during lockdown. CONCLUSIONS This study demonstrates the complexity of bereavement support needs during a pandemic. Specialised grief therapy needs to be more readily available to the minority of grievers who would benefit from it. A clear recommendation for a bereavement support action plan is to bolster the ability of social networks to provide support in times of loss. The fostering of social support in the wake of bereavement is a major gap that needs to be addressed in practice, policy, and research.
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Affiliation(s)
- Serra E. Ivynian
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
| | - Fiona Maccallum
- Faculty of Health and Behavioural Sciences, School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - Sungwon Chang
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
| | - Lauren J. Breen
- Curtin School of Population Health and Curtin enAble Institute, Curtin University, Perth, Western Australia
| | - Jane L. Phillips
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
- Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Meera Agar
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
| | - Annmarie Hosie
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
- School of Nursing & Midwifery, University of Notre Dame Australia, Darlinghurst, NSW, Australia
- St Vincent’s Health Network Sydney, Darlinghurst, NSW, Australia
| | - Jennifer Tieman
- Faculty of Health Sciences, RePaDD, Flinders University, Adelaide, SA, Australia
| | - Michelle DiGiacomo
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
| | - Tim Luckett
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jennifer Philip
- Department of Medicine, St Vincent’s Hospital, University of Melbourne, Fitzroy, VIC, Australia
| | - Ann Dadich
- School of Business, Western Sydney University, Parramatta, NSW, Australia
| | | | - Imelda Gilmore
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
| | - Janeane Harlum
- District Palliative Care Service, Liverpool Hospital, Liverpool, NSW, Australia
| | - Irina Kinchin
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Nicholas Glasgow
- Medical School, Australian National University, Canberra, ACT, Australia
| | - Elizabeth A. Lobb
- Faculty of Health, IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
- Department of Palliative Care, Calvary Health Care Kogarah, Kogarah, NSW, Australia
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Teo I, Paramasivam K, Chee WY, Ng C, Neo PSH, Lee GL. Deathbed experiences and meaning-making: Perspectives of family caregivers of patients who received cancer palliative care. Palliat Support Care 2024; 22:444-450. [PMID: 38053407 DOI: 10.1017/s1478951523001670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVES The deathbed symbolizes a time when the patient is dangerously ill and where death is imminent. The memories of family caregivers during this time can potentially shape their meaning-making of the patient's death and bereavement adjustment. We aimed to understand the experiences of family caregivers at the deathbed of patients receiving palliative care. We also examined caregiver's meaning-making that occurred after the patient's death. METHODS In this retrospective qualitative study, family caregivers of cancer patients who received palliative care in Singapore were recruited through purposive sampling. In-person, semi-structured interviews were individually conducted with study participants to understand their experiences from a caregiver's perspective before and after the death of the patient. Thematic content analysis method was conducted. RESULTS A total of 25 bereaved family caregivers were interviewed, with spouses, adult children, and others comprising one-third each of the sample. Six themes emerged from caregivers' recollected experiences around the patient deathbed: Lasting image of the patient, A time of intense emotions, Healthcare providers prepare caregivers, A time for saying goodbye, Rituals provide comfort, and Impact on family ties. Four themes emerged surrounding post-loss meaning-making: An end to the pain and suffering, "Have I done enough?," Significance in the timing of events, and Gaining strength and personal growth. SIGNIFICANCE OF RESULTS The deathbed is a salient time for family caregivers as they prepare for patient's death. There are opportunities to provide support to the family based on the study findings.
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Affiliation(s)
- Irene Teo
- Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | | | | | - Carolyn Ng
- Portland Institute for Loss and Transition, Portland, OR, USA
| | | | - Geok Ling Lee
- Department of Social Work, National University of Singapore, Singapore
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Muroya K, Tabuchi Y, Kumagai Y, Sakamoto M, Tajima T. Factors Contributing to Well-Being in Japanese Community-Dwelling Older Adults Who Experienced Spousal Bereavement. Res Gerontol Nurs 2024; 17:121-130. [PMID: 38598782 DOI: 10.3928/19404921-20240403-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
PURPOSE Providing support for older adults after spousal bereavement is crucial for psychological recovery through the grieving process and for promoting a healthy and happy remainder of life. The current study aimed to understand factors influencing well-being among Japanese community-dwelling older adults who experienced spousal bereavement by evaluating how their roles and activities affected their psychological well-being following the loss. METHOD We conducted a cross-sectional, anonymous, self-administered questionnaire survey of 332 older adults who had experienced death of a spouse in later adulthood. RESULTS Identified factors that affected well-being after spousal loss were sex, ability to go out without assistance from others, long duration since spousal loss, having a hobby, and adopting a life-oriented approach to cope with bereavement. Well-being following spousal loss was influenced by participants' activities and roles. CONCLUSION Findings of the current study provide potentially valuable suggestions for surviving spouses and their supporters when coping with grief following spousal loss. [Research in Gerontological Nursing, 17(3), 121-130.].
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Cengiz H, Cacciatore J. Status Consumption as Coping With Fear of Death: The Mediating Role of Death Avoidance and the Moderating Role of Materialism. Psychol Rep 2024:332941241251458. [PMID: 38684445 DOI: 10.1177/00332941241251458] [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: 05/02/2024]
Abstract
Individuals employ various coping mechanisms to deal with the fear of death. While materialism and status consumption are commonly recognized in the literature as such strategies, no study has yet empirically tested this premise. Accordingly, this study examined the mediating role of death avoidance in the link between the fear of death and death-related status consumption (DRSC). Data obtained from 346 participants were analyzed using structural equation modeling. The results showed that fear of death significantly and positively influences DRSC and that death avoidance partially and positively mediates this relationship. Results also revealed that materialism strengthens the relationship between fear of death and DRSC, while it does not significantly moderate the relationship between death avoidance and DRSC. These results support the conclusion that death-related status consumption may play a critical role as an avoidance mechanism in coping with the fear of death. This study, being among the few that investigate death-related consumer behaviors, enriches both terror management theory and the literature on consumer behavior in crises.
