Predictors of Client Satisfaction With Bereavement Counselling: The Role of Negative Effects

Bereaved persons seeking help in bereavement counselling report generally high client satisfaction. However, qualitative research suggests that some clients also indicate dissatisfying experiences and negative effects. The aim of this study was to investigate the contribution of content-, counsellor- and client-related characteristics and negative effects to client satisfaction. Bereaved participants (n = 53) who had completed bereavement counselling were recruited either online or via counselling organizations. In an online survey, they provided information about client-, loss- and counselling-related variables, present grief severity, negative effects of counselling and client satisfaction. In a hierarchical linear regression analysis controlling for recruitment strategy, online-recruited participants were less satisfied. In a second step additionally considering number of sessions, grief severity and negative effects, experiencing more negative effects predicted lower client satisfaction. The results indicate that negative effects could play an important role for client satisfaction. More research is needed to investigate this phenomenon.

Internalization of athletic body ideal as a mediating variable between family influence and body image of young women. A cross-cultural study of polish, Italian, and Ukrainian women

Introduction

Our aim was to analyze the strength of the family's influence on the internalization of the ideal of an athletic figure and, consequently, on the multifactorial image of the body, from the perspective of intercultural differences.

Methods

A total of 488 healthy women aged 19-26; of Polish (154), Ukrainian (228), and Italian (106) took part in the study. The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4) and the Multidimensional Body-Self Relations Questionnaire (MBSRQ 69) were used to measure athletic ideal internalization and family pressure. The body image of Ukrainian, Polish, and Italian women depends both on the degree of internalization the ideal of an athletic figure and influence of the family.

Results and Discussion

The research also suggests significant differences between the three populations, which may suggest cultural differences between young women living in Eastern, Central, and South European countries.

Carers' Motivations for, and Experiences of, Participating in Suicide Research

(1) Background: First-hand accounts of lived experience of suicide remain rare in the research literature. Increasing interest in the lived experience of suicide is resulting in more opportunities for people to participate in research based on their personal experience. How individuals choose to participate in research, and their experience of doing so, are important considerations in the ethical conduct of research. (2) Methods: To understand the experience of providing care for someone who has previously attempted suicide, a cross-sectional online community survey was conducted. This survey concluded with questions regarding motivation to participate and the experience of doing so. Of the 758 individuals who participated in the survey, 545 provided open-ended text responses to questions regarding motivation and 523 did so for questions regarding the experience of participating. It is these responses that are the focus of this paper. Data were analysed thematically. (3) Results: Motivations to participate were expressed as primarily altruistic in nature, with a future focus on improving the experience of the person who had attempted suicide alongside carers to ease distress. The experience of participating was difficult yet manageable, for all but a few participants. (4) Conclusions: With the increasing interest in first-hand accounts of suicide, how individuals experience participation in research is an important focus that requires further attention.

Use of the Core Bereavement Items in Adults Aged 50 and Older: A Psychometric Evaluation

The Core Bereavement Items (CBI) is a commonly used measure that assesses core grief and bereavement experiences. Although previous psychometric testing has been conducted, no studies have assessed its use specifically aimed at adults aged 50 and older or for those who lost a loved one who was hospice care. This is critical, as losses and additional obstacles in bereavement compound throughout the aging process. The present study investigated reliability, content validity, and internal structure of the CBI in bereaved adults aged 50 and older whose loved one died while in hospice care (N = 205). Associations based on age, marital status, and relationship with the died patients were consistent with preexisting research. Results of a Cronbach α reliability test found that the CBI has excellent reliability in this population. Further, content validity was established based on the judgment of subject matter experts. Exploratory factor analysis supported a 1-factor structure, with all items loading as General Grief Experiences. Based on this analysis, the CBI is a valid and reliable tool when used with adults aged 50 and older.

Parental death in young adults with divorced compared to non-divorced parents: The effect on prolonged grief and mental health

This cross-sectional survey compares the risk of mental health problems like poor well-being, complicated and prolonged grief, and mental disorders between young adults experiencing a divorced or non-divorced parent's death. 190 participants were recruited from Facebook via the Danish National Center for Grief. Well-being was measured using WHO-5, prolonged grief using PG-13 and complicated grief using BGQ, and common mental disorders using CMDQ. Findings confirmed deleterious effects on mental health in young adults experiencing parental death, but higher risk, when losing a divorced parent compared to a non-divorced parent, was associated to prolonged grief, complicated grief, bodily distress syndrome, and alcohol misuse.

