Abstract
BackgroundPatient death is an event that all health care workers will face at some point. Beyond the family, the greatest emotional strain is on people who work directly with the patient and family. Bereavement overload occurs after multiple losses without time for normal grief in between.AimTo investigate bereavement overload, its effects and related coping mechanisms of personnel working in adult medical wards.SettingFour adult medical wards at National District Hospital, Bloemfontein.MethodsAn analytical cross-sectional study design was performed with the aid of an interviewer-administered questionnaire. The target population included health care providers (13 doctors and 20 nurses), eight final-year medical students, and four administrative staff working in the four adult medical wards at National District Hospital, during August to October 2016.ResultsHalf (48.9%) of the 45 participants reported bereavement overload. None of the medical students reported bereavement overload compared to 60.0% of nurses, 75.0% of administrative staff and 53.9% of doctors. Nearly two-thirds (64.5%, n = 29) stated that they suffered from compassion fatigue. The majority of participants (62.2%) used only positive coping mechanisms. The use of negative coping mechanisms correlated directly with a longer duration in the medical field.ConclusionWith a 49% prevalence of bereavement overload, it is important that support systems are in place to prevent the effects of negative coping mechanisms. The desirable outcome is that health care providers, who suffer from bereavement overload, experience compassion satisfaction and become more dedicated to the patients’ well-being without expense to themselves.
Highlights
Psychologist Robert Kastenbaum first described bereavement overload more than 30 years ago as a situation where an individual is grieving more than one loss at the same time, or where losses occur shortly after each other, such that one loss is not dealt with before the other occurs.[1]Medicine is usually associated with treatment and cure, but there are instances where patients die
All the participants’ occupations required them to interact with patients and all participants had experienced more than one patient death in the ward
Compassion fatigue was prevalent in two-thirds of participants and highest in doctors
Summary
Psychologist Robert Kastenbaum first described bereavement overload more than 30 years ago as a situation where an individual is grieving more than one loss at the same time, or where losses occur shortly after each other, such that one loss is not dealt with before the other occurs.[1]Medicine is usually associated with treatment and cure, but there are instances where patients die. Psychologist Robert Kastenbaum first described bereavement overload more than 30 years ago as a situation where an individual is grieving more than one loss at the same time, or where losses occur shortly after each other, such that one loss is not dealt with before the other occurs.[1]. But normal adjustment process after a loss, such as death.[2] The grief process affects many aspects of life, including physical, emotional, cognitive, behavioural and spiritual adjustments.[2,3] Adjustment is needed after each death experience. These mechanisms can be either positive, which is behaviour that is beneficial to the person, or negative. Bereavement overload occurs after multiple losses without time for normal grief in between
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