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Nursing Interventions to Facilitate the Grieving Process after Perinatal Death: A Systematic Review.International Journal of Environmental... May 2021Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal... (Review)
Review
Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal death, parents experience the process of perinatal grief. Midwives and nurses can develop interventions to improve the perinatal grief process. The aim of this review was to determine the efficacy of nursing interventions to facilitate the process of grief as a result of perinatal death. A systematic review of the literature was carried out. Studies that met the selection criteria underwent a quality assessment using the Joanna Briggs Institute critical appraisal tool. Four articles were selected out of the 640 found. Two are quasi-experimental studies, and two are randomized controlled clinical studies. The interventions that were analyzed positively improve psychological self-concept and role functions, as well as mutual commitment, depression, post-traumatic stress and symptoms of grief. These interventions are effective if they are carried out both before perinatal loss and after it has occurred. The support of health professionals for affected parents, their participation in the loss, expressing feelings and emotions, using distraction methods, group sessions, social support, physical activity, and family education are some of the effective interventions.
Topics: Emotions; Female; Grief; Humans; Parturition; Perinatal Death; Pregnancy; Social Support
PubMed: 34073728
DOI: 10.3390/ijerph18115587 -
The British Journal of General Practice... Jan 2011Over half a million people die in Britain each year and, on average, a GP will have 20 patients die annually. Bereavement is associated with significant morbidity and... (Review)
Review
BACKGROUND
Over half a million people die in Britain each year and, on average, a GP will have 20 patients die annually. Bereavement is associated with significant morbidity and mortality, but the research evidence on which GPs and district nurses can base their practice is limited.
AIM
To review the existing literature concerning how GPs and district nurses think they should care for patients who are bereaved and how they do care for them. design systematic literature review.
METHOD
Searches of AMED, BNI, CINAHL, EMBASE, Medline and PsychInfo databases were undertaken, with citation searches of key papers and hand searches of two journals. Inclusion criteria were studies containing empirical data relating to adult bereavement care provided by GPs and district nurses. Information from data extraction forms were analysed using NVivo software, with a narrative synthesis of emergent themes.
RESULTS
Eleven papers relating to GPs and two relating to district nurses were included. Both groups viewed bereavement care as an important and satisfying part of their work, for which they had received little training. They were anxious not to 'medicalise' normal grief. Home visits, telephone consultations, and condolence letters were all used in their support of bereaved people.
CONCLUSION
A small number of studies were identified, most of which were > 10 years old, from single GP practices, or small in size and of limited quality. Although GPs and district nurses stated a preference to care for those who were bereaved in a proactive fashion, little is known of the extent to which this takes place in current practice, or the content of such care.
Topics: Adult; Bereavement; Community Health Nursing; General Practice; Hospice Care; Humans; Nurse's Role; Physician's Role; United Kingdom
PubMed: 21401990
DOI: 10.3399/bjgp11X549009 -
Frontiers in Psychiatry 2020Web-based interventions have been introduced as novel and effective treatments for mental disorders and, in recent years, specifically for the bereaved. However, a...
BACKGROUND
Web-based interventions have been introduced as novel and effective treatments for mental disorders and, in recent years, specifically for the bereaved. However, a systematic summary of the effectiveness of online interventions for people experiencing bereavement is still missing.
OBJECTIVE
A systematic literature search was conducted by four reviewers who reviewed and meta-analytically summarized the evidence for web-based interventions for bereaved people.
METHODS
Systematic searches (PubMed, Web of Science, PsycInfo, PsycArticles, Medline, and CINAHL) resulted in seven randomized controlled trials ( = 1,257) that addressed adults having experienced bereavement using internet-based interventions. We used random effects models to summarize treatment effects for between-group comparisons (treatment control at post) and stability over time (post follow-up).
RESULTS
All web-based interventions were based on cognitive behavioral therapy (CBT). In comparison with control groups, the interventions showed moderate ( = .54) to large effects ( = .86) for symptoms of grief and posttraumatic stress disorder (PTSD), respectively. The effect for depression was small ( = .44). All effects were stable over time. A higher number of treatment sessions achieved higher effects for grief symptoms and more individual feedback increased effects for depression. Other moderators ( dropout rate, time since loss, exposure) did not significantly reduce moderate degrees of heterogeneity between the studies.
LIMITATIONS
The number of includable studies was low in this review resulting to lower power for moderator analyses in particular.
