Bereavement Practices Research Articles

COVID-19 Deaths in Transnational Settings: Disrupted Bereavement and Pandemic-Related Prolonged Grief Disorder in the Latinx Immigrant Population.

The Latinx immigrant population experienced one of the highest COVID-19 death rates. Those left behind have exhibited rising rates of mental illness, particularly, pandemic-related prolonged grief disorder. The Latinx immigrant population is uniquely vulnerable to this disorder as a result of disrupted culturally appropriate bereavement practices, constrained social support, and concurrent COVID-19 stressors and immigration-related trauma. Despite a rising call for research on pandemic-related prolonged grief disorder, little is known about the true prevalence, cause, and appropriate treatment protocol behind this disorder in the Latinx immigrant population. Four areas of research critical to the identification and understanding of pandemic-related prolonged grief disorder in this population are recommended: 1) death and bereavement in transnational settings, 2) immigrant social networks and disrupted bereavement, 3) COVID-19 stressors and grieving, and 4) prolonged grief disorder and mental illness comorbidities. An understanding of these four contributing areas to Latinx immigrants' vulnerability to prolonged grief disorder is imperative to providers' development of assessments and treatment protocols needed to identify and treat prolonged grief disorder in this population.

Prevalence of Prolonged Grief Disorder in East Asia: A Systematic Review and Meta Analysis Introduction Findings

This poster examines the prevalence of Prolonged Grief Disorder (PGD) in the adult bereaved population of East Asia. Study results suggest cultural differences in bereavement practices may influence the prevalence of PGD in East Asia, highlighting the need for further research in other East Asian countries. From The Asian Conference on Psychology & the Behavioral Sciences 2024 Official Conference Proceedings.

Supportive and non-supportive social experiences following suicide loss: a qualitative study

BackgroundSuicide bereavement entails profound social stressors, including stigma and communication barriers, which can impair social support for suicide loss survivors (SLS). Despite recognized benefits of empathetic interactions, social support, and self-disclosure in mitigating adverse mental health outcomes after suicide loss, we lack a comprehensive understanding of the factors influencing perceived social support among SLS within their broader social environments. To address this gap, our study explores the diverse social experiences of SLS beyond their immediate circles. Specifically, we identify characteristics that define both supportive and non-supportive social experiences of SLS, as well as the facilitators and barriers to social support in the context of suicide bereavement.MethodsIn 2022, we conducted structured online individual interviews with a diverse sample of 18 SLS in Germany. We analyzed these interviews using qualitative content analysis.ResultsWe examined the social experiences of SLS across three phases and social contexts: (1) the immediate aftermath of the loss; (2) during bereavement practices; and (3) over time. Our findings show that proactive responses and personalized mourning rituals significantly enhance SLS’ sense of community support, while encounters characterized by avoidance or intrusive curiosity lead to feelings of isolation. Over time, supportive interactions often emerge from peers with similar experiences, promoting openness and shared vulnerability. Conversely, superficial engagement, along with experiences of others depersonalizing and avoiding conversations about the loss, contribute to a sense of marginalization.ConclusionsOur findings highlight the importance of proactive engagement and open dialogue, calling for societal and communicative shifts toward inclusive and compassionate approaches in addressing suicide loss. This study underscores the need for comprehensive strategies that enhance both suicide and grief literacy and address the taboo and stigma surrounding suicide, ultimately fostering supportive social environments for SLS.

Good (virtual) grief: The potential of online communities for bereaved older adults during Covid-19

During the pandemic, older adults were at risk of heightened social isolation and bereavement overload. However, engagement in online grief communities can facilitate meaningful social connections and promote healthy bereavement practices. This paper highlights the benefits of engaging in meaning-making, community building, and griefwork in later life. We engage with recent literature on virtual bereavement practices and discuss the ongoing potential for bereaved older adults to engage in online grief communities amid the new realities of Covid-19. We consider what it means to process grief in a virtual space and how this may shape approaches to death, dying, and bereavement during and after a global pandemic. We conclude with a call to action to develop accessible and affordable online engagement technologies for older adults to help mitigate a decline in well-being and promote healthy bereavement practices.