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Affiliation(s)
- Hakan Cengiz
- School of Social Work, Arizona State University, Phoenix, AZ, USA
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Hordyk SR, Macdonald ME, Brassard P, Okalik L, Papigatuk L. No time to grieve: Inuit loss experiences and grief practices in Nunavik, Quebec. Transcult Psychiatry 2023; 60:917-928. [PMID: 36344244 PMCID: PMC10725114 DOI: 10.1177/13634615221135423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article presents an overview of past and current grief rituals and practices and existing grassroots and institutional initiatives seeking to address the complex, prolonged, and traumatic grief experienced by many Inuit living in Quebec. While conducting a study seeking to identify the strengths, resources, and challenges for Nunavik's Inuit communities related to end-of-life care, results emerged concerning how family caregivers' grief related to the dying process was compounded by the sequelae of historic loss experiences (e.g., losses related to Canada's federal policies, including residential schools, forced relocations, and dog slaughters) and by present loss experiences (e.g., tragic and sudden deaths in local communities). To better support caregivers, an understanding of these grief experiences and a vision of bereavement care inclusive of community mobilization efforts to develop bereavement training and support is needed. We conclude with a discussion of a community capacity approach to bereavement care.
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Affiliation(s)
- Shawn Renee Hordyk
- École de travail social, Université du Québec à Montréal Faculté des sciences humaines, Canada
| | | | - Paul Brassard
- Division of Clinical Epidemiology – McGill University Health Centre, McGill University, Canada
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Chami JM, Pooley JA. Widowed Young: The Role of Stressors and Protective Factors for Resilience in Coping with Spousal Loss. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:477-504. [PMID: 34541943 DOI: 10.1177/00302228211047088] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While distressing, late life spousal loss is considered a normative life event and most demonstrate resilient recovery from grief. However, for 5-7% of the population spousal loss comes early, before the age of 50, and little is known about the factors that influence adjustment in this population. We used the DPM integrative framework to examine correlates and predictors of mental wellbeing and grief intensity in an international sample of 603 young widows and widowers. Contrary to existing bereavement research, loss-orientated stressors (e.g., expectedness and cause of death) did not predict bereavement outcomes. Employment and financial wellbeing were the only statistically significant restoration-orientated stressors associated with coping, mental wellbeing and grief intensity. We found no significant associations between parental status and coping or bereavement outcomes. Loss-orientated coping, followed by inter and intrapersonal protective factors for resilience and financial wellbeing were the greatest predictors of grief intensity. Loss-orientated coping was highest in early bereavement, the greatest predictor of grief intensity and associated with being unemployed, financial insecurity and decreased protective factors for resilience. Restoration-orientated coping was highest in later bereavement, was a weak predictor of grief intensity and associated with being employed, increased financial wellbeing and protective factors for resilience. Overall, we found the young-widowed population is at heightened risk of poor adjustment. Almost two-thirds reported decreased functioning, probable depression with high rates of psychological distress. Nearly half met diagnostic criteria for prolonged grief disorder. We discuss implications for research and clinical practice.
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Affiliation(s)
- Jane Marie Chami
- Department of Psychology and Social Science, Edith Cowan University, Perth, Australia
| | - Julie Ann Pooley
- Department of Psychology and Social Science, Edith Cowan University, Perth, Australia
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Selman LE, Turner N, Dawson L, Chamberlain C, Mustan A, Rivett A, Fox F. Engaging and supporting the public on the topic of grief and bereavement: an evaluation of Good Grief Festival. Palliat Care Soc Pract 2023; 17:26323524231189523. [PMID: 37533733 PMCID: PMC10392217 DOI: 10.1177/26323524231189523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background Good Grief Festival was originally planned as a face-to-face festival about grief and bereavement. Due to COVID-19, it was held online over 3 days in October 2020. Objective To evaluate the festival's reach and impact. Design Pre/post evaluation. Methods Pre-festival online surveys assessed reasons for attending and attitudes to bereavement across four items (fear of saying the wrong thing, avoiding talking to someone bereaved, knowing what to do if someone bereaved was struggling, knowing how to help). Post-festival online surveys evaluated audience experiences and the four attitude items. Free-text responses, analysed using thematic analysis, generated suggestions for improvement and general comments. Results Between 5003 and 6438 people attended, with most attending two to five events. Pre-festival survey participants (n = 3785) were mostly women (91%) and White (91%). About 9% were from Black or minoritised ethnic communities. About 14% were age ⩾65 years, 16% age ⩽34 years. Around 75% were members of the public, teachers, students or 'other'; 25% academics, clinicians or bereavement counsellors. A third had been bereaved in the last year; 6% had never been bereaved. People attended to learn about grief/bereavement (77%), be inspired (52%) and feel part of a community (49%). Post-festival participants (n = 685) reported feeling part of a community (68%), learning about grief/bereavement (68%) and being inspired (66%). 89% rated the festival as excellent/very good and 75% agreed that they felt more confident talking about grief after attending. Higher ratings and confidence were associated with attending more events. Post-festival attitudes were improved across all four items (p < 0.001). Attendees appreciated the festival, particularly valuing the online format, opportunities for connection during lockdown and the diversity and quality of speakers. Suggestions included improving registration, more interactive events and less content. Conclusion Good Grief Festival successfully reached a large public audience, with benefit in engagement, confidence and community-building. Evaluation was critical in shaping future events. Findings suggest festivals of this nature can play a central role in increasing death- and grief-literacy within a public health approach.