CONCLUSIONS
Overall, the results of web-based bereavement interventions are promising, and its low-threshold approach might reduce barriers to bereavement care. Nonetheless, future research should further examine potential moderators and specific treatment components ( exposure, feedback) and compare interventions with active controls.
PubMed: 32670101
DOI: 10.3389/fpsyt.2020.00525 -
Journal of Palliative Medicine May 2017Children's books have the potential to facilitate communication about death for children living with a serious illness and for children coping with the death of a loved... (Review)
Review
BACKGROUND
Children's books have the potential to facilitate communication about death for children living with a serious illness and for children coping with the death of a loved one.
OBJECTIVES
This study examines the content of children's literature relevant to the topic of dying and death and identifies books providers can share with children and their families.
DESIGN
A search of children's literature was conducted using four electronic databases and one additional search engine using the word "Death" or "Dying." Storybooks about dying, death, and bereavement published in English, French, or Spanish between 1995 and 2015 were included.
MEASUREMENTS
Each book underwent content analysis by at least two independent reviewers. Strict PRISMA standard was followed. Full protocol is available as PROSPERO #CRD42016042129.
RESULTS
Two hundred ten books met inclusion criteria. The dying subject was primarily a grandparent (n = 78) or pet (n = 44). Books on the experience of a child dying were scarce (n = 5). The word death or dying was used in 75% of the books (n = 158), while others utilized euphemisms. The majority of books featured animals (n = 40) or Caucasian subjects (n = 122) and included spiritual elements such as heaven (n = 122). Less than one-quarter of the books included tools for readers to address the topic of death.
CONCLUSIONS
Storybooks can be a helpful tool to introduce communication about dying and death with children. Gaps exist in current children's literature to effectively enable children to reflect on their own dying process. A general summary of available books is provided to assist those caring for children and families facing end-of-life issues.
Topics: Adaptation, Psychological; Adolescent; Adolescent Behavior; Attitude to Death; Bereavement; Child; Child Behavior; Female; Grief; Humans; Literature; Male
PubMed: 28346862
DOI: 10.1089/jpm.2016.0494 -
JMIR Mental Health Dec 2021Although grief and its symptoms constitute a normal reaction to experiences of loss, some of those affected still report elevated levels of distress after an extended... (Review)
Review
BACKGROUND
Although grief and its symptoms constitute a normal reaction to experiences of loss, some of those affected still report elevated levels of distress after an extended period, often termed complicated grief. Beneficial treatment effects of face-to-face therapies, for example, grief counseling or cognitive behavioral therapy against complicated grief, have been reported. Evaluations of internet- and mobile-based interventions targeting symptoms of grief in bereaved individuals with regard to objective quality criteria are currently lacking.
OBJECTIVE
We aim to conduct a systematic review and meta-analysis on the effectiveness and feasibility of internet- and mobile-based interventions against symptoms of grief after bereavement.
METHODS
We conducted systematic literature searches of randomized controlled trials or feasibility studies published before January 9, 2020, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, in PubMed, PsycINFO, Web of Science Core Collection, and the Cochrane Library. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations system. We further assessed aspects of feasibility and rated quality of interventions using criteria suggested by an expert panel on mental health care (German Association for Psychiatry, Psychotherapy, and Psychosomatics). A random-effects meta-analysis was conducted to assess between-group effect sizes.
RESULTS
In total, 9 trials (N=1349) were included. Of these, 7 studies were analyzed meta-analytically. Significant effects were found for symptoms of grief (g=0.54, 95% CI 0.32-0.77), depression (g=0.44, 95% CI 0.20-0.68), and posttraumatic stress (g=0.82, 95% CI 0.63-1.01). Heterogeneity was moderate for grief and depression (I=48.75% and 55.19%, respectively) and low for posttraumatic stress symptoms (I=0%). The overall quality of evidence was graded low (grief and depression) to moderate (posttraumatic stress). User satisfaction with the interventions was high, as was the quality of the interventions assessed using objective quality criteria.
CONCLUSIONS
Internet- or mobile-based interventions might constitute an effective treatment approach against symptoms of grief in bereaved adults. However, the small sample sizes and limited number of studies included in the review warrant further investigation.
TRIAL REGISTRATION
International Prospective Register of Systematic Reviews (PROSPERO) CRD42012002100; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131428.
PubMed: 34889769
DOI: 10.2196/29661 -
Lancet Regional Health. Americas Jul 2022The suicide rate in Guyana has consistently ranked as one of the highest in the world. This systematic review synthesises and critically analyses the existing literature... (Review)
Review
BACKGROUND
The suicide rate in Guyana has consistently ranked as one of the highest in the world. This systematic review synthesises and critically analyses the existing literature on suicidal behaviours and ideation in Guyana.