Providing a voice to the experience of bereavement support at Mexican workplaces

Literature on grief in the workplace is mainly represented in the last three decades and is predominantly western focused. An interpretative phenomenological research study was conducted using criterion sampling to recruit nine participants working full time in Mexican organizations who had a death loss of a close family member in 2018, 2019, 2020, or the first six months of 2021. Participants were interviewed to explore the types of practices offered from their workplace and the implications of those practices, and the felt experience as they made meaning through narrative and visual representation. Results revealed inconsistencies in organizations related to bereavement practices, such as organizations inconsistent communication of bereavement, providing time off, providing flexible bereavement support, and providing financial support for employees exists in the Mexican workplace. The implications of such practices were those of lack of organizational compassion, and insufficient flexibility around work expectations, financial support, and psychological support.

Gendered mourning: A perspective of Akan death culture in Ghana

Death is the commonest, incomprehensible, and inescapable reality confronting humanity in all nations and cultures. However, cultures vary in their conceptions of death, grieving and mourning rituals. Among the Akan of Ghana, mourning and funeral obsequies are essential cultural and spiritual practices. In this article, we draw insights from our reflective lived experiences and critical literature review to explore mourning and death rituals among the Akan as a stratified cultural system that reflects and reproduces broader gender patterns of masculinity and femininity in Ghana. We discuss the concept and cultural significance of mourning and bereavement practices, and further examine how socio-cultural notions of gender shape mourning and death rituals in Ghana. We argue that, as in many social and economic spaces in Ghana, funeral obsequies and bereavement practices represent sites for enacting and reproducing masculinity and femininity. The deleterious health and psychological consequences for men and women are further discussed.

Listening to Layers of Loss

Reflecting on the recent losses of her sister, father, and mother in the midst of the global pandemic, the author moves from acquaintance-level grief communication encounters through grief communication with friends, family, and, ultimately, the self-communication that has sustained her during this intense period of bereavement. Building upon scholarship in autoethnography, family communication, grief, and trauma studies, moreover, the author shares bereavement practices that have helped her process loss. Following her personal narrative, she provides seven offerings to encourage the bereaved reader and support their grief writing. The essay concludes by challenging assumptions of U.S. culture’s “grief illiteracy,” with a call for white writers, in particular, to interrogate the social scripts and systems of power and privilege manifest in their grief communication. Moreover, the author encourages all autoethnographers to build systemic critique from their multilayered personal considerations of grief and post-traumatic growth.

End-Of-Life Care Planning and Bereavement Practices Among Adult Day Services Centers, 2018.

Introduction: This study describes the end-of-life (EOL) care planning and bereavement practices among adult day services centers (ADSC) when an ADSC participant is dying or has died. Methods: Data are from the 2018 National Study of Long-term Care Providers' biennial survey of ADSCs. Respondents were asked about the following 4 practices: 1) honoring the deceased in some public way in this center; 2) offering bereavement services to staff and participants; 3) documenting in the care plan what is important to the individual at the end of life (EOL), such as the presence of family or religious or cultural practices; and 4) discussing spiritual needs at care planning conferences. ADSC characteristics included US Census region, metropolitan statistical area status, Medicaid authorization, electronic health records (EHR) use, for-profit status, employment of aides, services provision, and model type. Results: About 50% to 30% of ADSCs offered the EOL care planning or bereavement services. Honoring the deceased was the most common practice (53%), followed by bereavement services (37%), discussing spiritual needs (29%), and documenting what is important at EOL (28%). Fewer ADSCs in the West had EOL practices relative to the other regions. The EOL planning and bereavement practices were offered more often in ADSCs that used EHRs, accepted Medicaid, employed an aide, provided nursing, hospice, and palliative care services, and were categorized as medical models, compared with ADSCs without these characteristics. Conclusion: These results highlight the importance of understanding how ADSCs provide EOL and bereavement care to participants who are near EOL.

Bereavement practices of gynecologic oncologists: Physician and care team practices compared to caregiver needs.

