Consoling the Bereaved: Exploring How Sympathy Cards Influence What People Say

In a sequential mixed methods study, interview data showed that bereaved parents consistently reported "stupid" or "insensitive" things people said that were not helpful when their child died. Subsequently, a discourse analysis of 170 sympathy cards was conducted to assess societal messaging that may influence people's insensitive words. The findings reflected two distinct time periods in the bereavement process: a time of sadness followed by a time of peace. Possible links to insensitive things people said included: suggestions that the sad time should only last a few days, suggestions of "healing," religious statements such as the deceased being with God or advice to pray to God, and notions of celebration in some contexts. Very few excerpts were similar to the advice-giving quotes that interviewees considered to be insensitive. Many cards reflected the love and memories inherent in creating a continuing bond with the deceased and achieving peace.

Associations of religious and existential variables with psychosocial factors and biomarkers of cardiovascular risk in bereavement

Bereavement increases in prevalence as people age and is associated with multiple psychological and health risks, including cardiovascular risk. Religious and existential variables may play an important role in the health impacts of bereavement. Theorized pathways linking religious and existential variables with health have suggested these associations are due to intermediary psychosocial variables, but have not been tested in bereavement. This research empirically tested these pathways in a bereaved population. In N = 73 adults within 1 year of bereavement (mean age = 64.36), this study examined associations between (1) religious and existential characteristics (religious and spiritual struggles, intrinsic religiosity, and existential quest) and intermediary psychosocial variables (depression, loneliness, and difficulties in emotion regulation), and between (2) intermediary psychosocial variables and bereavement-relevant health outcomes (self-reported health, change in health since last year, grief severity, and cardiovascular biomarkers). Cardiovascular biomarkers (heart rate, heart rate variability, and blood pressure) were collected before, during, and after a laboratory grief recall emotion elicitation. Anticipated associations between self-reported religious and existential characteristics and intermediary variables, and between intermediary variables and self-reported bereavement-relevant outcomes, were consistently observed. However, associations between intermediary variables and cardiovascular biomarkers were largely unobserved. This study examined the role of religious and existential variables in whole-person health after bereavement and is among the first to include biomarkers of cardiovascular risk. Results suggest that although religious and existential variables are associated with important bereavement-related outcomes, these associations may be "skin-deep," and extensions to cardiovascular functioning should be re-examined.

Does time heal all wounds? An investigation of time, grief, and attitudes toward death

When experiencing the loss of a loved one, individuals adapt and change how they understand death, how they interpret the meaning of the loss, and how they remember the deceased. In the present study (N = 164), we investigated whether the time since the loss - recent or distant - was associated with individuals' bereavement, attitudes toward death, and their meaning of death. We found that individuals who experienced a recent loss reported more grief and more negative death attitudes compared to individuals who experienced a loss more than 5 years ago. Moreover, the bereavement appeared to completely mediate the time since the loss and the individuals' attitudes about death. The findings suggest that time-dependent adaptations after a loss shifts individuals' death attitudes, grief symptoms, and thoughts about death.

'I Hope You Can Rise Again': Linguistic Variation in Online Condolences

In the wake of tragic events such as the 'Paris Attacks of 2015', the expression of condolences through e-messages has become a common way for individuals to offer support and sympathy to those affected. However, limited research has been conducted on the linguistic aspects of condolence e-messages and how they reflect the speech act of condolence. This study aims to fill this gap by examining the syntactic and pragmatic elements present in these messages. The aim is to understand how the syntactic and pragmatic elements of these messages contribute to the expression of the communicative speech act of condolence. Condolence e-messages were identified and analyzed using an adapted version of Elwood's (2004) coding scheme. The analysis focused on common themes in the condolence sentences, revealing that some linguistic functions were overtly used to express grief. Additionally, specific words such as 'pray', 'love', and 'condolence' were frequently used in conjunction with the expressions of condolence. The findings highlight the influence of sociocultural factors in shaping the norms and variations in the production of speech acts across different cultures. Understanding these linguistic variations can contribute to effective communication and cultural sensitivity in expressing condolences.

