Kubler-Ross Research Articles

Emotional Changes in Hospitalized Patients in the COVID-19 Ward: Elizabeth Kubler-Ross Theory as an Analytical Framework

Aim: This study was conducted to determine emotional changes in hospitalized patients in the COVID-19 ward based on the Kubler-Ross theory. Background: Humans exhibit different behaviors in response to crises. COVID-19, as a health crisis, was accompanied by widespread changes in the behavior of patients. Methods: This descriptive-analytical study was conducted in 2021 using a census method on 139 hospitalized patients in the COVID-19 ward of the 22 Bahman Hospital in Khorramshahr, Iran. Data were collected using a researcher-made questionnaire to determine the stages of change in hospitalized COVID-19 patients. The data were analyzed using SPSS 22 software and one-sample t-test, independent t-test, one-way ANOVA, Tukey's post hoc test, and Pearson correlation coefficient at a significant level of 0.05. Results: The minimum age was 27 and the maximum age was 67 years. The levels of denial were moderate, while anger and bargaining were lower than average, and depression and acceptance were higher than average. The average denial, anger, and depression scores in male patients were significantly higher than those in female patients (p < 0.001). There was a significant negative correlation between denial and anger scores and age (p < 0.001) and a significant positive correlation between acceptance and age (p = 0.03). Conclusion: Since contracting COVID-19 and hospitalization in COVID-19 wards are associated with various behavioral changes, screening patients for behavioral changes is recommended to health policymakers and managers. Understanding these changes can help accurately diagnose and effectively treat these patients.

Pengalaman Pasien Terdiagnosa Kanker Paru Ditinjau dari Teori Elisabeth Kubler-Ross

This study aims to look at the patient's experience when diagnosed with lung cancer through the theoretical perspective of Elisabeth Kubler-Ross. The research method used is p qualitative with a phenomenological approach. The results of this study show several themes, one of which is the support needed by patients when diagnosed with lung cancer. Participants have sources of help, namely personal ability, family support, and the support of the Health Team, especially nurses. In conclusion, when someone is experiencing a bad condition caused by a disease, what is needed is support from all parties around them who can provide reinforcement and motivation to patients when diagnosed with lung cancer so that they get a strong foundation that becomes the main factor influencing participants in undergoing disease treatment.
 
 Keywords: Elisabeth Kubler-Ross, Lung Cancer, Experience

Book Reviews

Book Reviews

Trabalhando o luto em grupos de apoio para cuidadores de pacientes com Alzheimer: um relato de experiência extensionista

Objetivo: refletir sobre questões que envolvem a finitude humana e as diversas perdas no decorrer da existência, proporcionando o fortalecimento do grupo, sobre o tema.Método: relato de experiência, realizado por meio de uma oficina com o tema Processos do cuidado e fases do luto.Foi realizado em maio de 2019, com duração de 2 horas. Este trabalho deu ênfase aos cinco estágios do luto nomeados por Elisabeth Kubler-Ross.Resultado: Participaram15cuidadores familiares de pacientes com Alzheimer, 03 discentes, 01 docente e 01 técnico. A oficina foi realizada, através do debate, sobre questões que envolvem a morte e o morrer enfrentadas ao longo da vida, tornando os participantes mais conscientes do processo. Conclusão: embora todo sujeito tenha consciência de sua finitude, o medo da morte é algo que está muito presente nos discursos humanos, sobretudo para quem dedica anos às responsabilidades que envolvem tratamento e zelo com o outro.

Only the living can witness the passing of death: Mourning in times of pandemic.

This report presents the special characteristics of the psychotherapy process with patients who are grieving the loss of a loved one Because of the special background circumstances in which these losses have occurred-the COVID-19 pandemic as well as the 3 months lockdown because of it-I have called these griefs suspended In the article I offer the social background circumstances, the personal circumstances of the loss, and the therapeutic intervention with the special characteristics for both the therapist and the therapeutic setting Finally, I offer some specific tools for working with this type of grief All these considerations are made from the approach of Gestalt therapy as well as with the working model proposed by Dr Elisabeth Kubler-Ross This is coupled with my experience of more than 20 years in psychotherapeutic work with people who are living a grieving process (PsycInfo Database Record (c) 2021 APA, all rights reserved)

