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Wilson DM, Knox M, Banamwana G, Brown CA, Errasti-Ibarrondo B. Humor: A Grief Trigger and Also a Way to Manage or Live With Your Grief. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:514-529. [PMID: 35235471 PMCID: PMC11100260 DOI: 10.1177/00302228221075276] [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: 11/16/2022]
Abstract
In 2020-2021, a qualitative study was undertaken using an interpretive description methodology to identify what triggers grief in the first 2 years following the death of a beloved family member, and to gain other helpful insights about grief triggers from bereaved Canadian adult volunteers. In that study, a purposive sampling method was used to select 10 bereaved Canadian adult volunteers for in-depth, semi-structured interviews. This paper reports on the humor findings, as revealed to be a particularly complex grief trigger for many participants, as well as a periodic way for most to manage or live with their grief. Participant quotes and an extended discussion are included to illustrate the importance of these humor findings in relation to grief, and to inform bereaved people, bereavement service providers, and the general public about both helpful aspects and some cautionary considerations about humor.
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Affiliation(s)
- Donna M. Wilson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Michelle Knox
- Faculty of of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Cary A. Brown
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Hansen KL, Guldin MB, Fosgerau CF. Grief participation rights and the social support hierarchy: Exploring the communicative role of the bereaved in a social support interaction. DEATH STUDIES 2024; 48:465-477. [PMID: 37471460 DOI: 10.1080/07481187.2023.2235582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
This article explores how bereaved individuals co-construct social support and social norms in the social interaction of 14 bereavement group meetings in Denmark. To study this, we used a discourse analytical approach focusing on how the participants position their social supporters. The results show that the participants designate, uphold, and presuppose two hierarchical positions to bereaved and non-bereaved supporters with different abilities to understand them. Based on this finding, the concepts of "grief participation rights" and "social support hierarchy" are proposed to supplement existing notions of "rights to grieve" and "grief hierarchy." These concepts suggest that non-bereaved supporters are not accorded the same participatory rights in social support conversations as bereaved individuals who have suffered a similar loss as the speaker. The concepts are discussed in relation to effective social support and in the context of research on social disconnection in grief.
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Affiliation(s)
- Kathrine Lund Hansen
- Department of Nordic Studies and Linguistics, Copenhagen University, Copenhagen, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
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Marinaci T, Venuleo C, Rollo S, Ferrante L, Semeraro CG, Infurna MR, Nogueira DCOA. Supporting bereaved people: a qualitative study on the experience of informal support providers, before and during the pandemic scenario. DEATH STUDIES 2023; 48:250-266. [PMID: 37226959 DOI: 10.1080/07481187.2023.2216172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The COVID-19 outbreak has further highlighted the need to strengthen support networks to sustain grieving people. However, we know very little about the experience of those who, because of their emotional connection with the bereaved person or of their social function, find themselves supporting people in grief. The current study aimed to analyze the experience of grievers' informal support providers (relatives and friends, teachers, religious leaders, funeral providers, pharmacists, volunteers, and social service workers). 162 in-depth interviews were collected (meanage = 42.3, SD = 14.9; women = 63.6%). Findings highlight two different ways of talking about one's experience and two different ways of offering support. Such dissimilarities do not relate to the period in which support was offered (before or during the pandemic). The results will be discussed in order to highlight emerging training needs to support bereaved people in their difficult transition.
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Affiliation(s)
- Tiziana Marinaci
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Claudia Venuleo
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Simone Rollo
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Lucrezia Ferrante
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | | | - Maria Rita Infurna
- Department of Psychological, Educational, Physical Exercise and Training Sciences, University of Palermo, Palermo, Italy
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Breen LJ, Greene D, Rees CS, Black A, Cawthorne M, Egan SJ. A co-designed systematic review and meta-analysis of the efficacy of grief interventions for anxiety and depression in young people. J Affect Disord 2023; 335:289-297. [PMID: 37196936 DOI: 10.1016/j.jad.2023.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Grief in young people is common and associated with symptoms of anxiety and depression, yet grief interventions for this age group are under-researched. METHOD We conducted a systematic review and meta-analysis to examine the efficacy of grief interventions in young people. The process was co-designed with young people and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PsycINFO, Medline, and Web of Science databases were searched in July 2021 (updated December 2022). RESULTS We extracted results from 28 studies of grief interventions with young people (14-24 years) that measured anxiety and/or depression (N = 2803 participants, 60 % girls/women). Cognitive behavior therapy (CBT) for grief demonstrated a large effect for anxiety and medium effect for depression. Meta-regression indicated that CBT for grief that included a higher degree of CBT strategies, was not trauma focused, had >10 sessions, offered on an individual basis, and did not involve parents, was associated with larger effect sizes for anxiety. Supportive therapy had a moderate effect for anxiety and a small-moderate effect for depression. Writing interventions were not effective for anxiety or depression. LIMITATIONS Studies are limited in number and there were few randomized controlled studies. CONCLUSIONS Findings indicate that CBT for grief is an effective intervention for reducing symptoms of anxiety and depression in young people experiencing grief. CBT for grief should be offered as the first line treatment for grieving young people experiencing anxiety and depression. PROTOCOL REGISTRATION PROSPERO (registration number CRD42021264856).
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Affiliation(s)
- Lauren J Breen
- enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth 6845, Australia; Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia.
| | - Danyelle Greene
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | - Clare S Rees
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | - Amy Black
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | | | - Sarah J Egan
- enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth 6845, Australia; Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
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RamachandranNair R, Whitney R, Jones KC, Jack SM. Life after SUDEP: Experiences of traumatic loss and growth. Epilepsy Behav 2023; 141:109157. [PMID: 36889062 DOI: 10.1016/j.yebeh.2023.109157] [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: 12/23/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE To understand the experiences of bereaved relatives of individuals who passed due to sudden unexpected death in epilepsy (SUDEP) and to explore the impacts of death in their lives. METHODS The principles of fundamental qualitative description informed all design decisions. Stratified purposeful sampling included 21 bereaved relatives (parent, sibling, or spouse/partner), aged at least 18 years, of persons who passed away because of SUDEP. In-depth one-to-one interviews were conducted. Directed content analysis was used to code, categorize, and synthesize the interview data. RESULTS There was some criticism of emergency response and medical professionals involved in providing insensitive or poor care immediately after SUDEP occurred. Personal hardships described by participants following SUDEP included loss of personal identity, feeling depressed, experiencing guilt, having panic attacks, requiring therapy, as well as having difficulty with anniversaries, dates, and cleaning up a child's room. Bereaved spouses and parents in particular spoke of experiencing challenges in maintaining other relationships following the death. Some participants spoke of experiencing increased financial hardships. Ways of coping included keeping oneself busy, honoring the memory of the loved one, relying on friends and families, and engaging in advocacy/community work, including raising awareness on epilepsy and SUDEP. CONCLUSIONS Sudden unexpected death in epilepsy affected several aspects of the day-to-day lives of bereaved relatives. Though methods of coping were similar to the usual strategies adopted by all bereaved relatives, advocacy work related to raising awareness about epilepsy and SUDEP was unique to this group. Guidelines on SUDEP should ideally include recommendations for trauma-informed support and assessment for depression and anxiety to the bereaved relatives as well.