12021 Background: Gynecologic cancers account for over 34,000 deaths in the United States annually. Family-centered care is beneficial to the family unit and patient throughout the illness course. Research is lacking regarding how physicians should approach family members or other caregivers after a patient dies. We aimed to assess how gynecologic oncologists are currently practicing and compare that to family members’ needs during the bereavement period. Methods: We devised a set of paired surveys that were distributed to the Society for Gynecologic Oncology and to patient families. Families were recruited using social media, publicizing in local organizations, and advertising in University of Connecticut campus-wide emails. Likert-scale style questions with responses ranging from “1” to “10” were used to assess opinions on aspects of bereavement care and reported as means. Differences in means were assessed using ANOVA and T-tests and considered to be statistically significant if the P-value was < 0.05. Results: We received completed surveys from 129 physicians and 17 caregivers from different families. 48% of physicians reported contacting patient families, and, similarly, 47% of family members reported receiving contact from physicians. Physicians had a mean 6.21/10 confidence level (where 10 is maximum confidence) in providing bereavement care, while families reported 5.76/10 confidence in their physician’s ability to provide bereavement support ( P = 0.493). Factors that influenced physicians confidence in providing bereavement support were undergoing formal training in bereavement (6.84/10 vs 5.14/10 for physicians who had not been trained, P < 0.001) and being in practice for more than 11 years (5.65/10 for ≤10 years in practice, 7.05 for ≥11 years, P = 0.001). Physicians who contacted patients personally had a higher confidence level (6.98/10) in providing bereavement support compared with those who did not contact families (5.51/10, P < 0.001). Family members were nearly unanimous in reporting a desire for physicians to contact them personally (16/17), and stated that a phone call (56%) or a sympathy card (38%) were their preferred methods of contact. Conclusions: Our study suggests that although families appreciate contact from physicians after their loss, physicians do not have a high level of confidence in providing this support. Physicians who undergo bereavement training and who reached out after patients had died have higher confidence levels in interacting with family members. Based on these results, formal bereavement training should be incorporated into gynecologic oncology fellowships in order to increase the comfort levels and likelihood of gynecologic oncologists reaching out to families after a patient has died.

Bereavement Practices Among Head and Neck Cancer Surgeons

Head and neck cancer surgeons frequently interact with dying patients with advanced disease and their families, but little is known about their bereavement practices after a patient's death. The aim of this study is to elucidate the frequency of common bereavement practices, cited barriers to bereavement, and predictive physician factors that lead to an increase in bereavement practices among head and neck cancer surgeons. A 20-item survey was sent to 827 active surgeons of the American Head and Neck Society. Approval was obtained and the survey was distributed through the American Head and Neck Society. Demographics, frequency of common bereavement practices, empathy, and barriers were assessed. Multiple linear regression was performed to determine physician factors associated with more frequent bereavement follow-up. There were 156 respondents (18.9% response rate). Overall, surgeons were more likely to usually/always call (48.5%) or send a letter (42.4%) compared with other practices such as attending funerals (0%), offering family meetings (18.6%), or referring family members to counseling (7.7%). Many barriers were cited as being at least somewhat important: being unaware about a patient's death (67.3%) was the most cited, whereas 51.3% cited a lack of mentorship/training in this area. Scoring higher on empathy questions (P≤ .001) was associated with more frequent surgeon bereavement follow-up with the family of deceased patients. There is substantial practice variation among surgeons suggesting a lack of consensus on their roles in bereavement follow-up. Having higher empathy was predictive of higher engagement. NA Laryngoscope, 132:1971-1975, 2022.

Arab Muslims' Perceptions of Perinatal Loss Care in the United States of America.

