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Marek F, Oexle N. Supportive and non-supportive social experiences following suicide loss: a qualitative study. BMC Public Health 2024; 24:1190. [PMID: 38678182 PMCID: PMC11055309 DOI: 10.1186/s12889-024-18545-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Suicide bereavement entails profound social stressors, including stigma and communication barriers, which can impair social support for suicide loss survivors (SLS). Despite recognized benefits of empathetic interactions, social support, and self-disclosure in mitigating adverse mental health outcomes after suicide loss, we lack a comprehensive understanding of the factors influencing perceived social support among SLS within their broader social environments. To address this gap, our study explores the diverse social experiences of SLS beyond their immediate circles. Specifically, we identify characteristics that define both supportive and non-supportive social experiences of SLS, as well as the facilitators and barriers to social support in the context of suicide bereavement. METHODS In 2022, we conducted structured online individual interviews with a diverse sample of 18 SLS in Germany. We analyzed these interviews using qualitative content analysis. RESULTS We examined the social experiences of SLS across three phases and social contexts: (1) the immediate aftermath of the loss; (2) during bereavement practices; and (3) over time. Our findings show that proactive responses and personalized mourning rituals significantly enhance SLS' sense of community support, while encounters characterized by avoidance or intrusive curiosity lead to feelings of isolation. Over time, supportive interactions often emerge from peers with similar experiences, promoting openness and shared vulnerability. Conversely, superficial engagement, along with experiences of others depersonalizing and avoiding conversations about the loss, contribute to a sense of marginalization. CONCLUSIONS Our findings highlight the importance of proactive engagement and open dialogue, calling for societal and communicative shifts toward inclusive and compassionate approaches in addressing suicide loss. This study underscores the need for comprehensive strategies that enhance both suicide and grief literacy and address the taboo and stigma surrounding suicide, ultimately fostering supportive social environments for SLS.
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Affiliation(s)
- Franziska Marek
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm/Guenzburg, Germany.
| | - Nathalie Oexle
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm/Guenzburg, Germany
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Reblin M, Wong A, Arnoldy F, Pratt S, Dewoolkar A, Gramling R, Rizzo DM. The StoryListening Project: Feasibility and Acceptability of a Remotely Delivered Intervention to Alleviate Grief during the COVID-19 Pandemic. J Palliat Med 2023; 26:327-333. [PMID: 36067079 DOI: 10.1089/jpm.2022.0261] [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: 11/13/2022] Open
Abstract
Background: The events surrounding the COVID-19 pandemic have created heightened challenges to coping with loss and grief for family and friends of deceased individuals, as well as clinicians who experience loss of their patients. There is an urgent need for remotely delivered interventions to support those experiencing grief, particularly due to growing numbers of bereaved individuals during the COVID-19 pandemic. Objective: To determine the feasibility and acceptability of the brief, remotely delivered StoryListening storytelling intervention for individuals experiencing grief during the COVID pandemic. Setting/Subjects: A single-arm pilot study was conducted in the United States. Participants included adult English-speaking family members, friends, or clinicians of individuals who died during the COVID-19 pandemic. All participants engaged in a televideo StoryListening session with a trained StoryListening doula. Measurements: Participants completed a brief follow-up telephone interview two weeks after the StoryListening session. We describe enrollment and retention data to assess feasibility and conducted a deductive thematic analysis of the follow-up interview data to assess acceptability. Results: Sixteen clinicians and 48 friends/family members enrolled in the study (n = 64; 75% enrollment), 62 completed a StoryListening session; 60 completed the follow-up interview. Participants reported that the intervention was useful and offered a valuable opportunity to process their grief experience. Conclusions: The StoryListening intervention is feasible and acceptable for friends/family members and clinicians who have experienced grief during COVID. Our intervention may offer an accessible first-line option to address the increasing wave of bereavement-related distress and clinician burnout in the United States.
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Affiliation(s)
- Maija Reblin
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
| | - Ann Wong
- College of Arts and Sciences, University of Vermont, Burlington, Vermont, USA.,Honors College, University of Vermont, Burlington, Vermont, USA
| | - Francesca Arnoldy
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
| | - Susanna Pratt
- Office of Clinical Trials Research, University of Vermont, Burlington, Vermont, USA
| | - Advik Dewoolkar
- Department of Electrical and Biomedical Engineering, and University of Vermont, Burlington, Vermont, USA.,Honors College, University of Vermont, Burlington, Vermont, USA
| | - Robert Gramling
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
| | - Donna M Rizzo
- Department of Civil Engineering, University of Vermont, Burlington, Vermont, USA
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Dominguez-Rodriguez A, Gómez Sanz S, González Ramírez LP, Herdoiza-Arroyo PE, Trevino L, de la Rosa-Gómez A, González-Cantero JO, Macias-Aguinaga V, Miaja Ávila M. The efficacy and usability of an unguided web-based grief intervention for adults who lost a loved one during the COVID-19 pandemic: A Randomized Controlled Trial. J Med Internet Res 2023; 25:e43839. [PMID: 36877800 PMCID: PMC10131766 DOI: 10.2196/43839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/24/2022] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The death of a loved one was a challenge many people faced during the COVID-19 pandemic within a context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms which may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed. OBJECTIVE The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish), in reducing clinical symptoms of complicated grief, depression, post-traumatic stress, hopelessness, anxiety, and suicidal risk in adults. A secondary aim was to validate the usability of the self-applied intervention system. METHODS We used a randomized controlled trial (RCT) with an intervention group (IG) and a waitlist control group (CG). The groups were assessed three times (prior to beginning the intervention, upon completing the intervention, and three months post-intervention). The intervention was delivered online in an asynchronous format through the webpage Duelo COVID-19. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention. RESULTS A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45 finished the intervention and n=69 completed the waitlist time period). The majority of participants were women (n=103, 90.4%). Results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables, with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at three months post-intervention. Results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist, but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, results indicated a high level of satisfaction with Grief COVID. CONCLUSIONS The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide, post-traumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional online psychological tools to help reduce clinical symptoms in people experiencing grief due to the loss of a loved one during a pandemic. CLINICALTRIAL The study is registered in Clinical trials (NCT04638842).