세 영화에 재현된 안락사 담론: <밀리언 달러 베이비>, <유 돈 노우 잭>, <미 비포 유>

This paper investigates the discourse of euthanasia in three films: the 2004 film about a boxing trainer who helped the mercy killing of a boxer, <Million Dollar Baby>, the 2010 TV biopic about suicide-assist doctor Jack Kevorkian, <You Don’t Know Jack>, and the 2016 romantic drama about a paralysis patient who travels to Switzerland for assisted suicide, <Me Before You>. Though these films are similar in that they deal with euthanasia, they are a little different in their situation. The first film tells Frankie, a trainer who assisted the euthanasia of Maggie who was in an incurable vegetative state because of her injury in a world championship title match. The second film tells the story of Michigan pathologist Dr. Kevorkian, who over the course of his controversial career helped 130 people−all of them terminally ill−end their lives comfortably and humanely with an instrument that he made. Despite the gratitude his patients felt, his work sparked a national debate about the morality of euthanasia in humans and he was vilified by some prosecutors. The third film, <Me Before You>, is a fictional story of a wealthy young man in London, Will Traynor, who is left suddenly paralyzed by a road accident. In the end, Will decides that life without physical freedom isn’t worth living in spite of his love for Louisa Clark, his care-giver and he travels to Switzerland to die, leaving enough money to give Louisa the financial freedom to pursue her dreams. Will’s generous final act may confirm Elizabeth Kubler-Ross’s belief “Everyone should growth until one’s death.” The process of euthanasia thus prompts us to consider preparing for a good death, and, possibly, a good life for those we leave behind.

Solastalgia's mourning and the slowly evolving effect of asbestos pollution: A qualitative study in Italy

In Italy, the problem of asbestos pollution is increasing in severity. In fact, in recent years, the number of people affected by asbestos-related illnesses has been growing because of the fibre's slowly evolving effects and its progressive pollution in the environment adjacent to the places where it is processed. Even though the physical consequences of asbestos are now quite clear, few studies have examined the psychological consequences of this kind of disaster. Since it is difficult to perceive its pathogenicity in daily life, this study was conducted in the affected areas of north-eastern Italy, using the qualitative research in psychology with 51 persons who experienced asbestos-related illnesses (19 sick persons and 37 relatives of sick persons). Their narratives described being rooted in a space contaminated by an invisible enemy. In particular, attention was paid to the consequent solastalgia, a kind of mourning arising from loss of place attachment. Results of the qualitative analysis revealed how the different phases of the Elisabeth Kubler-Ross DABDA (Denial Anger Bargaining Depression Acceptance) model of coping with death constitute such feelings, whereas the dual-process model of Stroebe and Schut emphasised how these people seem to be loss oriented because of their perceived lack of community restoration. A discussion of the relationships between attribution of responsibility, entirely external and mostly inscribed in the DABDA categories of ‛anger’ and ‛acceptance’, is presented, with further considerations about mourning and the need to improve specific psychological support in this field of environmental disaster.

Choroba i strata jako regulator tożsamości: Rok magicznego myślenia Joan Didion

&#x0D; Cel badań. Celem artykułu było omówienie wpływu ekspresywnego pisania na sposób przeżywania żałoby i żalu po stracie. Analiza stanowi przyczynek do dyskusji o terapeutycznej mocy ekspresywnego pisania.&#x0D; Metodologia. Analizie poddano książkę Rok magicznego myślenia Joan Didion, w której autorka opisuje swoje zmagania z codziennością po nagłej śmierci jej męża. Pamiętnik został zanalizowany zgodnie z koncepcją autobiografistyki Georges’a Gusdorfa (2009). W kontekście książki omówiono również koncepcje odnoszące się do psychologii zdrowia i choroby: teorię pięciu etapów przeżywania żałoby według Elisabeth Kübler-Ross (2007) oraz sposoby radzenia sobie ze stresem Endlera i Parkera (1990).&#x0D; Wyniki. Analiza wykazała, iż myślenie magiczne, którym posługuje się autorka pamiętnika, służy jej za normatywny mechanizm obronny. Styl pisarski Joan Didion, zakorzeniony w tzw. nowym dziennikarstwie, przeplata się z refleksjami na temat śmierci, co czyni go jeszcze bardziej ekspresywnym i szczerym. Można zauważyć, że Didion sukcesywnie przechodzi przez kolejne etapy przeżywania żałoby, a sposobem radzenia sobie, z którego pisarka korzysta najczęściej, jest działanie. Odejście od myślenia magicznego pod koniec książki oraz ostateczne pogodzenie się ze śmiercią męża sugeruje, iż ekspresywne pisanie było jednym z czynników, który pomógł autorce w zmaganiach z żalem po stracie.&#x0D; Wnioski. Rok magicznego myślenia stanowi przykład tanatografii oraz jest logicznym i spójnym odbiciem przeżyć osoby zmagającej się z traumą po śmierci bliskiej osoby. W celu pełniejszego zbadania wpływu ekspresywnego pisania na samopoczucie i dobrostan wskazana byłaby podobna analiza książki Blue Nights, w której Didion zmaga się ze śmiercią córki.&#x0D; Słowa kluczowe: life writing, psychologia zdrowia i choroby, style radzenia sobie, tożsamość&#x0D; &#x0D;