One in four American women will experience a miscarriage, stillbirth or neonatal death each time she becomes pregnant. These perinatal losses occur even more frequently in women who are immigrants from developing countries. Care of Muslim families after perinatal loss is based primarily on expert opinion as opposed to research evidence, as few, if any, studies exist on this topic. It is critically important to know what parent's preferences for care actually are, since care that is incongruent with the desires of the bereaved parents may intensify their grief. The purpose of this study was to examine the perceptions and attitudes of immigrant Arab Muslims regarding psychosocial bereavement practices common in the United States after perinatal loss and to pilot test an investigator-developed instrument for collecting data regarding culturally relevant psychosocial bereavement practices of immigrant Arab Muslims after perinatal loss. The study employed a cross-sectional survey design using an investigator-developed instrument entitled the Arab Muslim Perceptions of Perinatal Loss Care (AMPPLC). The AMPPLC, available in both English and Arabic, was used to collect data on perinatal loss care from a convenience sample of 79 immigrant Arab Muslim adults (male n=43 [54.4%]; female n=36 [45.6%]). The study opened in June 2017 and closed in August 2019. The AMPPLC instrument demonstrated good reliability (α=0.89) in measuring participants' responses. Responses by survey participants did not always agree with prior published literature on Muslim preferences after a loss. Optimal care for Arab Muslim immigrants involves offering all options that are typically part of Western bereavement care as well as options that may be more specifically associated with Islam. This information will enable healthcare providers to provide more culturally sensitive and compassionate care to Middle Eastern Muslim parents during this difficult and tragic experience.

Grappling With Grief: Approaching Loss During the COVID-19 Pandemic

Back to table of contents Previous article Next article CommentaryFull AccessGrappling With Grief: Approaching Loss During the COVID-19 PandemicElizabeth Kim, B.S.Elizabeth KimSearch for more papers by this author, B.S.Published Online:21 Sep 2021https://doi.org/10.1176/appi.ajp-rj.2021.170103AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail As of August 8, 2021, there have been more than 4,265,903 deaths and 200,840,180 confirmed cases of coronavirus disease 2019 (COVID-19) reported by the World Health Organization (1). Individuals are additionally experiencing loss of jobs and loss of connection with the community. With the large number of deaths, the unexpected deaths of previously healthy or young individuals, the lack of traditional bereavement practices, disrupted routines, and disconnected social support systems, there is concern that the COVID-19 pandemic will contribute to an increase in mental health conditions, including prolonged grief disorder. During the COVID-19 pandemic, Robillard et al. (2) have reported increased rates of anxiety and depression in individuals without a prior psychiatric history and worsening of symptoms in those with preexisting psychiatric conditions. Eisma and Tamminga (3) have demonstrated that a recent, personal loss during the pandemic resulted in higher grief severity, compared with a recent loss before the pandemic.While the COVID-19 pandemic has created an environment in which individuals are susceptible to amplified grief, there are strategies to face this challenging time, particularly, Worden's grief task concept. Worden describes four tasks in the mourning process: accepting the reality of loss, working through the pain of grief, adjusting to an environment in which the deceased or lost is missing, and emotionally relocating the deceased or lost (4). Rather than stages of grief, which implies linearity, or phases of grief, which implies passivity, Worden's task-based framework is beneficial because it focuses on adaptation and active engagement. Because of ongoing changes in the virus itself and a lack of consistently applied guidelines to mitigate the spread of COVID-19, losses of educational and occupational opportunities, as well as participation in social networks, will ebb and flow. Therefore, Worden's approach is advantageous because it creates strategies for confronting and adjusting to various situations, ultimately promoting active progression through loss. It empowers individuals with a sense of action steps and purposeful development. Specifically, Worden explains the task of emotional relocation by motivating mourners to memorialize loss in a manner that prevents further deterioration (4). COVID-19 is changing the world and irreversibly shaping individual lives. Navigating through the mourning process while utilizing emotional relocation encourages recognition of and recovery from the losses faced during this period (see Box 1).BOX 1. COVID-19 grief experience checklistaAccept the reality of the loss.Face the fact that a person/place/thing/experience/relationship is gone.Examples:If the loss is a death, name the person/people that is/are gone.Due to physical distancing recommendations, consider hosting or attending a virtual funeral service.List losses experienced due to the COVID-19 pandemic (employment, social connection, recreational activities).Process the pain of grief.It is impossible to lose someone/something you have been deeply attached to without experiencing some level of pain.Examples:Describe the painful thoughts and feelings you are experiencing to someone you trust.Identify ways COVID-19–related losses have resulted in sadness, anxiety, anger, guilt, or loneliness.Adjust to an environment in which the loss is missing.Loss can result in a modification in roles, a need to develop new skills, a variation in sense of self, or a change in one's perspective of the world. Examples:External adjustments: Explore how COVID-19 has affected your everyday functioning (mask wearing, 6 feet of distancing, cleaning protocols, and temperature screenings).Internal adjustments: Identify how COVID-19–associated loss has affected your sense of self (occupation, participation in activities you enjoy).Spiritual adjustments: Describe how the pandemic has affected your beliefs, values, and assumptions about the world (safety, social responsibility, view of authorities).Emotionally relocate the loss.Remember a loss, yet stay connected to it in a way that does not prevent you from going on in life.Examples:Explain how you will memorialize losses experienced during the COVID-19 pandemic.Ponder ways that COVID-19 has shaped you and your relationships with others.a Adapted from Worden's grief task model (4). Before engaging with a task-based approach to the grieving experience, ensure that physiologic and safety needs are met. Although the items are listed in an order, they do not need to be completed in a specific, linear sequence.The COVID-19 pandemic has caused immense loss globally. Grieving in response to these losses is normal and appropriate; however, the circumstances in which we are grieving are novel. This task-based approach to grief, with emphasis on emotional relocation, will provide a more constructive perspective on the mourning process during this specific pandemic.At the time this commentary was accepted for publication, Elizabeth Kim was a fourth-year medical student at the University of Minnesota Medical School, Minneapolis.The author thanks Lora Wichser, M.D., for her support in reflecting and writing about the topics of grief and the COVID-19 pandemic.