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Affiliation(s)
- Rajesh RamachandranNair
- Department of Pediatrics (Neurology), McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
| | - Robyn Whitney
- Department of Pediatrics (Neurology), McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
| | - Kevin C Jones
- Department of Pediatrics (Neurology), McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
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Chen NC, Yang YM, Wu LM. Exploring the Taiwanese Anticipatory Experience of Grief Among Primary Caregivers in Palliative Home Care. Am J Hosp Palliat Care 2023; 40:136-146. [PMID: 35604817 DOI: 10.1177/10499091221096351] [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: 01/19/2023] Open
Abstract
Aims and Objectives: The goal of the present study was to explore anticipatory grief experiences among primary caregivers in home-based palliative care. We placed a special emphasis on coping methods adopted by individuals from Eastern cultures when facing death. Background: Most patients prefer spending their last days at home, which often exerts considerable physical and mental stress on their primary caregivers. Design: This study adopted a qualitative exploratory research design and used open-ended in-depth interviews to explore anticipatory grief experiences among primary caregivers of patients receiving palliative home care. Methods: In the study of the factors that Anticipatory Experience of Grief among Primary Caregivers in Palliative Home Care, we used the phenomenological approach and methods to glean answers. Posters and snowball sampling were used to individually recruit participants. In total, 16 primary hospice home caregivers participated. We used semi-structured interviews to collect data. The interviews were audio-recorded in a quiet location. Each interview was divided into two to three sessions, and each session lasted 60-90 minutes. For data analysis, field notes and audio recordings are transcribed into protocols. A thematic analysis method was used to analyze the context of the interviews. Sampling and analysis processes were repeated until theoretical saturation was achieved. Results: Four major themes emerged from the categorized interview data: meaning and manifestation as to the essence of life, the art of coping with death, realization and the gift of death, and adapting, coping with, and controlling emotions. Additionally, we observed, as with many Eastern cultures, a lunar calendar death in July and crying at the death of a relative is considered taboo. Conclusions: The coping methods adopted by individuals in Eastern cultures when facing death were summarized accordingly. These findings could serve as a reference to better understand the coping mechanisms these individuals use to address anticipatory grief when facing a family member's impending death. Relevance to Clinical Practice: Potential relevance for the present findings include acceptance of Eastern cultural grief customs, early hospice and palliative care interventions for helping individuals adjust to their grief, case management and resource consolidation, providing 24-hour telephone consultation services, regular assessment visits, and developing localized teaching materials for life-and-death education.
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Affiliation(s)
- Nai-Ching Chen
- Department of Home Health Care, 38018Chi Mei Medical Center, Tainan, Taiwan.,School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Mei Yang
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Plocha AH, Modrak SR, Hoopes MM, Priest AC, Donahoe AJ. Developmental Reengagement Without Depression: A Grounded Theory of Resilience Among Bereaved College Students. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221133585. [PMID: 36250264 DOI: 10.1177/00302228221133585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Bereavement is considered one of the most stressful experiences that young people face, and there are unique considerations for how this impacts college students. Applying a resilience framework to the experiences of bereaved college students can provide a better understanding of their experiences; however, studies on the ways that these individuals themselves define resilience are extremely limited. Furthermore, no studies to date have considered the intersection between college students' conceptualizations of resilience and the developmental features of emerging adulthood. The authors present the results of a grounded theory study in which 51 bereaved college students completed a questionnaire and 10 were interviewed to identify the age-salient tasks that they use to define resilience. Three primary themes were identified related to resilience: (a) emotional indicators, (b) behavioral indicators, and (c) fixed and/or unidentifiable factors. Findings were analyzed to reveal the bidirectional impact between grief and the developmental features of emerging adulthood.
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Affiliation(s)
| | | | - Molly M Hoopes
- Department of Psychology, Merrimack College, North Andover, MA, USA
| | | | - Amanda J Donahoe
- Department of Psychology, Merrimack College, North Andover, MA, USA
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Wallace Chi Ho C, Grace Suk Man L, Miranda Mei Mui L, Molin Kwok Yin L, Clare Tsz Kiu Y, Jody Ka-Wing W. Facing the loss of siblings in childhood: Interactions and dynamics between bereaved siblings and their parents. J Pediatr Nurs 2022; 66:e1-e8. [PMID: 35817622 DOI: 10.1016/j.pedn.2022.07.003] [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: 03/07/2022] [Revised: 05/23/2022] [Accepted: 07/02/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The loss of a child in a family is a painful experience. Despite this, most studies focus on the grieving experience of parents. Our understanding of sibling bereavement therefore remains underexplored. This study aims to address this gap by exploring the bereavement experience of younger bereaved siblings from the perspective of the bereaved child and the parents. METHOD This study is a qualitative study conducted in Hong Kong. We recruited eleven bereaved families from 2019 to 2020. Semi-structured interviews were conducted separately with bereaved children and parents. Thematic analyses were performed. FINDINGS Eleven bereaved siblings, aged 5 to 11, and their parents were interviewed. Four themes were generated: Parents' unawareness of bereaved siblings' grief, protecting parents from grief, comparison with the deceased siblings, and learning how to grieve. CONCLUSION Our findings suggest that the family dynamics and interactions in the grieving experience are complex. The impact of grief on the bereaved child could emanate from the loss of the sibling or from the grief of the parents or from family interactions. PRACTICE IMPLICATIONS This study highlights the importance of viewing the sibling bereavement experience in a family context and of enhancing sibling bereavement services. Helping professionals should not only provide more bereavement support to the bereaved siblings individually, but they should also enhance parents' capacity to support their bereaved children.
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Affiliation(s)
| | | | - Leung Miranda Mei Mui
- Fellow of the Hong Kong Academy of Nursing (Hong Kong College of Paediatric Nursing), Hong Kong
| | | | - Yu Clare Tsz Kiu
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong.
| | - Wu Jody Ka-Wing
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
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Cleary A, Dean J, Pollock D, McDaid L, Boyle F. Nature-based interventions for bereavement care: a scoping review protocol. JBI Evid Synth 2022; 20:1344-1352. [PMID: 34669688 DOI: 10.11124/jbies-21-00215] [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: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review is to understand the types of nature-based interventions currently used in bereavement care and to map the theories of change explaining how such interventions may support bereavement care. INTRODUCTION Bereavement can be associated with adverse psychosocial health outcomes. Nature-based interventions have been shown to have positive health and well-being outcomes, and offer diverse and flexible design and delivery options. However, this is an emerging field, and there is a need to explore the literature on the different types of nature-based interventions used in bereavement care and to identify the underpinning theories of change. INCLUSION CRITERIA This review will include studies or reviews of participants who have experienced bereavement following the death of a loved one, and who have taken part in a nature-based intervention (eg, animal-assisted therapy, care farming, therapeutic horticulture, community gardens). Considering all nature contexts and geographic locations, this review will include studies that explore the role of nature-based interventions in bereavement care. METHODS Searches will be conducted in eight databases: Web of Science, Scopus, PubMed, PsycINFO, CINAHL, Social Science Database (ProQuest), PTSDpubs (ProQuest), and Research Library: Health and Medicine (ProQuest). Manual searches of reference lists of included full-text articles and keyword searches of prominent journals will be conducted. Data on the type of nature-based intervention, target sample, health outcomes, measures and methods used, and theory of change will be extracted from selected articles. The data extraction results will be presented in tabular format along with a narrative summary.
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Affiliation(s)
- Anne Cleary
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Julie Dean
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
- Centre of Research Excellence in Stillbirth (Stillbirth CRE), The University of Queensland, Brisbane, QLD, Australia
| | - Danielle Pollock
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Lisa McDaid
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Fran Boyle
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
- Centre of Research Excellence in Stillbirth (Stillbirth CRE), The University of Queensland, Brisbane, QLD, Australia
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Bindley K, Lewis J, Travaglia J, DiGiacomo M. Caring and Grieving in the Context of Social and Structural Inequity: Experiences of Australian Carers With Social Welfare Needs. QUALITATIVE HEALTH RESEARCH 2022; 32:64-79. [PMID: 34836471 DOI: 10.1177/10497323211046875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Caring for and bereavement following the death of someone with a life-limiting illness may precipitate social welfare needs related to income support and housing. Nevertheless, carer experiences of welfare policy and institutions have not received significant attention. This qualitative study explored experiences of carers who navigated social welfare policy while caring for someone with a life-limiting illness, and in bereavement. In-depth interviews were conducted with 12 bereaved carers in an area associated with socioeconomic disadvantage. Carers differentially encountered precariousness, with some experiencing structural vulnerability. These positionalities appeared to be shaped by policy and process-related burdens, perceptions of the welfare state, and degrees of legitimisation or disenfranchisement of forms of capital and coping orientations. Recommendations that may improve carer experience were identified. Implications relate to the need for an expanded conceptualisation of vulnerability in health and welfare practice, policy that authentically validates caring and grieving, and upstream strategies that address inequity.