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Affiliation(s)
| | - Nicholas Turner
- Bristol Population Health Science Institute and Bristol Medical School, University of Bristol, Bristol, UK
| | - Lesel Dawson
- Department of English, School of Humanities, Faculty of Arts, University of Bristol, Bristol, UK
| | - Charlotte Chamberlain
- Palliative and End of Life Care Research Group, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Alison Rivett
- Public Engagement, University of Bristol, Bristol, UK
| | - Fiona Fox
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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8
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Levesque DA, Lunardini MM, Payne EL, Callison-Burch V. Grief Coach, a Text-Based Grief Support Intervention: Acceptability Among Hospice Family Members. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231159450. [PMID: 36867525 DOI: 10.1177/00302228231159450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
U.S. Medicare-certified hospices must provide bereavement care to family members for 13 months following a patient's death. This manuscript describes Grief Coach, a text message program that delivers expert grief support and can assist hospices in meeting the bereavement care mandate. It also describes the first 350 Grief Coach subscribers from hospice and the results of a survey of active subscribers (n = 154) to learn whether and how they found the program helpful. The 13-month program retention rate was 86%. Among survey respondents (n = 100, response rate = 65%), 73% rated the program as very helpful, and 74% rated it as contributing to their sense of being supported in their grief. Grievers aged 65+ and males gave the highest ratings. Respondents' comments identify key intervention content that they found helpful. These findings suggest that Grief Coach may be a promising component of hospice grief support programming to meet the needs of grieving family members.
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MacArthur ND, Kirby E, Mowll J. Bereavement affinities: A qualitative study of lived experiences of grief and loss. DEATH STUDIES 2023; 47:836-846. [PMID: 36327234 DOI: 10.1080/07481187.2022.2135044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Attending to bereaved peoples' lived experiences offers considerable potential for better understanding how to improve support following loss. In-depth interviews (n = 36) and solicited diaries (n = 23) were conducted with bereaved adults following a death in palliative or residential aged care. A constructivist grounded theory approach guided data analysis, through which three themes were derived: making sense of the lived experience of bereavement; relationships in bereavement; and bereavement over time. The results reveal the nuances within everyday experiences of bereavement, in particular the multiplicity of affinities, present or lacking, in social support and recognition.
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Affiliation(s)
- Nathan D MacArthur
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Emma Kirby
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Jane Mowll
- School of Social Sciences, University of New South Wales, Sydney, Australia
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Harrop E, Goss S, Farnell D, Longo M, Byrne A, Barawi K, Torrens-Burton A, Nelson A, Seddon K, Machin L, Sutton E, Roulston A, Finucane A, Penny A, Smith KV, Sivell S, Selman LE. Support needs and barriers to accessing support: Baseline results of a mixed-methods national survey of people bereaved during the COVID-19 pandemic. Palliat Med 2021; 35:1985-1997. [PMID: 34676792 PMCID: PMC8637353 DOI: 10.1177/02692163211043372] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The COVID-19 pandemic is a mass bereavement event which has profoundly disrupted grief experiences. Understanding support needs and access to support among people bereaved at this time is crucial to ensuring appropriate bereavement support infrastructure. AIM To investigate grief experiences, support needs and use of formal and informal bereavement support among people bereaved during the pandemic. DESIGN Baseline results from a longitudinal survey. Support needs and experiences of accessing support are reported using descriptive statistics and thematic analysis of free-text data. SETTING/PARTICIPANTS 711 adults bereaved in the UK between March and December 2020, recruited via media, social media, national associations and community/charitable organisations. RESULTS High-level needs for emotional support were identified. Most participants had not sought support from bereavement services (59%, n = 422) or their General-Practitioner (60%, n = 428). Of participants who had sought such support, over half experienced difficulties accessing bereavement services (56%, n = 149)/General-Practitioner support (52%, n = 135). About 51% reported high/severe vulnerability in grief; among these, 74% were not accessing bereavement or mental-health services. Barriers included limited availability, lack of appropriate support, discomfort asking for help and not knowing how to access services. About 39% (n = 279) experienced difficulties getting support from family/friends, including relational challenges, little face-to-face contact and disrupted collective mourning. The perceived uniqueness of pandemic bereavement and wider societal strains exacerbated their isolation. CONCLUSIONS People bereaved during the pandemic have high levels of support needs alongside difficulties accessing support. We recommend increased provision and tailoring of bereavement services, improved information on support options and social/educational initiatives to bolster informal support and ameliorate isolation.
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Affiliation(s)
- Emily Harrop
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Silvia Goss
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | | | - Mirella Longo
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Anthony Byrne
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Kali Barawi
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Anna Torrens-Burton
- PRIME Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Annmarie Nelson
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Kathy Seddon
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | | | - Eileen Sutton
- Palliative and End of Life Care Research Group, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Anne Finucane
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Alison Penny
- National Bereavement Alliance/Childhood Bereavement Network, London, UK
| | - Kirsten V Smith
- Centre for Anxiety Disorders and Trauma, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Stephanie Sivell
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Lucy E Selman
- Palliative and End of Life Care Research Group, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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McLean E, Singer J, Laurita E, Kahler J, Levin C, Papa A. Perception of grief responses: Are maladaptive grief responses and the stages of grief considered normal? DEATH STUDIES 2021; 46:1414-1423. [PMID: 34632956 DOI: 10.1080/07481187.2021.1983890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Literature indicates laypeople hold strong opinions about how persons should grieve. This study examined how individuals perceive normal grief. Participants across two distinct samples (Study 1: N = 510 via MTurk; Study 2: N = 210 via Qualtrics panels) completed the Perception of Grief Scale and Grief Expectations Questionnaire. Findings indicated participants endorsed maladaptive grief responses as normal relative to other responses to loss. Endorsement of maladaptive grief responses as normal predicted endorsement of grief work beliefs. If social expectations deem maladaptive grief to be normal, as this study suggests, bereaved individuals might implicitly push themselves to grieve maladaptively.
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Affiliation(s)
| | - Jonathan Singer
- Department of Psychology, Texas Tech University, Lubbock, TX, USA
| | - Emily Laurita
- Department of Psychology, University of Nevada, Reno, NV, USA
| | - Julie Kahler
- Health Services Research and Development, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
| | - Crissa Levin
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Anthony Papa
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
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12
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Jordan TR, Wotring AJ, McAfee CA, Polavarapu M, Cegelka D, Wagner-Greene VR, Hamdan Z. The COVID-19 pandemic has changed dying and grief: Will there be a surge of complicated grief? DEATH STUDIES 2021; 46:84-90. [PMID: 34027825 DOI: 10.1080/07481187.2021.1929571] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Worldwide, more than 3 million people have died from COVID-19. Each decedent represents a person who was loved, will be missed, and whose death elicited grief. COVID-19 has changed the way we die and grieve. Many people have died without family members and friends present and many of the bereft have grieved and mourned alone. Individuals and communities have experienced multiple losses within a short time while suffering from concomitant stress, anxiety, and depression. More deaths and more grief will continue in the foreseeable future. Preventive education is needed to prepare for and manage the likely increase in complicated grief.