Interfacing grief: haptic autotheory & performance as afterlife in Anne Carson’s Nox

This essay examines Anne Carson’s Nox (2010) – a mixed-media elegiac and autotheoretical work in which Carson mourns the death of her brother, Michael – and its afterlife in a movement-based performance choreographed by Rashaun Mitchell and Silas Riener. Whether a matter of ever-enlarging scales of space, digital and otherwise; the dissolution of bereavement practices or, more broadly, a poststructuralist favoring of abstraction, the contemporary displacement of the body in grief creates new creative demands of mourning. In the pages of Nox, Carson underscores the ongoing nature of loss by uniquely assembling an array of intimate ephemera: photographs, drawings, and letters are paired alongside textual fragments and translated lexical entries. By depathologizing the durational work of mourning and reclaiming its haptic dimensions, Carson reimagines an ancient impulse of the elegiac tradition – to materialize the abstraction of death into form – within a contemporary culture that so often leaves death unsubstantiated. Through critical analysis and personal recount, this essay considers how Carson taps into the longstanding feminist impulse to approach embodied experience as a location of theoretical inquiry. Beyond a phenomenology of grief, Carson’s engagement of autotheory is a haptic encounter: a proximal scene of feeling and contact site that presses us to expand our cultural frames for avowing loss.

Parents' experiences of care offered after stillbirth: An international online survey of high and middle-income countries.

Stillbirth, the death of a baby before birth, is associated with significant psychological and social consequences that can be mitigated by respectful and supportive bereavement care. The absence of high-level evidence to support the broad scope of perinatal bereavement practices means that offering a range of options identified as valued by parents has become an important indicator of care quality. This study aimed to describe bereavement care practices offered to parents across different high-income and middle-income countries. An online survey of parents of stillborn babies was conducted between December 2014 and February 2015. Frequencies of nine practices were compared between high-income and middle-income countries. Differences in proportions of reported practices and their associated odds ratios were calculated to compare high-income and middle-income countries. Over three thousand parents (3041) with a self-reported stillbirth in the preceding five years from 40 countries responded. Fifteen countries had atleast 40 responses. Significant differences in the prevalence of offering nine bereavement care practices were reported by women in high-income countries (HICs) compared with women in middle-income countries (MICs). All nine practices were reported to occur significantly more frequently by women in HICs, including opportunity to see and hold their baby (OR=4.8, 95% CI 4.0-5.9). The widespread occurrence of all nine practices was reported only for The Netherlands. Bereavement care after stillbirth varies between countries. Future research should look at why these differences occur, their impact on parents, and whether differences should be addressed, particularly how to support effective communication, decision-making, and follow-up care.