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Affiliation(s)
- Kristin Bindley
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, 110561The University of Technology, Ultimo, NSW, Australia
- Supportive and Palliative Care, 1760Western Sydney Local Health District, Mount Druitt NSW, Australia
| | - Joanne Lewis
- Faculty of Health, 110561The University of Technology Sydney, Ultimo, NSW, Australia
- Faculty of Health,110446University of Canberra, Bruce, ACT, Australia
| | - Joanne Travaglia
- Faculty of Health, 110561The University of Technology Sydney, Ultimo, NSW, Australia
| | - Michelle DiGiacomo
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, 110561The University of Technology, Ultimo, NSW, Australia
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Pattison NA, White C, Lone NI. Bereavement in critical care: A narrative review and practice exploration of current provision of support services and future challenges. J Intensive Care Soc 2021; 22:349-356. [PMID: 35154374 PMCID: PMC8829769 DOI: 10.1177/1751143720928898] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
This special article outlines the background to bereavement in critical care and scopes the current provision and evidence for bereavement support following death in critical care. Co-authored by a family member and former critical care patient, we aim to draw out the current challenges and think about how and where support can be implemented along the bereavement pathway. We draw on the literature to examine different trajectories of dying in critical care and explore how these might impact bereavement, highlighting important points and risk factors for complicated grief. We present graphic representation of the critical junctures for bereavement in critical care. Adjustment disorders around grief are explored and the consequences for families, including the existing evidence base. Finally, we propose new areas for research in this field.
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Affiliation(s)
- Natalie A Pattison
- East and North Herts NHS Trust, Hertfordshire, UK; University of Hertfordshire, Hertfordshire, UK; the Florence Nightingale Foundation, London, UK
| | | | - Nazir I Lone
- University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
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Wilson DM, Underwood L, Errasti-Ibarrondo B. A scoping research literature review to map the evidence on grief triggers. Soc Sci Med 2021; 282:114109. [PMID: 34157614 DOI: 10.1016/j.socscimed.2021.114109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/18/2022]
Abstract
Grief is understandably severe in the first days, if not weeks or months, following the death of a beloved person. Unless the mourner develops complicated grief, which is prolonged severe and impactful grief, the initial acute grief lessens in severity over time, although waves of significant grief will still occur with grief triggers. A scoping research literature review was undertaken in early 2021 to determine how often grief triggers occur, what the most common grief triggers are, the impact of triggered grief, and what can be done (by those not diagnosed with complicated grief) to manage grief triggers and mitigate the effect of them. Nine academic library databases were searched for English-language research reports using the keywords "grief trigger(s)" and "research": CINAHL, Directory of Open Access (online) Journals, Humanities Index, JSTOR, Medline (Ovid), Periodicals Index Online, PsychArticles, Scopus, and Web of Science. Six research papers relevant for review were published in the last two decades, with some evidence gained on how often grief triggers occur, what constitutes a grief trigger, and the impact of grief triggers. Major gaps in evidence were revealed, despite grief triggers being identified as a major consideration for grief in general and for grief recovery specifically.
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Affiliation(s)
- Donna M Wilson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G1C9, Canada.
| | - Leah Underwood
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G1C9, Canada
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13
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Bindley K, Lewis J, Travaglia J, DiGiacomo M. Social welfare needs of bereaved Australian carers: Implications of insights from palliative care and welfare workers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:631-642. [PMID: 33704840 DOI: 10.1111/hsc.13339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/09/2020] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
An individual and psychological emphasis has influenced practice and research on bereavement following informal care provision in the context of life-limiting illness. Consideration of the potential for bereavement to be shaped by intersecting social and structural inequities is needed; and should include an understanding of interactions with government institutions and social policy. This qualitative study employed interpretive description to explore the way in which palliative care workers and welfare sector workers perceive and approach experiences and needs of bereaved carers receiving government income support or housing assistance in Western Sydney, an area associated with recognised socioeconomic disadvantage. A total of 21 palliative care workers within a public health service and welfare workers from two government social welfare services participated in in-depth interviews. Data were analysed using framework analysis. Participants highlighted social welfare policy and related interactions that may impact bereavement, potentially related to financial, housing and employment precariousness. Personal, interpersonal and structural factors perceived to shape the navigation of welfare needs were explored, alongside needed professional and structural changes envisioned by workers. With limited forms of capital, vulnerably positioned carers may encounter difficulties that heighten their precariousness in bereavement. Transactional organisational cultures alongside health and welfare agencies that function in a siloed manner appear to contribute to structural burden for carers, following death due to life-limiting illness. Palliative care and welfare workers also associated elements of their work with bereaved carers with their own experiences of helplessness, frustration and distress. Findings point to a need for the development of interagency strategies in addition to policy underpinned by more nuanced understandings of vulnerability in bereavement, post-caring.
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Affiliation(s)
- Kristin Bindley
- Faculty of Health, The University of Technology Sydney, Ultimo, NSW, Australia
- Supportive and Palliative Care, Western Sydney Local Health District, Mt Druitt, NSW, Australia
| | - Joanne Lewis
- Faculty of Health, The University of Technology Sydney, Ultimo, NSW, Australia
| | - Joanne Travaglia
- Faculty of Health, The University of Technology Sydney, Ultimo, NSW, Australia
| | - Michelle DiGiacomo
- Faculty of Health, The University of Technology Sydney, Ultimo, NSW, Australia
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Silverman GS, Baroiller A, Hemer SR. Culture and grief: Ethnographic perspectives on ritual, relationships and remembering. DEATH STUDIES 2020; 45:1-8. [PMID: 33272138 DOI: 10.1080/07481187.2020.1851885] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This introduction to the special issue on Anthropology and grief explores the contributions of an ethnographic approach to the interdisciplinary study of grief. After a brief overview of previous anthropological research, we identify key themes emerging from this global collection of case studies: the benefits of long-term fieldwork in nuancing the complexity of grief and complicating cultural narratives that surround it; the ways in which emotional aspects of grief are shaped by cultural norms and by the manner of death; and the relationships between the living and dead, including ontologies of the dead and culturally sanctioned forms of remembering and forgetting.
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Affiliation(s)
- Gila S Silverman
- Arizona Center for Judaic Studies, University of Arizona, Tucson, AZ, USA
| | - Aurélien Baroiller
- Laboratoire d'Anthropologie des Mondes Contemporains, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Susan R Hemer
- Department of Anthropology and Development Studies, University of Adelaide, Australia
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How Do Parentally Bereaved Emerging Adults Define Resilience? It's a Process. JOURNAL OF COLLEGE COUNSELING 2020. [DOI: 10.1002/jocc.12169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Stemen SE. "I can't explain it": An examination of social convoys and after death communication narratives. DEATH STUDIES 2020; 46:1631-1640. [PMID: 32975496 DOI: 10.1080/07481187.2020.1825296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The hierarchical mapping technique is utilized to study individuals' social convoys (i.e., networks). Though convoys typically exclude deceased persons, the continuing bonds model argues that relationships between surviving and deceased persons can be sustained. After Death Communication (ADC), an experience where the deceased contacts surviving persons, facilitates continuing bonds. This study examines how ADC influences reports of convoys and continuing bonds. Using Labov's narrative framework, ADC narratives from 10 bereaved individuals were analyzed for content and structure. Most participants apologized, indicating their ADC experience was inexplicable. Consequently, reports of convoys and continuing bonds may be influenced by concerns of perception.
