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Current Psychiatry Reports Nov 2013Bereavement is a common experience in adults aged 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased... (Review)
Review
Bereavement is a common experience in adults aged 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7 % of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition and evidenced-based treatments for CG. Greater attention to CG detection and treatment in older adults is needed.
Topics: Adjustment Disorders; Age Factors; Aged; Bereavement; Evidence-Based Medicine; Grief; Humans; Middle Aged; Risk Factors
PubMed: 24068457
DOI: 10.1007/s11920-013-0406-z -
Prilozi (Makedonska Akademija Na... Oct 2021Grief is a process provoked as a response to different losses, such as death, loss of job, relationship breakdown, some unexpected life events and changes, etc. The... (Review)
Review
Grief is a process provoked as a response to different losses, such as death, loss of job, relationship breakdown, some unexpected life events and changes, etc. The experiences of loss and bereavement are very individual. Even though loss is expected, the person feels traumatized, especially if death is provoked by violence, natural disasters, or war. This pandemic, like other disasters (wars, tsunami, earthquakes, floods, etc.) has provoked intensive reactions of grief, reactions that could persist for years. The core symptoms of grief are described in the ICD-11 and DSM-5 manuals. The term "complicated grief" in the medical sense refers to a superimposed process that alters grief and modifies its course for the worse. Prolonged grief disorder (PGD) is characterized by normal grief symptoms, but these are symptoms that remain too intense for too long of a period. This article is a review of the manifestations and duration of grief in different occasions, and it is based on over 50 published papers, and discoveries in the Medline and Psych-Net databases. Commonly described reactions to grief are: shock, disbelief or denial, a high level of anxiety, distress, anger, sadness, insomnia, and a loss of appetite. As predictors for a high/slow decreasing trajectory of grief process are: female gender, reported symptoms of depression before the traumatic event, and higher scores on avoidance. However, grief is transient, even as we are is in the midst of its clutches. People should expect to fluctuate between moments of sadness and mourning, and moments of acceptance, or even happiness for being alive. Researchers suppose that when a crisis passes; most people will be able to bounce back and move on with their lives.
Topics: Anxiety; Bereavement; Diagnostic and Statistical Manual of Mental Disorders; Female; Grief; Humans; Stress Disorders, Post-Traumatic
PubMed: 34699700
DOI: 10.2478/prilozi-2021-0014 -
European Journal of Oncology Nursing :... Feb 2023Grief and bereavement is often present among patients and families during courses of cancer. Offering support for both patients and families is essential in the context... (Review)
Review
PURPOSE
Grief and bereavement is often present among patients and families during courses of cancer. Offering support for both patients and families is essential in the context of cancer nursing. Present scoping review offers an overview of existing knowledge, which can be used for inspiration in cancer-nursing. Hence, the objective of this study was to identify understandings of grief and bereavement, which is present in a cancer-nursing context and to develop insight on existing knowledge about nursing interventions targeted patients and their families' experiences of grief and bereavement due to cancer illness.
METHOD
The scoping review is conducted, inspired by the methodology of Joanna Briggs Institute. Sources of evidence are retrieved from a large number of databases and resources.
RESULTS
Twenty-two studies are included in the scoping review. The studies are retrieved from eight different countries. Findings are mapped in nine categories. Eight categories related to nursing care targeted patients and/or families experiencing grief and/or bereavement; One category related to understandings of grief and/or bereavement targeted patients and families.
CONCLUSION
Nursing interventions to support patients and their families during grief and bereavement covers a broad spectrum of interventions. E.g. communication; using artwork; cultural and spiritual care; bereavement care; supporting coping strategies. Different models and theoretical understandings were identified. E.g. The dual process model of coping with bereavement; A Divorced Family-focused Care Model; Family Strengths-Oriented Therapeutic Conversation (Fam-SOTC); and understandings of children's grieving process.
Topics: Child; Humans; Grief; Bereavement; Oncology Nursing; Neoplasms; Nurses; Family
PubMed: 36610290
DOI: 10.1016/j.ejon.2022.102260 -
Reproductive Health Jan 2021For most parents, getting pregnant means having a child. Generally, the couple outlines plans and has expectations regarding the baby. When these plans are interrupted...
The perinatal bereavement project: development and evaluation of supportive guidelines for families experiencing stillbirth and neonatal death in Southeast Brazil-a quasi-experimental before-and-after study.
BACKGROUND
For most parents, getting pregnant means having a child. Generally, the couple outlines plans and has expectations regarding the baby. When these plans are interrupted because of a perinatal loss, it turns out to be a traumatic experience for the family. Validating the grief of these losses has been a challenge to Brazilian society, which is evident considering the childbirth care offered to bereaved families in maternity wards. Positively assessed care that brings physical and emotional memories about the baby has a positive impact on the bereavement process that family undergoes. Therefore, this study aims to assess the effects supportive guidelines have on mental health. They were designed to assist grieving parents and their families while undergoing perinatal loss in public maternities in Ribeirão Preto, São Paulo state, Brazil.