Continuing Bonds in the Existential, Phenomenological, and Cultural Study of Grief: Prolegomena

The essay makes the case that continuing bonds is a useful perspective for bereavement studies based in existential, phenomenological, and cultural philosophy. First, the idea of continuing bonds has explanatory power for many phenomena in individual and family grief and in the multiple interactions between individual/family grief and larger social/cultural dynamics. Second, in the study of continuing bonds we find concepts that are akin to those in phenomenology and existentialism. Using some of my own scholarship and the scholarship of many others, the essay is structured by themes Edith Marie Steffen and I found in our 2018 anthology on developments in the continuing bonds model in the two decades after it was introduced: Continuing bonds (1) are inter-subjective, (2) are central in constructing meaning, (3) raise questions about the ontological status of our interactions with the dead, and (4) are best understood within their cultural setting.

Psychometric properties of the of the Persian version of the Coping Assessment for Bereavement and Loss Experiences (CABLE)

BACKGROUND AND AIM

The loss of a loved one through death is practically an inevitable part of the human experience. However, not all grieving people cope with this blow in the same way. One of the factors that may differentiate the grieving reactions of mourners in the face of this lesion is the strategies that the person uses in this situation to adapt and manage the situation. A valid and reliable tool is also needed to measure and evaluate coping strategies. The aim of this study was to translate and determine the characteristics of psychological tools for measuring coping with experiences of grief and loss (28 items) in people living in Tehran.

MATERIALS AND METHODS

This is a methodological study with a descriptive cross-sectional design that after obtaining written permission from the original developer and according to the WHO protocol, the Persian version of the questionnaire was completed by 480 people who experienced mourn in Tehran in February 2021 to October 2021. Then, the Face validity, Content validity and Construct validity of questionnaire were assessed. Cronbach's alpha coefficient, McDonald's omega and Test-retest were used to determine the reliability.

RESULTS

Cronbach's alpha for all items was 0.91 and intra-class correlation coefficient was 0.86, both of which indicate the reliability of the Persian version of the CABLE tool. Based on exploratory factor analysis, maximum likelihood (n = 260) and confirmatory factor analysis (n = 220) six factors were identified. Factors can explain 50% of the total variance observed. The model had an acceptable fit: GFI: 0.88, CFI: 0.96, IFI: 0.96, NFI: 0.92, PNFI: 0.82, RAMSEA: 0.058, CMIN / DF: 2.37 RMR: 0.056. Internal consistency and construct validity of the questionnaire were confirmed.

CONCLUSION

The findings of the present study indicate that the Persian version of CABLE has the appropriate validity and reliability to assess the compliance with the experiences of grief and loss in Persian population.

COVID-19, economic problems, and family relationships in eight Middle East and North African countries

OBJECTIVE

The aim was to assess the reported family relationships during the COVID-19 pandemic and the association between these relationships and individual, interpersonal, and country-level income in eight Middle East and North Africa (MENA) countries.

BACKGROUND

COVID-19 causes fear of infection, loss of loved ones, and economic problems that may affect family relationships.

METHODS

Data were collected from eight MENA countries using an online survey (July-August 2020). The dependent variable was change in family relationship during COVID-19, and the independent variables were individual, interpersonal, and country-level factors represented by sociodemographic factors, COVID-19 status, financial impact (whether participants lost or had reduced wages) and country income. Multilevel logistic regression analysis was conducted.

RESULTS

There were 1854 responses, mean (SD) age of 30.6 (9.9) years, 65.8% were female, 3.4% tested COVID-19 positive, and 20.8% reported lost/reduced wages. Family relationships were more likely to improve or remain unchanged (84.3%) for participants who had a history of COVID-19 (adjusted odds ratio [AOR] = 3.54, 95% confidence interval [CI]: [1.25, 10.01]). However, family relationships were more likely to not improve for those who knew someone who died of COVID-19 (AOR = 0.76, 95% CI [0.58, 0.99]) and those with lost/reduced wages (AOR = 0.69, 95% CI [0.52, 0.94]).

CONCLUSION

Family relationship improved or remained unchanged for those who tested positive for COVID-19 and did not improve for those who lost wages or lost someone due to COVID-19.

IMPLICATIONS

Policy makers should develop strategies to provide social and financial support to employees to reduce the losses and adverse social impact caused by the pandemic.