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Affiliation(s)
- Sara E Stemen
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
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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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Breen LJ, Kawashima D, Joy K, Cadell S, Roth D, Chow A, Macdonald ME. Grief literacy: A call to action for compassionate communities. DEATH STUDIES 2020; 46:425-433. [PMID: 32189580 DOI: 10.1080/07481187.2020.1739780] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The compassionate communities movement challenges the notion that death and dying should be housed within clinical and institutional contexts, and works to normalize conversations about death and dying by promoting death literacy and dialogue in public spaces. Community-based practices and conversations about grief remain marginal in this agenda. We aimed to theorize how grief could be better conceptualized and operationalized within the compassionate communities movement. We develop the concept of Grief Literacy and present vignettes to illustrate a grief literate society. Grief literacy augments the concept of death literacy, thereby further enhancing the potential of the compassionate communities approach.
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Affiliation(s)
- Lauren J Breen
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | | | - Karima Joy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Susan Cadell
- Renison University College, University of Waterloo, Waterloo, Canada
| | - David Roth
- Pütz-Roth Bestattungen und Trauerbegleitung oHG, Bergisch Gladbach, Germany
| | - Amy Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Disadvantaged and disenfranchised in bereavement: A scoping review of social and structural inequity following expected death. Soc Sci Med 2019; 242:112599. [PMID: 31644975 DOI: 10.1016/j.socscimed.2019.112599] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 10/03/2019] [Accepted: 10/10/2019] [Indexed: 11/20/2022]
Abstract
An emphasis on individual intervention and psychological complexity has characterised research on bereavement following an experience of life-limiting illness. Exploration of "structural vulnerability" as a positionality produced by social and structural inequity could provide insights into areas of practice and policy in need of development. This scoping review sought to summarise published research on experiences of social and structural inequities in the context of bereavement due to life-limiting illness. Underpinned by recognised methodological frameworks, systematic searches were conducted of four electronic databases. Eligible studies attended to bereavement experience following the death of an adult due to life-limiting illness, included consideration of social and structural inequities, and were undertaken in high income countries between 1990 and 2018. Following thematic analysis, a conceptual framework was developed. Of 322 records, 62 full text articles were retrieved and 15 papers met inclusion criteria. Studies highlighted unequal social status in bereavement related to gender, class, sexuality, ethnicity and age, with structural inequity experienced in interactions with institutions and social networks. Studies also identified that the experience of bereavement itself may be accompanied by exposure to disenfranchising systems and processes. Structural vulnerability appeared to be associated with outcomes including psychological distress, social disenfranchisement and practical concerns such as financial strain, housing insecurity and employment issues. Social and structural inequities potentially contribute to layered and patterned experiences of disadvantage and disenfranchisement following expected death, with implications for individual agency. Findings point to the need for consideration of socio-ecological approaches within and beyond specialist palliative care, involving development of more responsive social policy, coordinated advocacy, and systemic capacity building regarding experiences of grief, to better support populations positioned as structurally vulnerable in bereavement.
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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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Abstract
This article analyzes the negotiation of taboo surrounding grief after the suicide of a loved one. It draws on ethnographic fieldwork with a support group and individual interviews with its members. While the topic of taboo was prominent at group meetings, the same group members tended to claim in the interviews that they had not experienced it. To explore the issue of taboo, beyond affirmation or denial of its existence, we analyzed how the bereaved navigated the topic of suicide in language using Werner’s psychological theory of metaphor, which argues that metaphors arise to circumvent explicit reference to tabooed subjects. Members of the grief group clearly developed different strategies of metaphorical and other linguistic rephrasing to deal with the topics of death and suicide. Additionally, their language use differed depending on the person’s attitude toward the suicide, whether he or she was alone or with other group members, as well as whether the general public was being framed as an out-group.
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Affiliation(s)
| | - Brady Wagoner
- Center for Cultural Psychology, Aalborg University, Denmark
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Makgahlela M, Sodi T, Nkoana S, Mokwena J. Bereavement rituals and their related psychosocial functions in a Northern Sotho community of South Africa. DEATH STUDIES 2019; 45:91-100. [PMID: 31107175 DOI: 10.1080/07481187.2019.1616852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The study sought to explore bereavement rituals and their related psychosocial significance in an African cultural setting. A descriptive phenomenological design was adopted. Fourteen adults were purposefully sampled to participate in in-depth interviews. Data were analyzed using Hycner's adapted phenomenological method, which resulted in four themes: (a) the cleansing ritual ceremony/go-ntšha setšhila, (b) ancestor reverence rituals, (c) rituals for protecting the deceased spirit, and (d) vengeance ritual/letswa. Ritual performance is associated with diverse psychosocial benefits including the prevention of a culture-specific bereavement illness. Essentially, ritual performance is for healing in that it lessens bereavement from becoming disabling.
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Affiliation(s)
| | - Tholene Sodi
- Department of Psychology, University of Limpopo, Sovenga, South Africa
| | - Shai Nkoana
- Department of Psychology, University of Limpopo, Sovenga, South Africa
| | - Jabu Mokwena
- Department of Psychology, University of Limpopo, Sovenga, South Africa
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Bartel BT. Families grieving together: Integrating the loss of a child through ongoing relational connections. DEATH STUDIES 2019; 44:498-509. [PMID: 30907697 DOI: 10.1080/07481187.2019.1586794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study explored the relational dimensions of grieving within the family unit. Three families bereaved of a child, participated. Using the Qualitative Action-Project Method, individual and joint interviews were conducted with family members. Data analysis illuminated family grieving processes and demonstrated that grieving was an interactive process with individual, dyadic, multi-adic, and community levels of processing. The family grieving process included intentionality in grieving together and separately, recognition of differing grieving styles, and meaning came through the incorporation of ongoing rituals and remembrances. A finding emerged of family connection facilitated through an ongoing, shared, continuing bond with the deceased child.
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Affiliation(s)
- B Tammy Bartel
- Faculty of Humanities and Social Sciences, Trinity Western University, Langley, BC, Canada
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Abstract
OBJECTIVES Prolonged grief disorder is associated with significant distress and impairment and thus efforts to improve treatments are essential. The present pilot study tested the efficacy and feasibility of group Metacognitive Grief Therapy (MCGT) designed specifically for prolonged grief symptomatology to reduce the psychological distress and impaired function resulting from bereavement. DESIGN/PARTICIPANTS Twenty-two bereaved adult participants with prolonged grief symptomatology were randomised to a wait-list control (n=10) or an intervention condition (n=12) with a 3-month and 6-month follow-up. The wait-list control group was offered treatment after the post-test assessment. INTERVENTION Participants attended six group MCGT sessions that ran for 2 hours per week. OUTCOME MEASURES A primary outcome measure of prolonged grief symptomatology and secondary outcome measures of depression, anxiety, rumination, metacognitive beliefs and quality of life were taken pretreatment and post-treatment for both groups and at the 3-month and 6-month follow-up for the intervention group. A Generalised Linear Mixed Model was used to assess treatment efficacy. RESULTS Post-treatment intent-to-treat analyses showed MCGT reduced prolonged grief symptomatology (Cohen's d=1.7), depression (d=1.3), anxiety (d=0.8), stress (d=1.0), rumination (d=0.9) and increased quality of life (d=0.6), and these effects were maintained at the 3-month and 6-month follow-ups. No prepost between-group differences were found in metacognitive beliefs. However, a large significant effect was identified at the 3-month and 6-month follow-ups (d=1.0). CONCLUSION The results show promise for the utility of group MCGT for reducing psychological distress and promoting quality of life. Additionally, the results underscore the need for a full randomised controlled trial of group MCGT, which may be an important addition to the treatment armamentarium available to support people with prolonged grief. TRIAL REGISTRATION NUMBER ACTRN12613001270707; Results. ORIGINAL PROTOCOL: BMJ Open 2015;5:e007221. doi:10.1136/bmjopen-2014-007221.