On Life After Death: A Chaplain's View on the Process of Dying.

Elizabeth Kubler-Ross wrote the book On Life After Death to give her findings on what happens when a person dies. Over the course of 20 years, she found that no matter age, sex, religion, or culture, everyone spoke of the same things happening upon death. The insights and revelations that Kubler-Ross talks about will give a minister help when they speak with someone who is dying or has had a near-death experience.

Editorial introductions

Editorial introductions

The Byzantine Tradition of Dying with Christ in Monastic Ascesis in Comparison to the Stages of Grieving According to E. Kübler-Ross: an Attempt of Interdisciplinary Approach

Журнал «Вопросы теологии» — международный академический журнал по теологии. Журнал ориентирован на развитие всех направлений и областей, входящих в исследовательскую отрасль «Теология», прежде всего в том варианте, в каком она развивается в светских вузах и научно-исследовательских структурах, а также в духовных академиях.

From evidence to implementation: The global challenge for psychosocial oncology.

The human dimensions of medical care were highlighted by such pioneering figures as Cicely Saunders, Elizabeth Kubler-Ross, and Jimmie Holland and their tireless advocacy helped to build an evidence base for psychosocial and palliative interventions. In that spirit, we studied physical and psychological distress in advanced cancer and modeled pathways to distress in this population. We considered acute stress disorder as the prototype for psychological disturbances following the acute onset of life-threatening disorders, showing that it occurred in one-third of patients after the diagnosis of acute leukemia. To treat and prevent these symptoms, we developed Emotion and Symptom-focused Engagement (EASE), an integrated psychotherapeutic and early palliative intervention. We showed that EASE reduced both traumatic stress and physical suffering in these patients and a large multi-center trial is now underway. We also identified symptoms of depression and hopelessness n one quarter of patients with metastatic and advanced cancer, with worsening toward the end of life. To alleviate this distress, we developed a brief supportive-expressive therapy, referred to as Managing Cancer and Living Meaningfully (CALM). We showed in a large RCT that CALM improves depression, distress related to dying and death, and preparation for the end of life. We have now launched a global initiative involving 20 sites to date across North and South America, Europe, Australia, and Asia to have CALM implemented routinely in cancer care. Such initiatives are needed to move psychosocial care in cancer from evidence to implementation and to fulfill the dream of Jimmie Holland that cancer care be as humanistic as it is effective.

Editorial introductions

Editorial introductions

『死ぬ瞬間』死とその過程について, エリザベス・キューブラー・ロス著, 鈴木晶訳, 2001年1月, 中央公論新社刊, On Death and Dying by Elisabeth Kubler-Ross, 1969

『死ぬ瞬間』死とその過程について, エリザベス・キューブラー・ロス著, 鈴木晶訳, 2001年1月, 中央公論新社刊, On Death and Dying by Elisabeth Kubler-Ross, 1969

Ripeness, Readiness and Grief in Conflict Analysis

Social conflicts are a strong challenge for searchers and practitioners because they involve, among others, multiple issues, actors, cultures or decision making-processes. In assessing the pertinence of a conflict resolution effort, one of the most frequently used explanatory frameworks is ripeness theory (Zartman and Berman, 1982; Kriesberg, 1987; Zartman, 1989). Growing out of ripeness theory, readiness theory (Pruitt, 2005), based on ripeness is a recent effort to overcome the limits of ripeness theory. Among other things, readiness theory is more flexible and encompassing, and it makes it easier to apply ripeness theory as a conflict management tool. We believe that enriching readiness theory by bringing in the theory of grief developed by Elisabeth Kubler-Ross (1978) would even further our understanding of ripeness theory. This paper explores how grief theory can be used to expand ripeness and readiness theories.