METHODS
Systematic review with narrative synthesis was conducted following PRISMA guidelines. PubMed, PsychInfo, CINAHL and SCOPUS databases were searched until 31 March 2021. Articles which included the analysis of suicidal behaviour or suicidal ideation using data collected in Guyana were eligible for inclusion. Articles relating to the Jonestown mass murder-suicide event were excluded. This review was pre-registered with PROSPERO [CRD42021247669].
FINDINGS
The search resulted in 318 articles, of which 24 met eligibility for inclusion. The majority were quantitative (=18), relating to suicide mortality (=9), and suicide attempt and suicidal ideation (=9). Additionally, qualitative (=5) and mixed-method (=1) papers investigated the experiences of those bereaved by suicide, gatekeepers of suicidality, and adolescent students. Eleven studies were multinational, whilst 13 focused on Guyana. The quality of the publications varied.
INTERPRETATION
Despite high annual suicide rates in Guyana, published research is very limited. This review found preliminary evidence for key risk groups; males, female youth, and Indo-Guyanese ethnicity. Pesticide poisoning was identified as the most common method for suicide in Guyana. There is a need for local research investigating the context and narrative of suicide to inform culturally tailored prevention strategies. This study was limited to a narrative synthesis and may be impacted by publication bias.
FUNDING
This research was supported by an Australian Government Research Training Program Scholarship through Griffith University Australia.
REGISTRATION
Pre-registered in PROSPERO [CRD42021247669].
PubMed: 36778929
DOI: 10.1016/j.lana.2022.100253 -
Women and Birth : Journal of the... Sep 2023Evidence-informed, best-practice recommendations concerning bereavement photography following stillbirth have yet to be proposed. (Review)
Review
PROBLEM
Evidence-informed, best-practice recommendations concerning bereavement photography following stillbirth have yet to be proposed.
BACKGROUND
Previous research has highlighted the general importance of memory-making following pregnancy loss; however, scarce studies have specifically examined bereavement photography experiences.
AIM
To examine parents', healthcare professionals' and photographers' perspectives and experiences of stillbirth bereavement photography.
METHODS
Guided by JBI Collaboration methods, we conducted a systematic review and meta-synthesis (using a meta-aggregative approach) of 12 peer-reviewed studies conducted predominantly in high-income countries FINDINGS: Two overarching synthesised findings were generated: Bereavement photography as a helpful tool for the present and Bereavement photography as a helpful tool for the future. The proactive recommendation of memory-making influenced parents' decisions, and some parents not offered bereavement photography post-stillbirth expressed their desire for this opportunity retrospectively. Most parents who utilised bereavement photography were positive about their experiences. In the acute stages of loss, photographs supported meaningful introductions of the baby to their sibling(s) and validated parents' loss. Longer-term, the photographs validated the stillborn child's life, maintained memories and enabled parents to share their child's life with others.
DISCUSSION
Bereavement photography appeared beneficial, even though some parents felt conflicted about it. Parental views about photography appeared to fluctuate; many parents who rejected the offer of stillbirth photography described regret about their decision later. Conversely, parents who reluctantly accepted photographs were grateful.
CONCLUSION
Our review shows compelling evidence that bereavement photography should be normalised and offered to parents in the wake of stillbirth, with tactful, personalised approaches needed to assist with bereavement.
Topics: Pregnancy; Female; Infant; Child; Humans; Stillbirth; Retrospective Studies; Qualitative Research; Bereavement; Parents
PubMed: 36878762
DOI: 10.1016/j.wombi.2023.03.001 -
Behavioral Sciences (Basel, Switzerland) May 2019Bereavement is associated with impaired mental health, increases in adverse health behaviors, and heightened risk of suicidal ideation, attempts, and death by suicide.... (Review)
Review
Bereavement is associated with impaired mental health, increases in adverse health behaviors, and heightened risk of suicidal ideation, attempts, and death by suicide. The purpose of this literature review was to explore associations between cause of death and suicidal thoughts among bereaved individuals. Our aim was to compare incidence of suicidal ideation by cause of death and identify gaps in this literature to guide future research and clinical intervention. PRISMA-P guidelines were used to structure an electronic literature search in the PsycINFO, MEDLINE, and Web of Science databases. The search focused on English language studies that were published before February 2019 and sought to compare rates of suicidal ideation among bereaved people who lost a loved one to suicide, accidental overdose, cancer, dementia, cardiovascular disease, and HIV/AIDs. Ten articles were identified with suicide as cause of death, zero articles for accidental overdose, zero articles for cardiovascular disease, eight articles for cancer, one article for dementia, and one article for HIV/AIDs. Given the limited number of articles generated by our search, a formal meta-analysis was not appropriate. However, a comparison of results did suggest that suicide bereavement was associated with the highest rates of suicide ideation (14.1% to 49%). Stigma, isolation, avoidance behaviors, and psychological distress were associated with suicidal thoughts among bereaved individuals, regardless of the deceased's cause of death. Findings of this literature search revealed significant gaps in the literature, especially regarding thoughts of suicide in bereaved survivors of accidental overdose and cardiovascular disease. Results suggest that multiple causes of death are associated with suicidal ideation in bereavement, but that suicide bereavement may be the cause of death associated with the highest risk of suicidal ideation. More research is needed to understand the ways in which cause of death influences prevalence, risk, and protective factors associated with suicidal thoughts among bereaved individuals.