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Affiliation(s)
- Jenine Anne Wenn
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Moira O'Connor
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Robert T Kane
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Clare Samantha Rees
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Lauren J Breen
- School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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McCarthy JR, Evans R, Bowlby S, Wouango J. Making Sense of Family Deaths in Urban Senegal: Diversities, Contexts, and Comparisons. OMEGA-JOURNAL OF DEATH AND DYING 2018; 82:230-260. [PMID: 30360681 DOI: 10.1177/0030222818805351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite calls for cross-cultural research, Minority world perspectives still dominate death and bereavement studies, emphasizing individualized emotions and neglecting contextual diversities. In research concerned with contemporary African societies, on the other hand, death and loss are generally subsumed within concerns about AIDS or poverty, with little attention paid to the emotional and personal significance of a death. Here, we draw on interactionist sociology to present major themes from a qualitative study of family deaths in urban Senegal, theoretically framed through the duality of meanings-in-context. Such themes included family and community as support and motivation; religious beliefs and practices as frameworks for solace and (regulatory) meaning; and material circumstances as these are intrinsically bound up with emotions. Although we identify the experience of (embodied, emotional) pain as a common response across Minority and Majority worlds, we also explore significant divergencies, varying according to localized contexts and broader power dynamics.
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Breen LJ, Croucamp CJ, Rees CS. What do people really think about grief counseling? Examining community attitudes. DEATH STUDIES 2018; 43:611-618. [PMID: 30204555 DOI: 10.1080/07481187.2018.1506527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/01/2018] [Accepted: 03/14/2018] [Indexed: 06/08/2023]
Abstract
To understand why bereaved people who are highly distressed significantly underutilize grief counseling and therapy, we surveyed adults (N = 156) to investigate community attitudes toward grief counseling. Overall attitude was positive and women reported a significantly more positive attitude than men; there were no associations between attitude and age, country of birth, previous counseling, or bereavement experience. After controlling for gender, beliefs and affects explained attitudes toward grief counseling; behavioral responses did not. Targeting beliefs about grief counseling may promote positive attitudes so that people most likely to benefit from intervention will be more likely to seek it.
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Affiliation(s)
- Lauren J Breen
- School of Psychology, Curtin University , Perth , Australia
| | | | - Clare S Rees
- School of Psychology, Curtin University , Perth , Australia
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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: 18] [Impact Index Per Article: 3.0] [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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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: 7] [Impact Index Per Article: 1.2] [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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Jones E, Oka M, Clark J, Gardner H, Hunt R, Dutson S. Lived experience of young widowed individuals: A qualitative study. DEATH STUDIES 2018; 43:183-192. [PMID: 29498589 DOI: 10.1080/07481187.2018.1445137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Young widowhood is a unique experience that has received little in-depth attention in research and clinical settings. The present study examined the lived experiences of young men and women who had lost a spouse. Eleven men and women between the ages of 18 and 49 were interviewed about their experiences postloss using phenomenological methods. After coding the interviews, three themes emerged: (1) relationship prior to death, (2) coping, and (3) concerns. Clinical implications included the need for more accessible resources for young widowed individuals, such as therapeutic services, finances, and childcare.
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Affiliation(s)
- Eunicia Jones
- a Department of Human Development & Family Science, College of Health and Human Performance , East Carolina University , Greenville , South Carolina , USA
| | - Megan Oka
- b Department of Family, Consumer, and Human Development, College of Education and Human Services , Logan , Utah , USA
| | - Jeremy Clark
- b Department of Family, Consumer, and Human Development, College of Education and Human Services , Logan , Utah , USA
| | - Heather Gardner
- b Department of Family, Consumer, and Human Development, College of Education and Human Services , Logan , Utah , USA
| | - Robin Hunt
- b Department of Family, Consumer, and Human Development, College of Education and Human Services , Logan , Utah , USA
| | - Spencer Dutson
- b Department of Family, Consumer, and Human Development, College of Education and Human Services , Logan , Utah , USA
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Wenn J, O'Connor M, Breen LJ, Rees CS. Exploratory study of metacognitive beliefs about coping processes in prolonged grief symptomatology. DEATH STUDIES 2018; 43:143-153. [PMID: 29474138 DOI: 10.1080/07481187.2018.1440032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Despite research examining the role of metacognitive beliefs about coping processes in maintaining psychological disorders, to date, no studies have explored their role in the maintenance of prolonged grief. Twelve semistructured interviews were conducted with bereavement specialists and bereaved people with elevated grief to identify metacognitive beliefs about coping processes relevant to prolonged grief. Analysis revealed several metacognitive beliefs potentially driving maladaptive coping processes used by people with prolonged grief symptomatology. Findings may underpin the development of interventions that aim to modify unhelpful metacognitive beliefs that perpetuate maladaptive coping processes.
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Affiliation(s)
- Jenine Wenn
- a School of Psychology, Faculty of Health Sciences , Curtin University , Perth , Western Australia , Australia
| | - Moira O'Connor
- a School of Psychology, Faculty of Health Sciences , Curtin University , Perth , Western Australia , Australia
| | - Lauren J Breen
- a School of Psychology, Faculty of Health Sciences , Curtin University , Perth , Western Australia , Australia
| | - Clare S Rees
- a School of Psychology, Faculty of Health Sciences , Curtin University , Perth , Western Australia , Australia
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User acceptability of the diagnosis of prolonged grief disorder: How do professionals think about inclusion in ICD-11? J Affect Disord 2018; 229:306-313. [PMID: 29329064 DOI: 10.1016/j.jad.2017.12.095] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/23/2017] [Accepted: 12/31/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND For the next edition of the International Statistical Classification of Diseases (ICD-11) it is proposed to include prolonged grief disorder as a new diagnosis. The diagnosis describes persistent intensive and disabling grief reactions to bereavement (WHO, 2016b). The aim of the present survey was to determine the extent to which the diagnosis is accepted by practitioners in the healthcare and psychosocial field. METHODS A total of 2088 German-speaking professionals in the fields of psychotherapy, psychology, counselling, medicine and palliative care completed the online survey. RESULTS 42.4% of the participants felt that the advantages of including the diagnosis outweigh the disadvantages, 32.9% came to the conclusion that there are more disadvantages. The remaining 24.7% stated that advantages and disadvantages are balanced. The proposed classification as separate diagnosis was supported by 24.8%, while 60.0% preferred alternatives (e.g. as subtype of adjustment disorder). Furthermore, a time criterion of at least 12 months was voted for considerably more frequently (49.2%) than the proposed 6 months (11.3%). Objections were predominantly expressed with regard to pathologization of normal grief and to the difficulty of adequate crosscultural application of the diagnosis. LIMITATIONS Results are limited to predominantly German health-care professionals. The items did not undergo psychometric analyses. CONCLUSIONS The disagreement about the diagnosis found in specialist literature is also reflected in the responses by the participants. The present results provide stimulation for future questions and validation studies carried out as part of the ICD revision.
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Breen LJ, Karangoda MD, Kane RT, Howting DA, Aoun SM. Differences in meanings made according to prolonged grief symptomatology. DEATH STUDIES 2018; 42:69-78. [PMID: 28489494 DOI: 10.1080/07481187.2017.1328467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study investigated differences in specific meanings made following bereavement, according to participants' prolonged grief symptomatology. A survey of 580 bereaved adults (Mage = 61.6 years, 70.7% female) showed 13 meanings predicted symptomatology, with the largest differences between the two lower symptomatology groups and the high symptomatology group; the latter was more likely to report no meaning. The results provide further support for empirically distinct groups within the bereaved population, not only in terms of symptoms, etiology, outcomes, courses, and treatment responses, but also in their meanings made, and may assist in advancing meaning reconstruction interventions.