Healing the Collective Grief: A Story of a Marshallese Pastor from Okinawa

World War II and the Cold War never ended in the Marshall Islands. A seamless continuum of colonialism, wars and nuclear testing destroyed their ancestral islands, traditions, as well as the physical and spiritual wellbeing of the people; it caused them profound personal and collective grief. This article considers the grieving of the Marshallese people, through the lens of a life story of a migrant to the Marshall Islands from Okinawa, Chutaro Gushi (1911–1977). The examination uses the concepts provided by grief studies, such as personal grief and collective grief, and applies the theoretical and conceptual framework presented by the social constructionists, such as meaning making, social validation, and moral injury, to frame the understanding of their grieving, coping and healing processes. The life story of pastor Chutaro revealed an intricate reflexive interface between his personal grief and collective grief in the Marshall Islands. His personal grieving and healing process was also closely linked with the healing of the collective grief that was also an element of his personal grief. In this process, Christian churches played crucial roles to bridge the two levels of grief. They facilitated the transformation of Chutaro’s profound personal grief and moral injury into a powerful public mission to give voices to the victims of the nuclear tests in the Marshall Islands.

The Oxytocinergic System as a Mediator of Anti-stress and Instorative Effects Induced by Nature: The Calm and Connection Theory

Ever more research results demonstrate that human health and wellbeing are positively affected by stays in and/or exposure to natural areas, which leads, among other things, to a reduction in high stress levels. However, according to the studies, these natural areas must meet certain qualities. The qualities that are considered to be most health promoting are those that humans perceive in a positive way. Theories about how natural areas can reduce people's stress levels and improve their coping skills have mainly focused on how certain natural areas that are perceived as safe reduce the activity of the hypothalamic-pituitary-adrenal axis and consequent reduction of cortisol levels. This article discusses studies containing descriptions of how participants in rehabilitation perceive and react to natural phenomena. The common core variable in the analyzed studies was the experience of calm and connection, and this experience was associated with a reduction in stress levels and with being able to develop health and coping skills. We suggest that this experience provides a possible role for the oxytocinergic system to act as a physiological mediator for the positive and health-promoting effects in humans caused by nature. The theory is mainly based on analogies framed by theories and data from the fields of environmental psychology, horticulture, landscape architecture, medicine, and neuroscience. Oxytocin promotes different kinds of social interaction and bonding and exerts stress-reducing and healing effects. We propose that oxytocin is released by certain natural phenomena experienced as positive to decrease the levels of fear and stress, increase levels of trust and wellbeing, and possibly develop attachment or bonding to nature. By these effects, oxytocin will induce health-promoting effects. In situations characterized by low levels of fear and stress in response to release of oxytocin, the capacity for "growth" or psychological development might also be promoted. Such an instorative effect of nature, i.e., the capacity of nature to promote reorientation and the creation of new coping strategies, might hence represent an additional aspect of the oxytocin-linked effect profile, triggered in connection with certain nature phenomena. We conclude by proposing that the stress-relieving, health-promoting, restorative, and instorative effects of nature may involve activation of the oxytocinergic system.

Informing mothers of neonatal death and the need for family-centered bereavement care: A phenomenological qualitative study

PURPOSE

To understand the lived experience of mothers surrounding the time of being informed of neonatal deaths in intensive care units.

DESIGN

A phenomenological qualitative approach was employed.

METHODS

Twelve mothers (age 24-41 years) were identified from the neonatal mortality records of two large neonatal intensive care units with high neonate turnover rates in Amman, Jordan. Data were collected using semistructured interviews with the participants. Interpretive phenomenology was used to generate themes regarding the essence of the mother's experience.

RESULTS

Critical analyses of mothers' accounts revealed three major themes: (a) Minimize the hurt, which described how mothers intuited overprotection by their families while the news was conveyed indirectly to them; (b) The striking reality of death, which captured mothers' distressing experiences while realizing the loss of their neonates; and (c) Farwell my baby, which accentuated mothers' needs and experiences while neonates' bodies were honored and prepared for burial per the cultural norms in Jordan.