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Affiliation(s)
- Timothy R Jordan
- School of Population Health, University of Toledo, Toledo, Ohio, Toledo
| | - Amy J Wotring
- Department of Applied Sciences, Indiana State University, Terre Haute, Indiana, USA
| | - Colette A McAfee
- School of Nursing and Health Sciences, Westminster College, Salt Lake City, Utah, USA
| | | | - Derek Cegelka
- Department of Kinesiology and Health Science, Stephen F. Austin State University, Nacogdoches, Texas, USA
| | - Victoria R Wagner-Greene
- Department of Kinesiology and Health Science, Stephen F. Austin State University, Nacogdoches, Texas, USA
| | - Zena Hamdan
- Department of Health Administration, Capella University, Minneapolis, Minnesota, USA
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13
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Breen LJ. Harnessing social support for bereavement now and beyond the COVID-19 pandemic. Palliat Care Soc Pract 2021; 15:2632352420988009. [PMID: 34104884 PMCID: PMC8164552 DOI: 10.1177/2632352420988009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lauren J. Breen
- School of Psychology, Curtin University, GPO Box
U1987, Perth, WA 6845, Australia
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14
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Kustanti CY, Fang H, Linda Kang X, Chiou J, Wu S, Yunitri N, Chu H, Chou K. The Effectiveness of Bereavement Support for Adult Family Caregivers in Palliative Care: A Meta‐Analysis of Randomized Controlled Trials. J Nurs Scholarsh 2021; 53:208-217. [DOI: 10.1111/jnu.12630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Christina Yeni Kustanti
- PhD Student of School of Nursing, College of Nursing Taipei Medical University, Taipei, Taiwan and Lecturer of Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum Yogyakarta Indonesia
| | - Hui‐Fen Fang
- Director of Nursing department, Taipei Cancer Center, Taipei Medical University, Deputy Director of Cancer Center, Taipei Medical University Hospital and Deputy Director of Nursing Service Taipei Medical University Hospital Taipei Taiwan
| | - Xiao Linda Kang
- Postdoctoral Researcher of School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan and School of Nursing University of Pennsylvania USA
| | - Jeng‐Fong Chiou
- Professor, Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University and Attending Physician, Department of Radiation Oncology Taipei Medical University Hospital Taipei Taiwan
| | - Shen‐Chi Wu
- Attending Physician of Department of Palliative Medicine Division Taipei Medical University Hospital, Taipei Medical University Taipei Taiwan
| | - Ninik Yunitri
- PhD Student of School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan and Lecturer of Mental Health and Psychiatric Nursing Department, Faculty of Nursing Universitas Muhammadiyah Jakarta Indonesia
| | - Hsin Chu
- Associate Professor of Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan and Attending Physician of Department of Neurology Tri‐Service General Hospital, National Defense Medical Center Taipei Taiwan
| | - Kuei‐Ru Chou
- Lambda Beta‐at‐Large Distinguished Professor of School of Nursing and Dean of College of Nursing, Taipei Medical University, Taipei, Taiwan and Vice Director of Department of Nursing, Taipei Medical University‐Shuang Ho Hospital, New Taipei City, Taiwan and Center for Nursing and Healthcare Research in Clinical Practice Application Wan Fang Hospital Taipei Medical University, Taipei, Taiwan and Psychiatric Research Center, Taipei Medical University Hospital Taipei Taiwan
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15
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Aoun SM, Keegan O, Roberts A, Breen LJ. The impact of bereavement support on wellbeing: a comparative study between Australia and Ireland. Palliat Care Soc Pract 2020; 14:2632352420935132. [PMID: 32783026 PMCID: PMC7385836 DOI: 10.1177/2632352420935132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022] Open
Abstract
Background: There is a dearth of national and international data on the impact of social support on physical, mental, and financial outcomes following bereavement. Methods: We draw from two large, population-based studies of bereaved people in Australia and Ireland to compare bereaved people’s experience of support. The Australian study used a postal survey targeting clients of six funeral providers and the Irish study used telephone interviews with a random sample of the population. Results: Across both studies, the vast majority of bereaved people reported relying on informal supporters, particularly family and friends. While sources of professional help were the least used, they had the highest proportions of perceived unhelpfulness. A substantial proportion, 20% to 30% of bereaved people, reported worsening of their physical and mental health and about 30% did not feel their needs were met. Those who did not receive enough support reported the highest deterioration in wellbeing. Discussion: The compassionate communities approach, which harnesses the informal resources inherent in communities, needs to be strengthened by identifying a range of useful practice models that will address the support gaps. Ireland has taken the lead in developing a policy framework providing guidance on level of service provision, associated staff competencies, and training needs.
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Affiliation(s)
- Samar M Aoun
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia
| | - Orla Keegan
- Irish Hospice Foundation, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Lauren J Breen
- School of Psychology, Curtin University, Perth, WA, Australia
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16
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Morrigan B, Keesing S, Breen LJ. Exploring the Social Networks of Bereaved Spouses: Phenomenological Case Studies. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:268-284. [PMID: 32698677 DOI: 10.1177/0030222820944062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bereavement is a significant stressor that can affect and be affected by social support, yet there is little known about the social networks of bereaved individuals. We conducted an in-depth qualitative examination of the social networks of bereaved spouses through an interpretive phenomenological analysis. Five participants were interviewed about their social networks prior to and following bereavement. Participants described considerable changes in their social networks. They reported connecting with others who had experienced similar stressors, including via online support groups for widows/widowers, as a key strategy for re-engagement with their social worlds. The death of a spouse can precipitate the dramatic reorganization of social networks to incorporate and adapt to this crisis. Findings offer guidance for service providers to support bereaved spouses to harness existing social networks to optimize received support.