PubMed: 31091772
DOI: 10.3390/bs9050053 -
Sleep Medicine Reviews Oct 2020Severe, persistent and disabling grief occurs among a sizable minority experiencing bereavement, with diagnostic manuals newly including complicated grief (CG)...
Severe, persistent and disabling grief occurs among a sizable minority experiencing bereavement, with diagnostic manuals newly including complicated grief (CG) disorders. Sleep disturbances/disorders have been established as worsening affective and stress-related conditions. However, the role of sleep difficulties in bereavement and CG has not received similar scientific attention. We therefore conducted a systematic review with narrative syntheses on this topic to clarify the role of sleep in bereavement (PROSPERO: CRD42018093145). We searched PubMed, Web of Science and PsychInfo for peer-reviewed English-language articles including (at least one) bereaved sample and sleep disturbance measure. We identified 85 articles on 12.294 participants. We answered seven pre-defined research questions demonstrating: high prevalence of sleep disturbances in bereavement; positive associations of grief intensity with sleep difficulties; preliminary indications of risk factors of post-loss sleep disturbance; higher prevalence of sleep disturbances in CG, enhanced by psychiatric comorbidity (i.e., depression); and initial evidence of causal relationships between (complicated) grief and sleep. Grief therapy partly improves sleep difficulties, yet no intervention studies have specifically targeted sleep problems in bereaved persons. Causal relationships between sleep and grief require further examination in intensive longitudinal investigations, including randomized trials, thereby clarifying whether treating sleep problems enhances CG treatment effects.
Topics: Bereavement; Comorbidity; Depression; Humans; Prevalence; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires
PubMed: 32505968
DOI: 10.1016/j.smrv.2020.101331 -
Journal of Medical Internet Research Sep 2021Although patient portals are widely used for health promotion, little is known about the use of palliative care and end-of-life (PCEOL) portal tools available for... (Review)
Review
BACKGROUND
Although patient portals are widely used for health promotion, little is known about the use of palliative care and end-of-life (PCEOL) portal tools available for patients and caregivers.
OBJECTIVE
This study aims to identify and assess the user perspectives of PCEOL portal tools available to patients and caregivers described and evaluated in the literature.
METHODS
We performed a scoping review of the academic literature directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) extension for Scoping Review and searched three databases. Sources were included if they reported the development or testing of a feature, resource, tool, or intervention; focused on at least one PCEOL domain defined by the National Coalition for Hospice and Palliative Care; targeted adults with serious illness or caregivers; and were offered via a patient portal tethered to an electronic medical record. We independently screened the titles and abstracts (n=796) for eligibility. Full-text (84/796, 10.6%) sources were reviewed. We abstracted descriptions of the portal tool name, content, targeted population, and reported user acceptability for each tool from included sources (n=19).
RESULTS
In total, 19 articles describing 12 tools were included, addressing the following PCEOL domains: ethical or legal (n=5), physical (n=5), and psychological or psychiatric (n=2). No tools for bereavement or hospice care were identified. Studies have reported high acceptability of tools among users; however, few sources commented on usability among older adults.
CONCLUSIONS
PCEOL patient portal tools are understudied. As medical care increasingly moves toward virtual platforms, future research should investigate the usability and acceptability of PCEOL patient portal resources and evaluate their impact on health outcomes.
Topics: Aged; Caregivers; Hospice Care; Humans; Palliative Care; Patient Portals; Terminal Care
PubMed: 34528888
DOI: 10.2196/28797