Reasons why we read blogs and memorial pages of people who lost a child. Life motives of emotional rubberneckers

Researchers have been interested in the subject of accompanying individuals who experienced a child's terminal illness and death, sharing their grief online. Using The Reiss Motivation Profile and qualitative methods, the authors identified the life motives of emotional rubberneckers-grief blog and memorial page readers.Key reasons for the regular behavior of this kind are found: interest in the protagonist's health, compassion, will to help, and sense of bonding. Such activity provides support to the respondents. Readers' important life motives include the substantial need to care for their loved ones, to be needed, emotional stability, and a low need for power.

Bereavement-related regrets and unfinished business with the deceased

Unresolved relational issues with the deceased have been considered a prominent risk factor for negative bereavement outcomes. However, this area of study has suffered from a lack of conceptual clarity, with some commentators focusing on bereavement-related regret and others focusing on "unfinished business," or lingering or unspoken conflicts with the deceased. This study examined the two concepts in a sample of 229 bereaved individuals, finding them to be overlapping but distinct constructs. Unfinished business occurred more frequently with immediate family and friends and in cases of sudden and violent death of loved ones. Both forms of unresolved issues were associated with bereavement outcome, with the relation between distress over unfinished business and complicated grief symptomatology being particularly robust.

Transitional Instability Predicts Polymorphous Distress in Emerging Adults

The primary aim of this investigation is to determine the extent to which transitional instability can predict diverse markers of distress in emerging adults. Participants were 210 emerging adults, aged 18-25 who completed measures of distress that included loneliness, stress, problem drinking, and prescription medication use. One year later, they returned to complete these same measures of distress along with a measure of significant life transitions that they encountered during the past year in such domains as education, employment, residence, and relationships. Results of a structural equation modeling analysis showed that even after controlling for the potential reciprocal association between transitional instability and distress, the more transitional instability emerging adults experienced over the year, the higher their distress was at time 2. The results are consistent with models of transitional instability as a precipitant of distress in emerging adulthood.

Guilt in bereavement: Its relationship with complicated grief and depression

This study investigated the relationship between guilt and well-being of bereaved persons, and explored potential differences in the associations between guilt-complicated grief (CG) and guilt-depression. In total, 1358 Chinese bereaved adults were recruited to fill out questionnaires. Participants (N = 194) who had been bereaved within 2 years of the first survey, filled out the same questionnaires 1 year later. Higher guilt was associated with higher degrees of both CG and depression. The level of guilt predicted CG and depression symptoms 1 year later. Bereavement-related guilt has a closer association with CG than depression. Responsibility guilt, indebtedness guilt and degree of guilt feeling are more prominent aspects of guilt in CG than in depression. These findings demonstrate the significant role of guilt (perhaps a core symptom) in mental health of the bereaved, having implications for identifying persons with grief complications and depression.

Improving Comprehension in Written Medical Informed Consent Procedures

Abstract. Older adults are frequently required to undergo medical informed consent procedures. This study investigates the influence of four types of written language and visual support (Elaborated Plain Language, Easy-to-Read Language, Standard Version with additional picture, Easy-to-Read-Language with additional picture) on comprehension and affect, compared with the Standard Version alone. In an online survey, n = 87 younger participants aged 26–59 and n = 72 older participants aged 60–81 read a simulation of an informed consent form. Directly after reading it, we used the Understanding dimension of the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) to ask them about the information presented in the form. The results showed that, by reducing complexity and elaborating the provided information, comprehension of medical information could be improved in the older participant group. In the so-called Elaborated Plain Language groups, the results were the same for younger and older participants. This was not true for the groups that received the Standard Version, on which younger participants performed better. Variations in the language used had no influence on affect. Our conclusion is that Elaborated Plain Language can be recommended for use in medical informed consent procedures with older patients and should be taught to medical professionals.

Altruistic Preferences in Time Tradeoff

Whether respondents incorporate altruistic preferences in time tradeoff (TTO) exercises remains understudied. We present an extended quality-adjusted life-year model incorporating altruism. We derive that altruism may affect TTO values in 2 directions. First, “longevity altruists” may wish to prolong life for the sake of their loved ones (to avoid being missed). Second, “quality-of-life altruists” may have a preference to avoid bad health states resulting in being a burden to loved ones. The existence and influence of these preferences in a TTO were empirically confirmed in a sample of 1690 respondents from the general public. We classified respondents as “longevity altruists” or “quality-of-life altruists” based on their reasoning behind inclusion of loved ones in their TTO responses. In line with expectations, longevity altruists traded fewer years than quality-of-life altruists. Nonaltruists gave intermediate values.