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Affiliation(s)
| | - Sharon Keesing
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Lauren J Breen
- School of Psychology, Curtin University, Perth, Australia
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17
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Holm M, Weber Falk M, Lövgren M, Kreicbergs U, Alvariza A, Sveen J. Sources of social support and its importance for cancer-bereaved spouses and their minor children: A cross-sectional study. DEATH STUDIES 2020; 46:996-1002. [PMID: 32552419 DOI: 10.1080/07481187.2020.1780344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to evaluate the sources from which bereaved families with minor children reported receiving social support after the death of a parent/partner and which sources they perceived as important. Using an online platform, 23 adolescents, 42 parents, and 27 parent proxies for children aged 4-11 years, completed questionnaires. Family and friends were valued as the most important sources of social support, while social support from societal institutions, such as health care and school, was considered less important, and insufficient.
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Affiliation(s)
- Maja Holm
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Department of Nursing Sciences, Sophiahemmet University, Stockholm, Sweden
| | - Megan Weber Falk
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institute, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institute, Stockholm, Sweden
| | - Anette Alvariza
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Capio Palliative Care Unit, Dalen Hospital, Stockholm, Sweden
| | - Josefin Sveen
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Department of Neuroscience, National Center for Disaster Psychiatry, Uppsala University, Uppsala, Sweden
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18
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Beaunoyer E, Hiracheta Torres L, Maessen L, Guitton MJ. Grieving in the digital era: Mapping online support for grief and bereavement. PATIENT EDUCATION AND COUNSELING 2020; 103:S0738-3991(20)30331-1. [PMID: 32591255 DOI: 10.1016/j.pec.2020.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To describe the landscape of digital resources available for grief and bereavement, and to explore cultural variations through the analysis of patterns in three languages with a multinational repartition (English, French and Spanish). METHODS For each language, websites were collected through a systematized approach and classified according to their category (governmental, health, educational, social media, conventional media, spiritual), their country of origin, and the type of support they offered (practical support, services, peer support, informational support, resources). RESULTS A total of 2587 websites (English: 1003; French 678; Spanish: 906) were analyzed. Cultural variations were observed both for the websites' categories and the types of support. Half of the websites presented at least one type of support, informational support being the most prevalent, followed by practical support. English websites presented significantly more support than Spanish websites, with French websites in between. PRACTICE IMPLICATIONS By using an extensive survey, our results allow for a general mapping of online websites that is comparable across languages, but also unveil digital dynamics unknown to date. These results further the multicultural understanding of digital support for grief and bereavement, propose an innovative and operational typology for online support and raise awareness of the current support landscape.
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Affiliation(s)
- Elisabeth Beaunoyer
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada; Faculty of Nursing, Université Laval, Quebec City, QC, Canada; CERVO Brain Research Center, Quebec City, QC, Canada
| | | | - Lenn Maessen
- Faculty of Medicine, Hasselt University, Hasselt, Belgium
| | - Matthieu J Guitton
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada; CERVO Brain Research Center, Quebec City, QC, Canada.
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19
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Hayden L, Dunne S. "Dying With Dignity": A Qualitative Study With Caregivers on the Care of Individuals With Terminal Cancer. OMEGA-JOURNAL OF DEATH AND DYING 2020; 84:1122-1145. [PMID: 32493167 DOI: 10.1177/0030222820930135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to examine family members' attitudes and perceptions regarding their choice of care in the event of terminal illness, based on their experience in a caregiver's role, while a loved one was terminally ill. All participants (N = 10) had cared for an immediate family member with terminal cancer. Snowball sampling was used. Qualitative data were collected through in-depth, semi-structured interviews. The data were transcribed verbatim and analyzed using thematic analysis. Five themes were identified from the data. These included two themes relating to participants' experience of care, two themes in relation to participants' attitudes toward the type of care they experienced and a final theme related to the role of religion and spirituality in dealing with loss. The findings of this study support the integration of multidisciplinary healthcare teams and the introduction of holistic care as early as possible within hospitals for individuals with terminal cancer, using the biopsychosocial-spiritual model.
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Affiliation(s)
- Lucy Hayden
- School of Psychology, Dublin City University
| | - Simon Dunne
- School of Psychology, Dublin City University
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20
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Breen LJ, Moullin JC. The value of implementation science in bridging the evidence gap in bereavement care. DEATH STUDIES 2020; 46:639-647. [PMID: 32250203 DOI: 10.1080/07481187.2020.1747572] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is a gap in the use of evidence in bereavement care. Implementation science is a field focused on moving evidence into practice and therefore may help close the gap. Implementation science advances the design, relevance, and dissemination of research and the adoption, implementation, and maintenance of evidence-based practices. We provide an overview of implementation science, describe five implementation frameworks (Knowledge to Action; Behavior Change Wheel; Exploration Preparation Implementation Sustainment; Interactive Systems Framework; and Reach, Adoption, Implementation, Maintenance), and illustrate their application in bereavement care. These advancements will promote high-quality bereavement care that improves the lives of bereaved people.
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Affiliation(s)
- Lauren J Breen
- School of Psychology, Curtin University, Perth, Australia
| | - Joanna C Moullin
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Australia
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21
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Breen LJ, Aoun SM, O'Connor M, Johnson AR, Howting D. Effect of caregiving at end of life on grief, quality of life and general health: A prospective, longitudinal, comparative study. Palliat Med 2020; 34:145-154. [PMID: 31659934 DOI: 10.1177/0269216319880766] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Determining the effect of caregiving and bereavement remains a challenge. To date, no study has employed a comparison group to investigate caregivers' grief, quality of life and general health in relation to non-caregivers. AIM We aimed to determine how caregivers' grief, quality of life and general health changed following death compared to non-caregivers and whether pre-death grief predicted these outcomes. DESIGN A prospective, longitudinal study of family caregivers and a comparison group matched for age, gender and postcode was conducted. All participants completed questionnaires at four points - once pre-death and three times post-death (3-4 months, 6-7 months and 9-10 months). SETTING/PARTICIPANTS Participants (N = 70) were family caregivers of persons receiving palliative care, mostly for cancer, recruited from three palliative care providers in Western Australia and matched comparisons recruited from advertisements. RESULTS There were significant differences between the caregivers' and comparisons' grief, general health and quality of life at pre-death, 3-4 months and 6-7 months post-death, but not at 9-10 months post-death. The rate of progression in these constructs following death was independent from the intensity of pre-death grief. However, caregiver prolonged grief score significantly predicted prolonged grief score at 6-7 and 9-10 months post-death. CONCLUSION It took 9-10 months for the caregivers' grief, general health and quality of life to correspond to the comparison group. These findings present an opportunity for palliative care research and practice to consider how best to support the majority of caregivers without grief complications so that their pre- and post-death support needs are realised.