PRACTICE IMPLICATIONS

Our findings highlighted the complex dynamics of familial interactions and cultural influences on mothers' bereavement experiences at the time of neonatal death. The grieving mothers expressed unfulfilled needs of receiving professional bereavement support at the time of neonatal death. Strategies are needed to optimize the supportive role of specialized nurses in providing family-centered bereavement care to mothers and their families who experience neonatal death.

A Compassionate Communities Approach in a Grief and Bereavement Support Program: Bridging the Gap in Palliative Care

Grief and bereavement support is a fundamental component of palliative care, yet there is a gap in practice as not all palliative care services offer it. The compassionate communities (CC) approach aims to build community capacity to address grief as grief support is considered everyone's responsibility. This study describes the characteristics, development, growth and attendees of a grief support program that uses a CC approach to bridge the gap of grief support in palliative care.

Memorial tattoos: Advancing continuing bonds theory

A memorial tattoo is a tattoo that honors a person who has died. We aimed to understand how memorial tattoos could be an expression of a bereaved person's continuing relationship with the deceased person that the tattoo memorializes. We interviewed 41 people and used qualitative description grounded in a symbolic interactionist framework to analyze the transcripts. This research expands on continuing bonds theory by showing that memorial tattoos are an expression of the bond with the deceased as well as a way to communicate with others about their ongoing connection and to challenge stigma.

The role of personal and communal religiosity in the context of bereavement

Religion and spirituality often become relevant after the death of a loved one. In light of the multidimensionality of religion and spirituality, we investigate the role of communal religiosity in predicting associations between personal religiosity and bereavement outcomes. A mixed-methods analysis of interviews and questionnaires from 33 bereaved adults was conducted. Interview mentions of personal and communal religiosity, and their associations with self-reported religious coping and grief symptoms, were assessed. Personal (β = 0.55, p < .01) and communal religiosity (β = 0.50, p < .01) predicted positive religious coping, as well as negative religious coping and grief severity (β = 0.53, p < .01). In addition, personal religiosity predicted more negative religious coping for participants who expressed low communal religiosity, β = 1.58, SE = .15, t(28) = 4.08, p < .001. After loss, personal religiosity by itself is not necessarily protective. The presence of personal and communal religiosity contributes to positive religious coping, and reduced negative religious coping. However, the absence of communal religiosity indicates vulnerability.

Is my grief too public for you? The digitalization of grief on Facebook™

Social media platforms such as Facebook, Twitter, Instagram, and Tumblr provide users a metaphorical space to share their feelings and experiences with others, including on the topics of grief and loss. The purpose of the current study was to examine why people post grief messages on Facebook and how they feel about others' grief posts. Findings showed that participants post about their grief and loss on Facebook to commemorate the dead, express their grief, connect with others, and remember special occasions.

Making Sense of Family Deaths in Urban Senegal: Diversities, Contexts, and Comparisons

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.

Mothers' Grief Experiences of Losing Their Only Child in the 2008 Sichuan Earthquake: A Qualitative Longitudinal Study

The purpose of this study is to explore bereaved mothers' 2-year experiences of losing their only child in the 2008 Sichuan earthquake. Taking an interpretative phenomenological approach, this study interviewed six bereaved mothers four times (6 months, 12 months, 18 months, and 24 months) in Dujiangyan area in Sichuan Province. The findings suggest that these mothers' personal grief experiences evolved: initially, anger toward the cause of their children's deaths, following despair of meaningless life, guilt and regret, and finally yearning. Although their yearning and missing ebbed after 2 years, these mothers still had unresolved grief. These mothers also faced strained marital relationships and additional pressure from social interactions. This study illuminates that these mothers' personal grief experiences and their coping strategies corresponded to Chinese family and sociocultural context.

Grief as a Mystical Journey: Fowler's Stages of Faith Development and Their Relation to Post-Traumatic Growth

This paper explores the relationship between embedded theological assumptions and the ways in which one copes with loss and bereavement. Based on James Fowler's research on Stages of Faith Development, the paper examines common Western psycho-spiritual beliefs related to loss, trauma, and grief, and proposes that profound loss experiences have the potential to lead the griever to a shift in theological thinking. It addresses the ways in which a "crisis of faith" triggered by loss or trauma prompts the questioning of closely-held beliefs, which can lead to an expanded spiritual perspective that can be beneficial to the healing process.