Grieving online: newcomers' constructions of grief in an online support group

Research into peer conversations in online grief support groups remains scarce. The authors used discourse analysis to examine 107 initial posts to one such group to examine how newcomers constructed their initial posts to display their eligibility for membership. The authors identified three discursive features: formulating unusual stories of loss, describing uncontrollable emotional and physical states, and engaging in "troubles telling." These discursive patterns illustrate how grief is constructed in ways that may simultaneously conform to and resist norms around grief that exist offline. Implications for practitioners include the need to support individuals through validation of their "nonnormal" grief.

Child maltreatment and marijuana problems in young adults: examining the role of motives and emotion dysregulation

It is well established that childhood maltreatment is an important predictor of marijuana use, but few studies have examined the mechanisms underlying this relationship. The current study examines marijuana motives as mediators of the relationship between childhood maltreatment and marijuana use in a sample of young adults. In addition, pathways from childhood maltreatment to emotion dysregulation, coping motives, and marijuana use were explored. Participants were 125 young adults (ages 19-25, 66.9% female) recruited through online community advertising. All participants completed questionnaires assessing childhood maltreatment, emotion dysregulation, marijuana motives, past year and past three-month marijuana use, and marijuana problems. Correlational analyses revealed bivariate relationships between childhood maltreatment, emotion dysregulation, marijuana motives and marijuana problems (rs=.24-.50). Mediation analyses revealed that coping motives mediated the relationship between childhood maltreatment and marijuana problems, and emotion dysregulation was associated with marijuana problems both directly and indirectly via coping motives. The present findings highlight emotion dysregulation and coping motives as important underlying mechanisms in the relationship between childhood maltreatment and marijuana problems.

Finding meaning in loss: the mediating role of social support between personality and two construals of meaning

Dimensions of personality may shape an individual's response to loss both directly and indirectly through its effects on other variables such as an individual's ability to seek social support. The mediating effect of social support on the relationship between personality (i.e., extraversion and neuroticism) and 2 construals of meaning (i.e., sense-making and benefit-finding) among 325 bereaved individuals was explored using path analysis. Supporting our hypotheses, social support mediated the relationship between personality and construals of meaning. Neuroticism was negatively and indirectly associated with both sense-making and benefit-finding through social support. Extraversion had a significant positive relationship to social support, which, in turn, mediated the impact of extraversion on both sense-making and benefit finding. The model explained 35% of the variance in social support, 19% of the variance in sense-making, and 25% of the variance in benefit-finding. Implications are discussed in light of existing theories of bereavement and loss.

Attachment, Social Support, and Responses following the Death of a Companion Animal

This research tested hypotheses concerning attachment, social support, and grief responses to the loss of animal companionship. Participants whose companion cat or dog had recently died ( N = 429) completed the Attachment Style Questionnaire, the Inventory of Complicated Grief, and the Multidimensional Health Profile-Psychosocial Functioning questionnaires. Both attachment anxiety and attachment avoidance were found to be positively associated with respondents' grief, depression, anxiety, and somatic symptoms. Social support was found to be negatively associated with these outcomes as well as with attachment anxiety and attachment avoidance. In multiple regression analyses, attachment anxiety incrementally predicted grief, anxiety and somatic symptoms, attachment avoidance incrementally predicted grief and depression, and social support incrementally predicted all outcomes. Interaction effects of attachment and social support in relation to outcomes were not found. The present study's implications and limitations are discussed, as are directions for future research.

Use of ultrasound imaging by physiotherapists: a pilot study to survey use, skills and training

OBJECTIVE

This study aimed to design and pilot a questionnaire to survey the use of ultrasound imaging (USI) by physiotherapists in the United Kingdom (UK), the type and content of ultrasound training physiotherapists using USI had undertaken and their perceived future training needs.

BACKGROUND

The use of USI by physiotherapists is becoming increasingly common but is highly operator dependent and there are safety and professional issues regarding use in physiotherapy practice. Currently there are no specific training guidelines relating to physiotherapists using USI.

METHODS

A questionnaire was developed, based on research literature and guidelines. Twelve experts in USI commented on the content and design. The electronic on-line questionnaire was piloted on groups that were likely to be users of USI.

RESULTS

Forty-six respondents completed the questionnaire. Results indicated that USI is used predominantly for biofeedback and there are many unmet training needs. Respondents reported a mismatch between techniques for which they had received training and those that they used in practice and indicated a more structured training framework is required.

CONCLUSIONS

The development and piloting of the questionnaire provides a starting point for a more extensive evaluation of how USI is being used, the training needs of physiotherapists and benefits as a biofeedback tool. Refinement is needed and replication in a larger sample. Results could assist the development of a structured formal training framework encompassing key skills.