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Affiliation(s)
- Lauren J Breen
- School of Psychology, Curtin University, Perth, WA, Australia
| | - Samar M Aoun
- Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.,The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
| | - Moira O'Connor
- School of Psychology, Curtin University, Perth, WA, Australia
| | | | - Denise Howting
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia.,Centre for Medical Research, The University of Western Australia, Perth, WA, Australia.,Harry Perkins Institute of Medical Research, Perth, WA, Australia
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22
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Hay A, Hall CW, Sealey M, Lobb EA, Breen LJ. Developing a practice-based research agenda for grief and bereavement care. DEATH STUDIES 2019; 45:331-341. [PMID: 31293223 DOI: 10.1080/07481187.2019.1636897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We aimed to identify practitioners' perspectives on current research priorities in grief and bereavement care. Grief and bereavement care providers were invited to participate in a three-phase Delphi study to create expert consensus on the top priorities for grief and bereavement research. A total of 140 participants completed Phase 1, 84 completed Phase 2, and 70 completed Phase 3. These top 10 research priorities form the basis of a practice-based research agenda for grief and bereavement care to enable researchers to respond to key issues in grief and bereavement care that will ultimately improve the lives of bereaved people.
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Affiliation(s)
- Ashton Hay
- School of Psychology, Curtin University, Perth, Australia
| | | | - Margaret Sealey
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
| | - Elizabeth A Lobb
- Calvary Health Care Kogarah, Kogarah, Australia
- Cunningham Centre for Palliative Care, Darlinghurst, Australia
- School of Medicine, University of Notre Dame Sydney, Darlinghurst, Australia
| | - Lauren J Breen
- School of Psychology, Curtin University, Perth, Australia
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23
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Erikson A, Puntillo K, McAdam J. Family members' opinions about bereavement care after cardiac intensive care unit patients' deaths. Nurs Crit Care 2019; 24:209-221. [DOI: 10.1111/nicc.12439] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Alyssa Erikson
- Department of NursingCalifornia State University Monterey Bay, Seaside California
| | - Kathleen Puntillo
- Department of NursingUniversity of California San Francisco California
| | - Jennifer McAdam
- Department of NursingSamuel Merritt University Oakland California
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24
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Matching response to need: What makes social networks fit for providing bereavement support? PLoS One 2019; 14:e0213367. [PMID: 30845193 PMCID: PMC6405096 DOI: 10.1371/journal.pone.0213367] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 02/19/2019] [Indexed: 11/29/2022] Open
Abstract
The objectives of this study were to explore the goodness of fit between the bereaved peoples’ needs and the support offered by their social networks; to ascertain whether this support was experienced as helpful or unhelpful by bereaved people; and to explore both the types of social networks that offer effective support and the characteristics of the communities that encourage and nurture such networks. This study was based on qualitative interviews from twenty bereaved people, in Western Australia, interviewed in 2013. A framework analysis of these interviews was undertaken using a deductive approach based on the goodness of fit framework. Much of this support is provided informally in community settings by a range of people already involved in the everyday lives of those recently bereaved; and that support can be helpful or unhelpful depending on its amount, timing, function and structure. Improving the fit between the bereaved person’s needs and the support offered may thus involve identifying and enhancing the caring capacity of existing networks. An important strategy for achieving this is to train community members in mapping and developing these naturally occurring networks. Some such networks will include relationships of long standing, others may be circles of care formed during a period of caring. Peer support bereavement networks develop from these existing networks and may also recruit new members who were not part of the caring circle. The findings endorse social models of bereavement care that fit within a public health approach rather than relying solely on professional care. As exemplified by Compassionate Communities policies and practices, establishing collaboration between community networks and professional services is vital for effective and sustainable bereavement care.
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25
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Ware OD, Cagle JG. Informal Caregiving Networks for Hospice Patients With Cancer and Their Impact on Outcomes: A Brief Report. Am J Hosp Palliat Care 2019; 36:235-240. [DOI: 10.1177/1049909118792011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This prospective study investigates informal care networks and their impact on hospice outcomes. Primary caregivers (N = 47) were the main source of data from 2 time points: within a week of enrollment in hospice and bereavement. Data were also collected from 42 secondary caregivers. Intraclass correlation coefficients (ICCs) determined correspondence between primary and secondary caregivers regarding informal care network size. Correlations were used to test associations between variables. Nonparametric paired sample tests were used to analyze change in anger and guilt. The ICC found poor correspondence (−0.13) between primary and secondary caregivers’ network descriptions. Correlational analyses found a strong/moderate negative association between quality of dying (QOD) and grief ( r = −0.605, P < .05). Study participants reported increased anger (0.4, P < .05, range 1-5) and guilt (0.4, P < .05, range 1-5), particularly among caregivers with high levels of support. Findings suggest that improving QOD may facilitate postdeath coping for caregivers.