The Long Shadow: Collateral Impact and Finding Resilience Amidst a Global Pandemic Pediatric Palliative Care Social Work During COVID-19

This manuscript illuminates the nuanced ways in which the COVID-19 pandemic has impacted the pediatric palliative care social work role and clinical care in caring for children with life-limiting illnesses and their families throughout the country. The authors discuss memorable moments, logistical impacts, telehealth usage, decision-making experiences, end of life care, bereavement practices, specialized interventions, and self-care. The paper concludes with lessons learned and practical recommendations for the future.

Developing a model of bereavement care in an adult tertiary hospital.

Objectives Hospitals are the most common place of death in Australia. Bereavement care is recognised by national standards as being central to providing high-quality care at the end of life, and has significant health implications on morbidity, mortality and health service usage. Despite this, bereavement care is not routinely or systematically provided in most Australian hospitals. This study aimed to develop a comprehensive, evidence-based model of bereavement care specific to the needs of an acute Australian adult tertiary hospital. Methods This study used a multiple-methods design, which included a scoping literature review, a survey of current institutional bereavement practices, interviews with bereaved family members and staff focus groups and the development of a model of bereavement care for the acute hospital service through advisory group and expert consensus. Results Staff and bereaved family members strongly supported a systematic approach to bereavement, perceiving the need for greater support, training, coordination and follow-up. In all, 10 core elements were developed to support a structured model of bereavement care provision and follow-up for the acute hospital organisation. Conclusions This evidence-generated model of care promotes the provision of quality and systematic bereavement care in the acute hospital setting. What is known about the topic? Acute hospitals are the most common place to die in Australia, yet there is a lack of understanding of how bereavement care is or should be provided in these environments. The bereavement period is associated with increased use of health services and worse morbidity and mortality, and thus has significant implications for public health. The provision of bereavement care in acute hospitals is often sporadic, often involving untrained staff who may not provide evidence-based care. What does this paper add? This paper describes the development of a comprehensive, evidence-based model of bereavement care specific to the needs of an Australian acute hospital. What are the implications for practitioners? Developing a consistent approach to bereavement for the acute care sector has the potential to support staff, minimise conflict at the end of life, facilitate recognition of those suffering from difficult bereavement and proactively engage services for these people. It is hoped that such a model of care can find relevance across acute hospitals in Australia, to improve the quality and consistency of bereavement care.

Bereavement practices employed by hospitals and medical practitioners toward attending funeral of patients: A systematic review.

To ascertain bereavement practices offered by hospitals and medical practitioners (MPs), factors that influence the likelihood of MPs' involvement in funeral attendance, the benefits and barriers to attendance to a patient's funeral as perceived by MPs and the rate of attendance to patients' funeral by MPs. MEDLINE (Ovid), Embase, PubMed, and Google Scholar were searched with a systematic search structure for randomized controlled trials, comparative observational studies, case series, cross-sectional studies, editorials, and letters. The search was limited to English only. The study was registered with Prospero (Registration Number: CRD42018095368). A total of 381 articles were identified with 46 articles meeting the inclusion criteria. Of the 46, 16 were editorials and 12 were letters. Eighteen were cross-sectional studies conducted in the United States, Canada, Australia, Israel, and Ireland. Year of publication ranged from 1990 to 2017. Of these, 12 were quantitative, 3 were qualitative, and 3 were mixed-method studies. Two of the cross-sectional studies involved family members of deceased patients while others involved MPs. Bereavement practices offered by hospitals included memorial services, letters, and services provided by bereavement coordinators. Bereavement practices employed by MPs included answering or making phone calls, attending family meetings, and sending condolence letters. MPs' attendance at a patient's funeral was influenced by MPs' gender, age years of experience the medical specialty. Perceived benefits of MPs' attendance at a patient's funeral included providing support to the family, extending the professional relationship, illustrating respect to the patient and the family, resolving guilt and personal growth. Barriers to the attendance included a lack of time, blurring of professional boundaries, personal discomfort with death, emotional arousal, and discouragement by colleagues. General practice had an attendance rate of 71%. Attendance rates for palliative care, oncology, and psychiatrists ranged from 63% to 81%, 7.1% to 67%, and 15% to 67%, respectively. Intensivists had an attendance rate of 22%. Several bereavement practices are provided by hospitals and MPs. Funeral attendance is an uncommon bereavement practice. MPs' attitudes toward attending a patient's funeral are understudied in many specialties. Patient factors that influence MPs' participation in bereavement practices are poorly understood.