METHOD
A mixed-methods (qualitative/quantitative), quasi-experimental (before/after) study. The intervention is the implementation of bereavement supportive guidelines for women who experienced a stillbirth or a neonatal death. A total of forty women will be included. Twenty participants will be assessed before and twenty will be assessed after the implementation of the guidelines. A semi-structured questionnaire and three scales will be used to assess the effects of the guidelines. Health care professionals and managers of all childbirth facilities will be invited to participate in focus group. Data will be analyzed using statistical tests, as well as thematic analysis approach.
DISCUSSION
The Perinatal Bereavement guidelines are a local adaptation of the Canadian and British corresponding guidelines. These guidelines have been developed based on the families' needs of baby memories during the bereavement process and include the following aspects: (1) Organization of care into periods, considering their respective needs along the process; (2) Creation of the Bereavement Professional figure in maternity wards; (3) Adequacy of the institutional environment; (4) Communication of the guidance; (5) Creation of baby memories. We expect that the current project generates additional evidence for improving the mental health of women and families that experience a perinatal loss. Trial registration RBR-3cpthr For many couples, getting pregnant does not only mean carrying a baby, but also having a child. Most of the time, the couple has already made many plans and has expectations towards the child. When these plans are interrupted because of a perinatal loss, it turns out to be a traumatic experience for the family. In Brazilian culture, validating this traumatic grief is very difficult, especially when it happens too soon. The barriers can be noticed not only by the way society deals with the parents' grief, but also when we see the care the grieving families receive from the health care establishment. Creating physical and emotional memories might bring the parents satisfaction regarding the care they receive when a baby dies. These memories can be built when there is good communication throughout the care received; shared decisions; the chance to see and hold the baby, as well as collect memories; privacy and continuous care during the whole process, including when there is a new pregnancy, childbirth and postnatal period. With this in mind, among the most important factors are the training of health staff and other professionals, the preparation of the maternity ward to support bereaved families and the continuous support to the professionals involved in the bereavement. This article proposes guidelines to support the families who are experiencing stillbirth and neonatal death. It may be followed by childbirth professionals (nurses, midwives, obstetricians and employees of a maternity ward), managers, researchers, policymakers or those interested in developing specific protocols for their maternity wards.
Topics: Bereavement; Brazil; Child; Female; Grief; Humans; Infant, Newborn; Parents; Perinatal Care; Perinatal Death; Postnatal Care; Practice Guidelines as Topic; Pregnancy; Professional-Patient Relations; Social Support; Stillbirth
PubMed: 33407643
DOI: 10.1186/s12978-020-01040-4 -
Current Opinion in Psychology Feb 2022Although grief is a reaction to a social loss, it has been viewed almost exclusively through the lens of individual psychology and not sociology. In this article, we... (Review)
Review
Although grief is a reaction to a social loss, it has been viewed almost exclusively through the lens of individual psychology and not sociology. In this article, we suggest that more attention to sociological aspects of grief is warranted. We propose a micro-sociological theory of bereavement and grief to complement, not replace, psychological perspectives. We assert that bereavement represents a state of loss-associated social deprivations (e.g. social disconnection). Furthermore, we postulate that addressing social deprivations (e.g. enhancing social connection) will lessen severity of distressing, disabling grief and, thereby, promote adjustment to loss. Future research is needed to test our theory and the hypotheses that follow from it in the service of promoting adaptation to bereavement.
Topics: Adaptation, Psychological; Bereavement; Grief; Humans; Social Theory; Sociology
PubMed: 34333375
DOI: 10.1016/j.copsyc.2021.06.016 -
BMJ Supportive & Palliative Care Dec 2023The increase in the number of jurisdictions legalising medical assistance in dying (MAiD) has contributed to a growth in the number of family and friends who may face... (Review)
Review
OBJECTIVES
The increase in the number of jurisdictions legalising medical assistance in dying (MAiD) has contributed to a growth in the number of family and friends who may face unique elements of grief and bereavement. The aim of this study was to review the literature of grief and bereavement of family and friends following MAiD, and to summarise findings for the development of community resources and programming.
METHODS
We performed a scoping review with workshop consultation of stakeholders. Six electronic databases and the grey literature were searched for qualitative, quantitative and review articles. Content-analytical techniques and multidisciplinary discussions led to the development of concepts and a conceptual framework.
RESULTS
Twenty-eight articles met the inclusion criteria. We identified five concepts that impact the grief and bereavement of family/friends: relationships between family/friends and the patient as well as healthcare providers; aspects of MAiD grief which can include secrecy and/or anticipatory grief; preparations which may include family/friends and should be centralised and harmonised; end of life as an opportunity for ceremony; and the aftereffects during which mental health outcomes are studied.
CONCLUSION
This multidisciplinary scoping review incorporates stakeholder consultation to find that support is needed to address the complicated and changing emotions of family/friends before, during and after a MAiD death. Furthermore, additional societal normalisation of MAiD is necessary to reduce secrecy and stigma and improve the accessibility of resources for family/friends.