Dying in Five Stages: Death and Emotions in Kübler-Ross and Her Influence

Dying in Five Stages: Death and Emotions in Kübler-Ross and Her Influence

The Phantom of the Opera: A Case Study of Severe Major Depressive Disorder with Psychotic Features

Objective: Portrayals of psychiatry in the arts have been enjoyed by audiences for almost a century. Courses designed to teach psychopathology have used examples from the arts to emphasize major teaching points. This paper frames Elisabeth Kubler-Ross’s stage theory of grief within selected scenes of Andrew Lloyd Webber’s musical, The Phantom of the Opera, to achieve course objectives such as the etiology, course, and levels of severity of Major Depressive Disorder. Methods: Course content from our Psychopathology course was transformed into a dialogue between an examining psychiatrist and a Broadway performer who was in character. The performance was part of a special Grand Rounds reviewing the Mood Disorders. Results: Goals and objectives were readily achieved with over 450 faculties in attendance. Conclusions: Organizing a curriculum with performing arts is an innovative teaching method that allows for review of mental disorders such as those demonstrated in The Phantom of the Opera.

Dr. Elisabeth Kubler-Ross stages of dying and phenomenology of grief

Birth and death are both natural events but the emotional impact and the personal meanings of these events are vastly different. Birth may be anticipated with excitement and optimism, while the reality of death may be avoided and been denied. Elisabeth Kubler-Ross has been a pioneer in arousing popular and medical interest in the subject of death and dying. A physician who worked with dying patients and encouraged them to talk about themselves and their feelings toward their impending death. She found that most of the patients she had contact with welcomed the opportunity to speak openly about their conditions. After speaking with some 500 terminally ill patients, Kubler-Ross proposed that there were five stages in coming to terms with death: denial, anger, bargaining, depression and acceptance. This is a review article.

The Nursing Care in Front of the Dying Process in Oncology

Introduction: This study deals with the theme of the process of death/dying experienced by cancer patients from the perspective of nursing theoretically based the Elizabeth Kubler-Ross studies pioneered in describing the attitudes and emotional reactions raised by harmonizing death in terminally ill patients. Objective: To describe the care in nursing about the process of death/dying patient in oncology. Methods: integrative review with qualitative approach. Results: It was observed that the nursing care in oncology front of the patient in the process of death/dying is a daily challenge in dealing with the worsening condition of the patient, acceptance, fear, anxiety and confidence, taking care of the patient with no chance of cure, but not out of the possibility of care. Conclusion: This study showed a body of knowledge about the process of death/dying experienced by patients hospitalized in Oncology Units from the perspective of nurses tending to a technical assistance, fragmented and impregnated by rules and routines at the expense of the essence of human care, in favour of a process of death and dying with dignity.

Grief and Bereavement: Updated Theories and New Tools for Providers (FR413)

•Describe updated theories on grief, loss, and bereavement.•Describe ways in which providers can engage patients and families in legacy work.•Recognize provider grief and identify ways to prevent compassion fatigue. As palliative care and hospice providers, we are often witnesses to patients and families struggling with grief and loss. Historically, Elizabeth Kubler-Ross’s five-stage model has helped providers and individuals understand the grieving process in an accessible and intuitive manner. However, updated theories are emerging that describe the grieving process as “tasks” instead of “stages.” Reframing the grieving process as tasks allows providers to better understand how they can serve bereaved patients and families who are working through these tasks. Providers can be particularly instrumental in encouraging legacy work that allows patients to support their family and friends by leaving a legacy and provides the bereaved with a tangible way to remember their deceased loved one. Examples of legacy work as well as practical tools for patients and providers to engage in legacy work will be discussed. Healthcare providers caring for seriously ill and dying patients often feel grief as well. Learning to grieve is a coping skill. Similarly to the tasks that grieving patients and families are facing, providers can also use this new framework to do their own grief work. Recognizing and understanding our own grief can help prevent compassion fatigue and burnout.