Beyond Right or Wrong: Attitudes and Practices of Physicians, Nurses, Psychologists, and Social Workers Regarding Attendance at Patient Funerals.

Health professionals' bereavement practices, including funeral attendance, have attracted relatively little attention from researchers. There may be a number of motivations and perceived benefits for health professionals to attend patient funerals. There are no published data comparing different groups of health professionals' perceptions of and practices in attending the funerals of their patients. To understand the attitudes and practices of health professionals toward attendance at patient funerals. Cross-sectional nationwide online survey of attitudes and practices toward attendance at patient funerals based upon data from interviews with health professionals. Australian health practitioners from medicine, nursing, psychology, social work, and other allied health professions (n = 1098). Attendance at patient funerals was predicted by age, telling colleagues about own funeral attendance practices, having discussions with colleagues about funeral attendance, having long relationships with patients, and having a majority of patients at the end of life. Nonattendance was predicted by believing that if they cannot attend all funerals, they prefer not to attend any, feeling that colleagues disapprove of funeral attendance, believing that attending funerals is crossing the line between the personal and the professional, and being a psychologist. Our findings emphasize the need for more open discussions and reflection among individuals and groups of health practitioners regarding attendance at funerals. Understanding the motivations of physicians, nurses, social workers, and other allied health practitioners to attend or not attend patient funerals is an important first step in working toward policies, protocols, and guidelines to support best practice.

Grief and Bereavement Practices Among Igbo People of South-Eastern Nigeria: Implications for Counselling

Death is as old as human kind, but always appears in minds as fresh as a new born when and wherever it occurs. Death or loss of loved one/valuable items is a tragedy, disastrous and difficult to swallow within a short period of its occurrence. The unpredictable psychological feeling called grief is usually accompanied with emotional setbacks like; anxiety, depression, insomnia, anger, feeling of guilt, sadness, despair and yearning among others determines the level of attachment to the loss and so the likely period of bereavement. The unfortunate circumstances seem to manifest themselves even among animals particularly mammals for example; chimpanzees exhibit silence behavior around the dead member, gorillas use sign language and even expressing sadness about the deceased member, elephants display destructive unusual habit on seeing motionless member, some deer mostly sniff and poke while looking at their lifeless deceased among others. However, this paper attempts to define the concepts of grief, mourning, counselling and bereavement practices by various groups around the world, with much emphasis on Igbo people of South-Eastern Nigeria as well as its counselling implications.

Family-centered bereavement practices in Danish intensive care units: a cross-sectional national survey

BackgroundMortality in Danish intensive care units (ICUs) continues at 27%, resulting in a large number of bereaved family members being cared for in the ICU. ObjectivesTo investigate the provision of bereavement care and follow-up services for bereaved families in Danish ICUs. MethodologySelf-administered computerized cross-sectional nation-wide survey of Danish ICUs. ResultsNurses at 46 of 48 (96%) ICUs in Denmark responded. Bereavement care at the time of patient death included viewing the patient in ICU (100%), and in the hospital mortuary (59%). Information about hospital-based follow-up for the family was provided in 72% of units, whereas only one unit provided information on community-based bereavement follow-up. Bereavement follow-up services after hospitalization were offered to families in 59% of ICUs and included an ICU visit, meeting with the staff present at the time of death, a letter of condolence, a phone call to the family, referral to a priest or clergyman, or referral to other counseling. Although many interventions were common, there were variations within the elements offered. Nurses and physicians were the most consistent health care staff involved in bereavement services. ConclusionMost ICUs in Denmark offered bereavement follow-up services, but these varied in their approach, were not evidence-based, and lacked formal evaluation. More systematic quality improvement of bereavement practices is required.