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Affiliation(s)
- Lauren J Breen
- a School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Michelle D Karangoda
- a School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Robert T Kane
- a School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Denise A Howting
- b School of Nursing, Midwifery and Paramedicine , Curtin University , Perth , Australia
| | - Samar M Aoun
- b School of Nursing, Midwifery and Paramedicine , Curtin University , Perth , Australia
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Abstract
Resumo A compreensão sobre o luto sofreu profundas modificações em seus aspectos teóricos e práticos, com repercussões importantes na recente versão do DSM. Não apenas o contexto cultural, mas também a clínica psicológica impactou profundamente a sua compreensão. A psicologia fenomenológico-existencial estuda os fenômenos como vivências no mundo, contribuindo com a reflexão sobre o caráter vivencial e pathico do enlutamento. Este estudo objetiva apresentar o luto nessa perspectiva e suas implicações para a clínica psicológica. Quando submetemos o fenômeno do luto à epoché, deparamo-nos com a evidência da intersubjetividade. O luto é uma vivência que tem início na abrupta supressão do outro enquanto corporeidade, rompendo os sentidos habituais do mundo-vida. Diante da suspensão de sentidos, propõe-se que o setting clínico permita o retomar e o ressignificar das narrativas interrompidas, diante de um novo mundo-vida que se abre fora do horizonte das predeterminações teóricas.
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Bereavement support standards and bereavement care pathway for quality palliative care. Palliat Support Care 2017; 16:375-387. [DOI: 10.1017/s1478951517000451] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:Provision of bereavement support is an essential component of palliative care service delivery. While bereavement support is integral to palliative care, it is typically insufficiently resourced, under-researched, and not systematically applied. Our aim was to develop bereavement standards to assist palliative care services to provide targeted support to family caregivers.Method:We employed a multiple-methods design for our study, which included: (1) a literature review, (2) a survey of palliative care service providers in Australia, (3) interviews with national (Australian) and international experts, (4) key stakeholder workshops, and (5) a modified Delphi-type survey.Results:A total of 10 standards were developed along with a pragmatic care pathway to assist palliative care services with implementation of the standards.Significance of results:The bereavement standards and care pathway constitute a key initiative in the evolution of bereavement support provided by palliative care services. Future endeavors should refine and examine the impact of these standards. Additional research is required to enhance systematic approaches to quality bereavement care.
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Abstract
Bereaved parents have higher morbidity and mortality rates when compared to nonbereaved parents. Although parental grief is well studied, the complexities of challenges bereaved parents face are not understood. This study describes parental bereavement challenges during the first 6 months following the death of their child. The complex parental bereavement challenges are characterized by the absence of the child, their emotional response, and the changed relationships with family and friends. The adaptive leadership framework is a useful framework to identify and classify challenges. Future research can use this framework to provide a structure that test interventions to address the challenges.
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Affiliation(s)
- Nancy Dias
- a Indiana University School of Nursing , Indianapolis , Indiana , USA
| | - Sharron Docherty
- b Department of Pediatrics, School of Medicine , Duke University School of Nursing , Durham , North Carolina , USA
| | - Debra Brandon
- b Department of Pediatrics, School of Medicine , Duke University School of Nursing , Durham , North Carolina , USA
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McSpedden M, Mullan B, Sharpe L, Breen LJ, Lobb EA. The presence and predictors of complicated grief symptoms in perinatally bereaved mothers from a bereavement support organization. DEATH STUDIES 2017; 41:112-117. [PMID: 27573073 DOI: 10.1080/07481187.2016.1210696] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The present study investigated the presence and possible predictors of complicated grief symptoms in perinatally bereaved mothers (N = 121) up to 5 years postbereavement. The presence of complicated grief scores in the clinical range was 12.4%, which is higher than in many other bereaved populations, and the presence of other living children may protect against the development of complicated grief symptoms. The majority of the women were able to negotiate a perinatal loss without developing complicated grief; however, there remains an important group of women who up to 5 years later score in the clinical range for complicated grief symptoms.
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Affiliation(s)
- Margaret McSpedden
- a School of Psychology , University of Sydney , Sydney , NSW , Australia
| | - Barbara Mullan
- a School of Psychology , University of Sydney , Sydney , NSW , Australia
- b Health Psychology and Behaviour Medicine, School of Psychology and Speech Pathology , Curtin University , Perth , WA , Australia
| | - Louise Sharpe
- a School of Psychology , University of Sydney , Sydney , NSW , Australia
| | - Lauren J Breen
- b Health Psychology and Behaviour Medicine, School of Psychology and Speech Pathology , Curtin University , Perth , WA , Australia
| | - Elizabeth A Lobb
- c Calvary Health Care Kogarah , Sydney , NSW , Australia
- d St. Vincent's Hospital, Cunningham Centre for Palliative Care, Darlinghurst , Sydney , NSW , Australia
- e School of Medicine, University of Notre Dame Australia , Sydney , NSW , Australia
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Cotter P, Meysner L, Lee CW. Participant experiences of Eye Movement Desensitisation and Reprocessing vs. Cognitive Behavioural Therapy for grief: similarities and differences. Eur J Psychotraumatol 2017; 8:1375838. [PMID: 29163856 PMCID: PMC5687803 DOI: 10.1080/20008198.2017.1375838] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/22/2017] [Indexed: 12/28/2022] Open
Abstract
Background and Objective: Previous research has used quantitative methods to assess the impact of grief therapy. However, rarely have participants been asked about how they have been affected by treatment using qualitative methods. This study sought to explore participants' experiences of two therapeutic approaches to grief: Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Method: Nineteen participants were randomly allocated to receive seven weekly therapy sessions of either CBT or EMDR. Approximately two weeks after completing therapy, a semi-structured interview was conducted with each participant. Interviews were transcribed and a thematic analysis was performed. Results: Participant reports common to both therapies included developments in insight, a positive shift in emotions, increased activity, improved self-confidence and a healthier mental relationship to the deceased. Participants also responded by describing experiences that were unique to each therapy. Those who completed CBT described the acquisition of emotion regulation tools and shifting from being in an ongoing state of grief to feeling that they were at a new stage in their lives. Participants who completed EMDR reported that distressing memories were less clear and felt more distant from such memories following treatment. Conclusions: Although both therapies resulted in some similar changes for participants, there were unique experiences associated with each therapy. These findings are discussed in terms of implications for the underlying key processes of each therapy and the processes of recovery in grief.
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Affiliation(s)
- Prudence Cotter
- Department of Psychology and Exercise Science, Murdoch University, Perth, Australia
| | - Larissa Meysner
- Department of Psychology and Exercise Science, Murdoch University, Perth, Australia
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Kennedy AJ, Versace VL, Brumby SA. Research protocol for a digital intervention to reduce stigma among males with a personal experience of suicide in the Australian farming community. BMC Public Health 2016; 16:1204. [PMID: 27899094 PMCID: PMC5129616 DOI: 10.1186/s12889-016-3874-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/24/2016] [Indexed: 11/24/2022] Open
Abstract
Background Australian farming communities have up to twice the suicide rate of the general population. Men, particularly, demonstrate debilitating self- and perceived-stigma associated with an experience of suicide. The Ripple Effect is aimed to reduce suicide stigma within the social, cultural, geographical and psychological contexts in which it occurs. Methods A mixed-method design with multi-level evaluation will be effected following the development and delivery of a personalised website experience (combining shared stories, education, personal goal setting and links to resources) to farming men, aged 30–64 years, with an experience of suicide. Pre- and post-surveys will be used to assess changes in self- and perceived-stigma and suicide literacy. Online feedback from participants and semi-structured interviews during follow-up will be thematically analysed. Discussion This project will provide information about increasingly accessible, innovative approaches to reducing the debilitating health and wellbeing effects of suicide stigma on a population of Australia’s farmers. Trial registration This research protocol was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN: ACTRN12616000289415) on 7th March, 2016.