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Affiliation(s)
- Orrin D. Ware
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - John G. Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
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26
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Christian KM, Aoun SM, Breen LJ. How religious and spiritual beliefs explain prolonged grief disorder symptoms. DEATH STUDIES 2018; 43:316-323. [PMID: 29757102 DOI: 10.1080/07481187.2018.1469054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study investigated the importance of religious and spiritual beliefs in daily life in explaining prolonged grief disorder (PGD) symptomatology. Participants were 588 bereaved adults who completed a questionnaire. The importance of spiritual beliefs in daily life explained a small to medium, significant 3% of variance in PGD symptoms, but religious beliefs in daily life did not. Individuals who placed moderate importance on spiritual beliefs in their daily life may experience more intense grief.
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Affiliation(s)
- Kim M Christian
- a School of Psychology , Curtin University , Perth , Australia
| | - Samar M Aoun
- b School of Psychology and Public Health , La Trobe University , Victoria , Australia
- c Institute for Health Research , Notre Dame University , Western Australia , Australia
| | - Lauren J Breen
- a School of Psychology , Curtin University , Perth , Australia
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27
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Pooler C, Richman-Eisenstat J, Kalluri M. Early integrated palliative approach for idiopathic pulmonary fibrosis: A narrative study of bereaved caregivers' experiences. Palliat Med 2018; 32:1455-1464. [PMID: 30056786 DOI: 10.1177/0269216318789025] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis has an uncertain and rapid trajectory after diagnosis. Palliative care is rarely utilized, although both patients and caregivers experience a distressingly high symptom burden. Most patients die in hospital. AIM The purpose of this study was to explore bereaved caregivers' experiences and perceptions of an early integrated palliative approach implemented at a Multidisciplinary Interstitial Lung Disease Clinic. DESIGN A narrative approach was used, with thematic and content analysis of open-ended interviews. SETTING/PARTICIPANTS The clinic is located in a large western Canadian city. Caregivers of deceased patients were recruited through purposive sampling. The eight participants were either spouses or adult children. RESULTS Five major themes were identified: Having a Terminal Disease; Planning Goals and Wishes for Care; Living Life and Creating Memories; Feeling Strain and Responsibility; and Nearing the End. Caregivers had little understanding of prognosis prior to advance care planning conversations at the clinic. Advance care planning conversations enabled caregivers to know and support patients' goals and wishes. Caregivers described feeling informed, prepared, and supported when death was near. They expressed neither distress nor anxiety related to patients' symptoms or strain of relationships. CONCLUSION Collaboration and close communication among caregivers, respirologists, and home care enabled effective symptom management and out of hospital deaths. Patients and caregivers had opportunities to enjoy events, create memories, determine preferences, and make plans. Further research on an early integrated palliative approach in Idiopathic Pulmonary Fibrosis is warranted related to quality of life, experience with death and dying, and caregiver bereavement.
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Affiliation(s)
- Charlotte Pooler
- 1 Palliative and End of Life Care & Community Programs, Continuing Care, Alberta Health Services, Edmonton, AB, Canada
| | - Janice Richman-Eisenstat
- 2 Faculty of Medicine & Dentistry, University of Alberta.,3 Alberta Health Services, Edmonton, AB, Canada
| | - Meena Kalluri
- 2 Faculty of Medicine & Dentistry, University of Alberta.,3 Alberta Health Services, Edmonton, AB, Canada
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28
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Logan EL, Thornton JA, Kane RT, Breen LJ. Social support following bereavement: The role of beliefs, expectations, and support intentions. DEATH STUDIES 2018; 42:471-482. [PMID: 28985147 DOI: 10.1080/07481187.2017.1382610] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Social support is one of the strongest determinants of bereavement outcomes, yet little is understood about the community's recognition of grief and intentions to provide social support to grieving persons. A total of 476 adults responded to an online vignette and questionnaire measuring grief norms and supportive intentions. Respondent gender, age, and bereavement status all had some association with expectations of grief, intentions to support, perceived helpfulness of support attempts, and opinions toward the diagnostic classification of grief. Given that most bereavement support is informal, this study informs the development of community capacity to provide constructive, timely bereavement support.
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Affiliation(s)
- Emma L Logan
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia , Australia
| | - Jennifer A Thornton
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia , Australia
| | - Robert T Kane
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia , Australia
| | - Lauren J Breen
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia , Australia
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29
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Breen LJ, Szylit R, Gilbert KR, Macpherson C, Murphy I, Nadeau JW, Reis E Silva D, Wiegand DL. Invitation to grief in the family context. DEATH STUDIES 2018; 43:173-182. [PMID: 29733763 DOI: 10.1080/07481187.2018.1442375] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Grief is a family affair, yet it is commonly viewed as an individual phenomenon. As an international, interdisciplinary team, we explore grief within a family context across theoretical, research, practice, and educational domains. Families are complex and working with this complexity is challenging but necessary for a holistic view of grief. We therefore encourage an increased focus on theorizing, researching, practicing, and educating using innovative approaches to address the complexities of grief within the context of families. Learnings from within each domain will affirm and enhance the development of family-level thinking and approaches.
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Affiliation(s)
- Lauren J Breen
- a School of Psychology , Curtin University , Perth, Western Australia, Australia
| | - Regina Szylit
- b School of Nursing, University of São Paulo , São Paulo , Brazil
| | | | - Catriona Macpherson
- d Fife Specialist Palliative Care, Victoria Hospice, Kirkcaldy , Fife , Scotland
| | - Irene Murphy
- e Marymount University Hospital and Hospice , Cork , Ireland
| | | | - Daniela Reis E Silva
- g Laboratory for Research and Intervention on Grief and Bereavement, Pontifical Catholic University of São Paulo, São Paulo , Brazil
| | - Debra L Wiegand
- h School of Nursing , University of Maryland , Baltimore, Maryland, USA
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30
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Logan EL, Thornton JA, Breen LJ. What determines supportive behaviors following bereavement? A systematic review and call to action. DEATH STUDIES 2018; 42:104-114. [PMID: 28494205 DOI: 10.1080/07481187.2017.1329760] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Very few factors that impact the grieving process can be modified after the fact to the extent that social support can. However, social support has received limited research attention, resulting in little conceptual understanding of the mechanisms behind perceptions of, and intentions to support, grieving persons. This systematic review aimed to explore bereaved, decedent, and respondent-related determinants of the provision of social support. The review yielded 42 studies impacted by various methodological and sampling limitations. This review poses a call to the field for more rigorous study of social support determinants to better assist the bereaved and their natural supporters.