Topics: Humans; Friends; Social Support; Grief; Bereavement; Death; Family
PubMed: 36100431
DOI: 10.1136/spcare-2022-003715 -
Pediatric Critical Care Medicine : a... Aug 2018To describe the health outcomes of bereaved parents and identify practical strategies for critical care providers as they support and provide anticipatory guidance to... (Review)
Review
OBJECTIVES
To describe the health outcomes of bereaved parents and identify practical strategies for critical care providers as they support and provide anticipatory guidance to bereaved parents.
DATA SOURCES
PubMed and PsycInfo databases with search terms of bereavement, grief, with parent and pediatric or child complimented by personal experience and knowledge.
STUDY SELECTION
We sought studies describing parental health outcomes and needs of bereaved parents after the death of their child.
DATA SYNTHESIS
A narrative literature review was performed and framed from the perspective of PICU providers who care for bereaved parents. We aimed to describe experiences of grief and short- and long-term consequences and approaches to the care of parents and families in the immediate period and in the months after the death of a child.
CONCLUSIONS
The death of a child is a traumatic experience that can put parents at risk for adverse mental and physical health during bereavement. Health professionals working in PICUs can benefit from knowing these risks to best support bereaved parents, both during their child's hospitalization and in the early postdeath period. The bereavement experience of parents is an adaptive process, and ongoing professional support may be required for vulnerable families. After the child's hospitalization and death, a bereavement follow-up meeting with PICU physician(s) and staff may allow parents to gain additional information, emotional support, and provide an opportunity for parents to give feedback on their experiences.
Topics: Child; Death; Female; Grief; Humans; Intensive Care Units, Pediatric; Male; Needs Assessment; Outcome Assessment, Health Care; Parents; Professional-Family Relations; Social Support
PubMed: 30080812
DOI: 10.1097/PCC.0000000000001466 -
International Journal of Environmental... Mar 2023Childhood bereavement (CB) resulting from a parent or primary caregiver death is associated with a range of adverse outcomes. Little is known about the association... (Observational Study)
Observational Study
Childhood bereavement (CB) resulting from a parent or primary caregiver death is associated with a range of adverse outcomes. Little is known about the association between CB and adult flourishing in the context of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs). In a cross-sectional observational study, we examined how ACEs, PCEs, and adult flourishing differs by self-reported CB history among 9468 Chinese young adults (18-35 years), of which 4.3% experienced CB ( = 409). Data collection included convenience sampling among university students in Mainland China. Respondents voluntarily completed an online survey between August and November 2020. Descriptive statistics, chi-square tests, and logistic regressions examined frequencies and differences in ACEs, PCEs, and flourishing by the history of CB controlling for a few demographic covariates. Bereaved individuals reported significantly higher ACEs and lower PCEs. The odds of experiencing emotional, physical, and sexual abuse as well as household substance abuse, parental mental illness, and parental incarceration ranged from 2.0-5.2 times higher for bereaved individuals. Bereaved participants also reported significant negative relationships with Flourishing Index (β = -0.35, t = -4.19, < 0.001) and Secure Flourishing Index (β = -0.40, t = -4.96, < 0.001). Consistent with previous research, our findings demonstrate the lasting effects of CB on well-being. We discuss study implications for ACEs and PCEs screening and surveillance as well as grief counseling to promote flourishing among bereaved youth in China and beyond.
Topics: Adolescent; Humans; Young Adult; Bereavement; Cross-Sectional Studies; East Asian People; Grief; Surveys and Questionnaires; Adult
PubMed: 36901641
DOI: 10.3390/ijerph20054631 -
The British Journal of General Practice... Oct 2016
Review
Topics: Adaptation, Psychological; Bereavement; Death; General Practice; Grief; Humans; Spirituality; Terminal Care
PubMed: 27688503
DOI: 10.3399/bjgp16X687325 -
Omega Mar 2017Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to "prescribe" stages. Basically, this perspective... (Review)
Review
Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to "prescribe" stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively, as a progression that bereaved persons must follow in order to adapt to loss. It is of paramount importance to assess stage theory, not least in view of the current status of the maladaptive "persistent complex bereavement-related disorder" as a category for further research in DSM-5. We therefore review the status and value of this approach. It has remained hugely influential among researchers as well as practitioners across recent decades, but there has also been forceful opposition. Major concerns include the absence of sound empirical evidence, conceptual clarity, or explanatory potential. It lacks practical utility for the design or allocation of treatment services, and it does not help identification of those at risk or with complications in the grieving process. Most disturbingly, the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not. Following such lines of reasoning, we argue that stage theory should be discarded by all concerned (including bereaved persons themselves); at best, it should be relegated to the realms of history. There are alternative models that better represent grieving processes. We develop guidelines to enhance such a move beyond the stage approach in both theory and practice.
Topics: Attitude of Health Personnel; Bereavement; Counseling; Humans; Models, Psychological
PubMed: 28355991
DOI: 10.1177/0030222817691870