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Affiliation(s)
- Alison J Kennedy
- National Centre for Farmer Health/Deakin University, Tyers Street, Hamilton, VIC, Australia, 3300.
| | - Vincent Lawrence Versace
- Deakin University, School of Medicine, Deakin Rural Health (DRH), Princes Highway, Warrnambool, VIC, Australia, 3280
| | - Susan A Brumby
- National Centre for Farmer Health/Deakin University, Tyers Street, Hamilton, VIC, Australia, 3300
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Breen LJ, Aoun SM, Rumbold B, McNamara B, Howting DA, Mancini V. Building Community Capacity in Bereavement Support. Am J Hosp Palliat Care 2016; 34:275-281. [DOI: 10.1177/1049909115615568] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Most bereaved people do not require specialist intervention, yet building community capacity in providing bereavement support is underdeveloped. While family caregivers indicate a need for more information about bereavement, there is little evidence to guide what this information might contain. Objective: The study’s purpose was to inform bereavement support by determining the advice people bereaved through expected deaths in palliative care have for others in that situation. Design: Four funeral providers posted a questionnaire to previous clients who had used their services 6 to 24 months prior and 678 bereaved people responded. Setting/Participants: The sample size for this study comprised 265 bereaved people whose relative used palliative care services. Measurements: The questionnaire comprised 82 questions about caregiving, bereavement support, current bereavement-related distress, and 2 open-ended questions concerning their bereavement, one of them on advice they have to other people in the same situation. Results: Family caregivers (n = 140) of people who received palliative care responded to the open-ended question about advice for others. An open content analysis yielded 3 themes—preparations for bereavement, utilizing social networks, and strategies for dealing with grief. Conclusions: Bereaved family caregivers’ experiential knowledge can be harnessed to progress the development of bereavement care strategies for the good of the community. These responses could be incorporated into information brochures, posters, and other community education avenues in order to upskill palliative care bereavement volunteers and the wider community so that bereaved family caregivers are best supported.
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Affiliation(s)
| | - Samar M. Aoun
- Curtin University, Perth, Western Australia, Australia
| | - Bruce Rumbold
- La Trobe University, Perth, Western Australia, Australia
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Poole J, Ward J, DeLuca E, Shildrick M, Abbey S, Mauthner O, Ross H. Grief and loss for patients before and after heart transplant. Heart Lung 2016; 45:193-8. [PMID: 26897722 DOI: 10.1016/j.hrtlng.2016.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/14/2016] [Accepted: 01/16/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The purpose of the study was to examine the loss and grief experiences of patients waiting for and living with new hearts. BACKGROUND There is much scholarship on loss and grief. Less attention has been paid to these issues in clinical transplantation, and even less on the patient experience. METHODS Part of a qualitative inquiry oriented to the work of Merleau-Ponty, a secondary analysis was carried out on audiovisual data from interviews with thirty participants. RESULTS Patients experience loss and three forms of grief. Pre-transplant patients waiting for transplant experience loss and anticipatory grief related to their own death and the future death of their donor. Transplanted patients experience long-lasting complicated grief with respect to the donor and disenfranchised grief which may not be sanctioned. CONCLUSIONS Loss as well as anticipatory, complicated and disenfranchised grief may have been inadvertently disregarded or downplayed. More research and attention is needed.
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Affiliation(s)
- Jennifer Poole
- School of Social Work, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada.
| | - Jennifer Ward
- School of Social Work, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
| | - Enza DeLuca
- Division of Cardiology and Transplant, University Health Network, 585 University Avenue, PMB 11-137, Toronto, Ontario M5G 2N2, Canada
| | | | - Susan Abbey
- Department of Psychiatry, University Health Network, 585 University Avenue, PMB 11-100D, Toronto, Ontario M5G 2N2, Canada
| | - Oliver Mauthner
- Institute of Nursing Science, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Heather Ross
- Division of Cardiology and Transplant, University Health Network, 585 University Avenue, PMB 11-137, Toronto, Ontario M5G 2N2, Canada
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Wenn J, O'Connor M, Breen LJ, Kane RT, Rees CS. Efficacy of metacognitive therapy for prolonged grief disorder: protocol for a randomised controlled trial. BMJ Open 2015; 5:e007221. [PMID: 26646828 PMCID: PMC4680007 DOI: 10.1136/bmjopen-2014-007221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Studies of effective psychotherapy for individuals suffering from the effects of prolonged grief disorder (PGD) are scarce. This paper describes the protocol for an evaluation of a metacognitive therapy programme designed specifically for PGD, to reduce the psychological distress and loss of functioning resulting from bereavement. METHODS AND ANALYSIS The proposed trial comprises three phases. Phase 1 consists of a review of the literature and semistructured interviews with key members of the target population to inform the development of a metacognitive therapy programme for Prolonged Grief. Phase 2 involves a randomised controlled trial to implement and evaluate the programme. Male and female adults (N=34) will be randomly assigned to either a wait list or an intervention group. Measures of PGD, anxiety, depression, rumination, metacognitions and quality of life will be taken pretreatment and posttreatment and at the 3-month and 6-month follow-up. The generalised linear mixed model will be used to assess treatment efficacy. Phase 3 will test the social validity of the programme. DISCUSSION This study is the first empirical investigation of the efficacy of a targeted metacognitive treatment programme for PGD. A focus on identifying and changing the metacognitive mechanisms underpinning the development and maintenance of prolonged grief is likely to be beneficial to theory and practice. ETHICS Ethics approval was obtained from Curtin University Human Research Ethics Committee (Approval number HR 41/2013.) TRIAL REGISTRATION NUMBER ACTRN12613001270707.
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Affiliation(s)
- Jenine Wenn
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Moira O'Connor
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Lauren J Breen
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Robert T Kane
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Clare S Rees
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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Sealey M, Breen LJ, O'Connor M, Aoun SM. A scoping review of bereavement risk assessment measures: Implications for palliative care. Palliat Med 2015; 29:577-89. [PMID: 25805738 DOI: 10.1177/0269216315576262] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Palliative care standards and policies recommend that bereavement support be provided to family caregivers, yet uncertainty surrounds whether support currently offered by palliative care services throughout developed countries meets caregiver needs. The public health model of bereavement support, which aligns bereavement support needs with intervention, may address this gap between policy and practice. AIM The aim was to review the literature to identify bereavement risk assessment measures appropriate for different points in the caring and bereavement trajectories, evaluate their psychometric properties and assess feasibility for use in palliative care. DESIGN A scoping review was systematically undertaken following Arksey and O'Malley's methodological framework. DATA SOURCES PsycINFO, CINAHL, PubMed and Cochrane Reviews databases, as well as grey literature including Internet searches of Google, World Health Organization, CareSearch, the Grey Literature Report and OAIster were searched. Bereavement organisations and palliative care websites, reference lists in obtained articles and grief and bereavement handbooks were also scrutinised. RESULTS Of 3142 records screened, 356 records yielded 70 grief measures. In all, 19 measures published between 1982 and 2014 were identified for inclusion in this review, and categorised for use with family caregivers at three points in time - before the patient's death (n = 5), in the period following the death (n = 10) and for screening of prolonged or complex grief (n = 4). The majority had acceptable psychometric properties; feasibility for use in palliative care varied substantially. CONCLUSION This review is an important preliminary step in improving the assessment of bereavement risk and, consequently, better bereavement outcomes for palliative care family caregivers.