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Affiliation(s)
- Emma L Logan
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia , Australia
| | - Jennifer A Thornton
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia , Australia
| | - Lauren J Breen
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia , Australia
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31
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Bereavement support for family caregivers: The gap between guidelines and practice in palliative care. PLoS One 2017; 12:e0184750. [PMID: 28977013 PMCID: PMC5627900 DOI: 10.1371/journal.pone.0184750] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/30/2017] [Indexed: 11/28/2022] Open
Abstract
Background Standards for bereavement care propose that support should be matched to risk and need. However, studies in many countries demonstrate that palliative care services continue to adopt a generic approach in offering support to bereaved families. Objective To identify patterns of bereavement support in palliative care services based upon the experience of bereaved people from a population based survey and in relation to clinical practice guidelines. Design An anonymous postal survey collected information from clients of six funeral providers in four Australian states (2014–15), 6 to 24 months after the death of their family member or friend, with 1,139 responding. Responses from 506 bereaved relatives of people who had terminal illnesses were analysed. Of these, 298 had used palliative care services and 208 had not. Results More people with cancer (64%) had received palliative care in comparison to other illnesses such as heart disease, dementia and organ failure (4–10%). The support for family caregivers before and after their relative’s death was not considered optimal. Only 39.4% of the bereaved reported being specifically asked about their emotional/ psychological distress pre-bereavement, and just half of the bereaved perceived they had enough support from palliative care services. Half of the bereaved had a follow up contact from the service at 3–6 weeks, and a quarter had a follow-up at 6 months. Their qualitative feedback underlined the limited helpfulness of the blanket approach to bereavement support, which was often described as “not personal” or “generic”, or “just standard practice”. Conclusions Timeliness and consistency of relationship is crucial to building rapport and trust in the service’s ability to help at post-bereavement as well as a focus on the specific rather than the generic needs of the bereaved. In light of these limitations, palliative care services might do better investing their efforts principally in assessing and supporting family caregivers during the pre-bereavement period and developing community capacity and referral pathways for bereavement care. Our findings suggest that bereavement support in Australian palliative care services has only a tenuous relationship with guidelines and assessment tools, a conclusion also drawn in studies from other countries, emphasizing the international implications of our study.
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The meaning and experience of bereavement support: A qualitative interview study of bereaved family caregivers. Palliat Support Care 2017. [DOI: 10.1017/s1478951517000475] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:Experiences of bereavement can be stressful and are frequently complicated by emotional, familial, and financial issues. Some—though not all—caregivers may benefit from bereavement support. While considered standard within palliative care services in Australia, bereavement support is not widely utilized by family caregivers. There is little research focused on the forms of bereavement support desired or required by family caregivers, how such care is viewed, and/or how bereavement support is experienced. This study examined the experiences of bereaved family caregivers and their impressions of and interactions with bereavement support.Method:This paper reports on one aspect of a broader study designed to explore a range of experiences of patients and caregivers to and through palliative care. Focusing on experiences of bereavement, it draws on qualitative semistructured interviews with 15 family caregivers of palliative care patients within a specialist palliative care unit of an Australian metropolitan hospital. The interviews for this stage of the study were initiated 3–9 months after an initial interview with a family caregiver, during which time the palliative patient had died, and they covered family caregivers' experiences of bereavement and bereavement support. Interviews were digitally audiotaped and transcribed in full. A thematic analysis was conducted utilizing the framework approach wherein interview transcripts were reviewed, key themes identified, and explanations developed.Results:The research identified four prevalent themes: (1) sociocultural constructions of bereavement support as for the incapable or socially isolated; (2) perceptions of bereavement support services as narrow in scope; (3) the “personal” character of bereavement and subsequent incompatibility with formalized support, and (4) issues around the timing and style of approaches to being offered support.Significance of results:Systematic pre-bereavement planning and careful communication about the services offered by palliative care bereavement support centers may improve receipt of support among bereaved family caregivers in need.
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Götze H, Brähler E, Gansera L, Schnabel A, Gottschalk-Fleischer A, Köhler N. Anxiety, depression and quality of life in family caregivers of palliative cancer patients during home care and after the patient's death. Eur J Cancer Care (Engl) 2016; 27:e12606. [PMID: 27859889 DOI: 10.1111/ecc.12606] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 11/27/2022]
Abstract
We examined psychological parameters in family caregivers of palliative cancer patients before and after the death of the patients. Caregivers' data about depression and anxiety (Hospital Anxiety and Depression Scale), quality-of-life (Short Form-8 Health Survey), and social support (Oslo Social Support Scale) were collected at the beginning of home care (t1) and 2 months after the patient had died (t2). Regression models were employed to examine factors related to depression and anxiety in the bereaved caregivers. We interviewed 72 relatives, who were the primary caregiver of a patient. One-third (31.9%) of caregivers had high anxiety levels and 29.2% had high depression levels (t1, cut-off = 10). At t2, anxiety and depression had decreased significantly. There were no changes in quality-of-life over time. At both points of assessments, quality-of-life was lower than in the general population. Relevant factors for higher anxiety and depression in the bereaved caregivers were high levels of distress at t1, insufficient social support and low physical function. Bereaved caregivers were particularly depressed when they had been the spouse of the patient. Healthcare professionals should consider social isolation of caring relatives both during homecare and afterwards. Thus, it seems to be important to routinely offer support to spouses.
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Affiliation(s)
- H Götze
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany
| | - L Gansera
- Department of Psychiatry, Psychosomatics and Psychotherapy, HELIOS Park-Klinikum Leipzig, Leipzig, Germany
| | - A Schnabel
- Leipziger Palliativgesellschaft, Palliative Care Service (SAPV), Leipzig, Germany
| | - A Gottschalk-Fleischer
- Department of Internal Medicine, Muldentalkliniken, Medical Hospital Wurzen, Wurzen, Germany
| | - N Köhler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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