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Affiliation(s)
- Alejandro Dominguez-Rodriguez
- Department of Psychology, Health and Technology, University of Twente, Enschede, NL.,Health Sciences Area, Valencian International University, Valencia, ES
| | - Sergio Gómez Sanz
- Department of Psychiatry, Universidad de Sevilla, Seville, ES.,Health Sciences Area, Valencian International University, Valencia, ES
| | | | | | | | - Anabel de la Rosa-Gómez
- Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, MX
| | - Joel Omar González-Cantero
- Department of Behavioral Sciences, Centro Universitario de los Valles, Universidad de Guadalajara, Guadalajara, MX
| | | | - Melina Miaja Ávila
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Guadalajara, MX
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4
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Flaskerud JH. Post-Pandemic Psychosocial Issues. Issues Ment Health Nurs 2023; 44:130-133. [PMID: 35666683 DOI: 10.1080/01612840.2022.2082224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Salisbury MR, Harmsen CRW, Muller RT. Help-Seeking Buffers the Impact of Grief on Quality of Life: A Study of Loss During the COVID-19 Pandemic. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221146337. [PMID: 36534615 PMCID: PMC9780555 DOI: 10.1177/00302228221146337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic has presented a global challenge for anticipating the support and treatment needs of bereaved individuals. However, no studies have examined how mourners have been coping with grief and which strategies may buffer negative mental health consequences. We examined the various coping strategies being used and which strategies best support quality of life. Participants completed self-report measures of demographic and loss-related characteristics, grief symptoms, quality of life (QOL), and coping strategies used. Despite help-seeking being one of the least endorsed coping strategies used, help-seeking was the only coping strategy that buffered the impact of grief on QOL for individuals with high grief severity. Results support predictions that grief may become a global mental health concern requiring increased accessibility and availability of grief therapies and professional supports for bereaved individuals during and in the aftermath of the pandemic.
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Hajebi A, Rasoulian M, Fathi M, Tiyuri A, Abbasinejad M, Naserbakht M, Asadi A, Khademoreza N. Randomized controlled trial for the efficacy of three versus five sessions of grief counseling on the psychological aspects following COVID-19 bereavement: A study protocol. Front Psychiatry 2022; 13:1047448. [PMID: 36545034 PMCID: PMC9760675 DOI: 10.3389/fpsyt.2022.1047448] [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: 09/18/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, many people have experienced traumatic losses and therefore are at risk of developing complicated grief regarding the restrictions on the performance of routine mourning rituals. This study is a randomized controlled trial for assessing the efficacy of three versus five sessions of grief counseling on grief intensity, psychological distress, and quality of life of grief among bereaved people due to COVID-19. METHODS A total of 120 bereaved people, due to COVID-19, will be enrolled in this multi-center randomized controlled trial after assessment for inclusion and exclusion criteria. Following the informed consent procedure, participants will be allocated into two groups equally by the Stratified Balanced Block Randomization, one of them delivering a three-session grief counseling intervention and the other delivering a five-session grief counseling intervention. The intervention will be delivered by trained psychologists via in-person individual sessions. The primary outcome is grief intensity, and the secondary outcomes are psychological distress, quality of life, and satisfaction of the participants. These outcomes will be measured by the Grief Intensity Scale (GIS), the General Health Questionnaire-28 (GHQ-28), the Short Form Health Survey-12 (SF-12), and the Client Satisfaction Questionnaire (CSQ-8), respectively. The assessments will be done at three time points, one before the intervention and the others 1 month and 3 months after the intervention. The data will be analyzed using the SPSS V.18 and Stata V.11 software. The analysis approach will be "intention to treat." DISCUSSION Results of this study can be applied for selecting the most suitable intervention leading to the prevention of complicated grief and the maintenance and promotion of the mental health of bereaved people due to COVID-19. CLINICAL TRIAL REGISTRATION [irct.ir], identifier [IRCT20200505047305N1].
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Affiliation(s)
- Ahmad Hajebi
- Research Center for Addiction & Risky Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Rasoulian
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Marjan Fathi
- Health Deputy, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Tiyuri
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Abbasinejad
- Department for Mental Health and Substance Abuse, Ministry of Health and Medical Education, Tehran, Iran
| | - Morteza Naserbakht
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Asadi
- Department for Mental Health and Substance Abuse, Ministry of Health and Medical Education, Tehran, Iran
| | - Nooshin Khademoreza
- Mental Health Research Center, Psychosocial Health Research Institute, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
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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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