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Affiliation(s)
- Margaret Sealey
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Lauren J Breen
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Moira O'Connor
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Samar M Aoun
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Aoun SM, Breen LJ, Howting DA, Rumbold B, McNamara B, Hegney D. Who needs bereavement support? A population based survey of bereavement risk and support need. PLoS One 2015; 10:e0121101. [PMID: 25811912 PMCID: PMC4374848 DOI: 10.1371/journal.pone.0121101] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/09/2015] [Indexed: 11/29/2022] Open
Abstract
This study identifies and describes the profiles of bereavement risk and support needs of a community sample in Australia and tests the fit of the data with the three-tiered public health model for bereavement support. Family members who were bereaved 6–24 months prior to the survey and who were clients of four funeral providers participated (May-July 2013). A postal survey was used to collect information about bereaved people’s experience of caring and perceived satisfaction with any bereavement support provided. The questionnaire included a validated risk assessment screening measure for Prolonged Grief Disorder (PG-13). A total of 678 bereaved people responded. The model predicted that 60% of the sample would be low risk, 30% moderate risk, and 10% high risk. Actual figures were very close at 58.4%, 35.2% and 6.4% respectively. The analysis of the demographic characteristics, experience and impact of caring and bereavement, and satisfaction with support received from a variety of sources revealed differential experiences and needs that align with the expectation of low, moderate, and high bereavement support need, as articulated in the public health model. This is the first empirical test of the public health model of bereavement support. As there is a lack of clear evidence to guide development and allocation of bereavement support programs, the findings have the potential to inform the ability of services, community organizations and informal networks to prioritize care according to each level of bereavement need. This is essential to achieve cost-effective and equitable resource allocation.
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Affiliation(s)
- Samar M. Aoun
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- * E-mail:
| | - Lauren J. Breen
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Denise A. Howting
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Bruce Rumbold
- Palliative Care Unit, Department of Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Beverley McNamara
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Desley Hegney
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Nursing and Midwifery, University of Southern Queensland, Brisbane, Queensland, Australia
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Beischel J, Mosher C, Boccuzzi M. The Possible Effects on Bereavement of Assisted After-Death Communication during Readings with Psychic Mediums: A Continuing Bonds Perspective. OMEGA-JOURNAL OF DEATH AND DYING 2015; 70:169-94. [DOI: 10.2190/om.70.2.b] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Unresolved, complicated, prolonged, or traumatic grief can have detrimental effects on mental and/or physical health. The effects of traditional grief counseling, with its focus on the client's acceptance of separation and integration of loss, are unclear. Within the model of continuing bonds, however, grief resolution includes an ongoing relationship between the living and the deceased. Spontaneous and induced experiences of after-death communication (ADC) have been shown to be beneficial in the resolution of grief by demonstrating these continued bonds. Presently, many bereaved individuals are experiencing assisted ADCs by receiving readings from psychic mediums and though little is known about the effects of this selfprescribed treatment option, anecdotal reports and exploratory data posit a positive outcome. This article aims to inform those who work with the bereaved about the relationships between grief, spontaneous, induced, and assisted ADC experiences, and the continuing bonds paradigm. Suggestions for future research are also included.
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Affiliation(s)
- Julie Beischel
- The Windbridge Institute for Applied Research in Human Potential, Tucson,
Arizona
| | - Chad Mosher
- The Windbridge Institute for Applied Research in Human Potential, Tucson,
Arizona
| | - Mark Boccuzzi
- The Windbridge Institute for Applied Research in Human Potential, Tucson,
Arizona
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45
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Rosenbaum JL, Smith JR, Yan Y, Abram N, Jeffe DB. Impact of a Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial. DEATH STUDIES 2015; 39:191-200. [PMID: 25530502 PMCID: PMC4382412 DOI: 10.1080/07481187.2014.946628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby's death in a Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, the authors measured grief change from a 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD viewers with DVD nonviewers and controls. DVD viewers reported higher grief at 3-month interviews compared with DVD nonviewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care.
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Affiliation(s)
- Joan L Rosenbaum
- a Edward Mallinckrodt Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , USA
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Bentley B, O'Connor M. Conducting research interviews with bereaved family carers: when do we ask? J Palliat Med 2014; 18:241-5. [PMID: 25517136 DOI: 10.1089/jpm.2014.0320] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Interviews with bereaved family carers to examine the end-of-life experience of the deceased are important tools for palliative care researchers, but the ethics of approaching the bereaved when they are grieving and vulnerable is often debated. OBJECTIVE The aim of this study was to explore the insights of bereaved family carers about the most appropriate time to be involved in a research interview about the end of life and death of their family member. METHODS This qualitative study used a social constructionist framework. Twenty-two bereaved family carers of people with motor neurone disease (MND) and cancer were interviewed in Western Australia. RESULTS Most family carers (86%) feel comfortable being interviewed about the death of their family member within the first 5 months of bereavement, with 43% reporting they could be interviewed within weeks after death. Family carers reported that recall would be better earlier in bereavement and felt it may be helpful to them to talk about their experiences earlier. They said bereaved people should be allowed to decide for themselves when to be involved in an interview. CONCLUSIONS These findings indicate that interviews with the bereaved may be most fruitful for researchers and beneficial to family carers when they are allowed to make the choice about timing for themselves, beginning weeks after the death of their family member.
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Affiliation(s)
- Brenda Bentley
- 1 School of Health Professions, Murdoch University, Murdoch, Western Australia , Australia
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Botha KJ, Guilfoyle A, Botha D. Beyond normal grief: A critical reflection on immediate post-death experiences of survivors of suicide. ACTA ACUST UNITED AC 2014. [DOI: 10.5172/jamh.8.1.37] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Andrew Guilfoyle
- School of Psychology and Social Science, Faculty of Computing, Health and Science, Edith Cowan University, Perth, Western Australia
| | - Derek Botha
- Counsellor, Claremont, Cape Town, South Africa
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Fernandez ME, Breen LJ, Simpson TA. Renegotiating Identities: Experiences of Loss and Recovery for Women With Bipolar Disorder. QUALITATIVE HEALTH RESEARCH 2014; 24:890-900. [PMID: 24970246 DOI: 10.1177/1049732314538550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Along with major changes in mood, people living with bipolar disorder (BD) often experience recurrent hospital admissions, feelings of failure and hopelessness, social stigma, underemployment, and a loss of independence. In this study we explored the experiences of loss, coping, and recovery in a community sample of women living with BD. Ten women each participated in a semistructured interview. We used the constant comparative method to analyze the data. We identified three themes from the data: identity bound by the diagnostic label, multidimensional effects of the bipolar disorder identity, and strategies for renegotiating identity. For these women, recovery involved an ongoing process of balancing their sick self with their healthy self. The findings contribute to conceptualizations of loss, coping mechanisms for dealing with loss, and the relevance of loss in recovery for people living at the margins with BD.
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Affiliation(s)
- Maria E Fernandez
- Department for Child Protection and Family Support, Geraldton, Western Australia, Australia
| | - Lauren J Breen
- Curtin University, Bentley, Western Australia, Australia
| | - Terry A Simpson
- Edith Cowan University, Joondalup, Western Australia, Australia
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Breen LJ, Aoun SM, O'Connor M, Rumbold B. Bridging the gaps in palliative care bereavement support: an international perspective. DEATH STUDIES 2014; 38:54-61. [PMID: 24521046 DOI: 10.1080/07481187.2012.725451] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A review of palliative care policies and bereavement support practices in the United States, Canada, United Kingdom, Australia, and Japan demonstrated 4 challenges: questions over providing universal versus targeted support; a lack of clear evidence driving service delivery; informal or no risk assessment; and limited or no evaluation of services. Bridging the gaps between the policy and practice of palliative care bereavement support requires acknowledging the challenges of medical and public health models, improving bereavement need assessment processes, enhancing the role of primary care providers, and extending research to provide an evidence-base for interventions.
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Affiliation(s)
- Lauren J Breen
- a School of Psychology and Speech Pathology, Faculty of Health Sciences , Curtin University , Perth , Australia
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