Experience Of Bereavement Research Articles

Chinese college students' PGD symptoms and their relationship to cognitive variables: a latent profile analysis.

Bereavement is a commonly experienced grief event; however, bereavement can also trigger a number of psychological consequences, such as prolonged grief disorder (PGD). At present, the differences in prolonged grief disorder symptoms (PGD symptoms) among various individuals and how those symptoms relate to cognitive variables are unclear. In the present study, 817 Chinese college students with bereavement experience were selected as participants. Based on the evaluation results of their irrational beliefs, bereavement-related irrational beliefs, basic world assumptions, and PGD symptoms, an individual-centered latent profile analysis was used to divide a group with PGD symptoms into several subgroups and comprehensively examine the relationships between these subgroups and cognitive variables. (1) The severity of PGD symptoms among Chinese college students can be categorized into three subgroups: mild, moderate, and severe. (2) Cognitive variables such as irrational beliefs and basic world assumptions were all found to correlate with the severity of PGD symptoms; bereavement-related irrational beliefs was the variable with the largest correlation. However, for the first time, this study found that different dimensions of basic world assumptions had different directions of correlation, based on the severity of the PGD symptoms. Justice, control, randomness, and self-control had significantly positive correlations. Conversely, benevolence of the world, benevolence of people, and worthiness of the self had significantly negative correlations. These results have important reference value for cognitive behavioral therapy (CBT) treatment and interventions for PGD issues in Chinese college students.

Bereavement during lockdown: the potential impact of COVID-19 restrictions on grief and post-traumatic stress disorder in a Turkish-Muslim population

ABSTRACT The current study examined whether disruption to performing Islamic death rituals could be linked to core bereavement and post-traumatic stress disorder (PTSD) symptoms in Turkish-Muslim individuals who lost their close relatives to COVID-19. Participants (n = 52) completed a Demographic Information and Bereavement Experience (DIBEF) form with items probing demographics, attendance to rituals, receiving social support, and perceived disruption to bereavement via COVID-19 restrictions. The Core Bereavement Items (CBI) and the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) were used to measure symptomatology. The results showed that 92.3% of the participants did not receive condolence visitors, 98.1% failed to say goodbye, and 78.8% could not practice their religious duties. Importantly, perceived disruption score was significantly linked to the CBI (but not PCL-C) scores. The potential role of perceived disruption to bereavement in aggravating the grief response is discussed in relation to the dual process model of coping with bereavement.

The impact of a child’s suicide on family structure and relationships between its members

The main objective of this article is to analyse the available literature on the impact of a child’s suicide on family structure and relationships between family members. The available literature from 1976-2021 was analysed. The analysis showed that families abandoned after the suicide death of a family member experience feelings of hurt, denial, shock and anger, resentment, shame and guilt. Social ostracism affects the social exclusion of families affected by the suicide death of a child, who are deprived of adequate support from institutions and the community. Bereaved families, being in shock and confusion at the beginning of their bereavement, had no one to turn to for help. The sudden death of a child by suicide leads to a deepening of the trauma and makes the grieving process impossible. People who have suffered a loss feel the need to give the death some meaning. The results of the literature search are, however, not satisfactory, contributing to my own research in terms of the family’s experience of bereavement following the death of their child by suicide. The findings show little development in the topic of postvention following the suicide death of a child. There is no public education on this subject.

Family characteristics and childcare patterns associated with early social functioning in cancer-bereaved parents.

Bereaved parents experience life-long grief after the death of their child from cancer. Parents who can integrate their grief and maintain their social functioning early in bereavement, even in the setting of concurrent psychosocial distress, have improved outcomes. Identifying the factors associated with bereaved parents' early social functioning can guide future supportive interventions. The authors surveyed parents of children who died from cancer at two large centers 6-24 months after death, assessing bereavement experiences using validated and pilot tested tools. Univariable and multivariable logistical regression models were used to examine which family and child demographic, treatment, and end-of-life (EOL) factors were associated with maintained parental social functioning (T scores ≥40 on the Patient-Reported Outcomes Measurement Information System Ability to Participate in Social Roles and Activities-Short Form questionnaire). One hundred twenty-eight parents of 88 children participated (38% household response rate); most parents identified as female (63%) and White (88%). Parents' median age was 47 years (interquartile range, 10 years); and the median time from the child's death to survey completion was 13 months (interquartile range, 10 months). In multivariate modeling, parents without household material hardship and those who felt prepared for EOL circumstances had increased odds of maintained social functioning (odds ratio, 4.7 [95% confidence interval, 1.6-13.7; p<.004] and 5.5 [95% confidence interval, 1.9-15.9; p<.002], respectively). Parents who felt prepared for their child's EOL and those without household material hardship were more likely to have maintained social functioning in the first 2 years after their child's death. Interventions targeting EOL preparedness and alleviating household material hardship may improve bereavement outcomes.

Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years

Objectives Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. Method Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. Results Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. Conclusion Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.

Artificial intelligence, Internet addiction, and palliative care

IntroductionRecent advances in artificial intelligence (AI) have recaptured and revised the essential roles of death in life and mind. However, their prospects and risks require further study. Because of the development of digital technologies (for example, AI-based chatbots), the process of bereavement may have become complex, immersive, and even addictive. Furthermore, AI-enabled generation of medical notes can ease the administrative burden for healthcare professionals; however, the clinical application of generative AI remains largely speculative.ObjectivesThis study aimed to illuminate the emerging concept and experience of death, bereavement, and addiction associated with cybernetics, thereby expanding their cognitive and ethical aspects.MethodsIn this preliminary review, we performed a literature search to identify the current state-of-the-art literature on AI and Internet addiction. We also inspected the possible adaptations to pursue mental well-being with the modified death concept. We mainly searched the PubMed and Web of Science databases using relevant keywords. All retrieved studies were assessed for eligibility to reduce the selection bias.ResultsCurrent cybernetics have meaningfully recontextualized death that allows interaction with deceased individuals (for example, scholars and artists) to establish their virtual, besides biological, existence using AI-based chatbots. Furthermore, AI consistently provides evidence-based answers to public health inquiries; nevertheless, it may offer unsuitable advice rather than referrals that can sometimes facilitate suicide or harm (instead of help) people in grief, thus requiring more fine-tuned governance. Accordingly, the maladaptive use of existing AI-related communication (such as metaverse characters) can increase Internet addiction prevalence and further complicate autonomy and self-motivation. In addition, excessive internet access is frequently associated with reduced self-control, cognitive flexibility, and exaggerated automatic processing.ConclusionsWe are challenged to acknowledge the tradeoffs of AI and consider ways to compromise by employing flexible perspectives. The emerging concept of death affects or improves the conventional one. The potential advantages and pitfalls of AI-related technology must be carefully weighed against the profound effects they may have on people’s identities, relationships, and mental health. These issues require continued monitoring and assessment in light of the AI/cybernetic-related studies. We hope these results will inspire further research into the appropriate use of AI and palliative care, including suicide prevention, euthanasia, and grief management.Disclosure of InterestNone Declared

Bereavement Care Team: Improving ICU Nurses' Professional Bereavement and Patient Family Experience.

When nurses care for dying patients, their compassion fatigue may increase and lead to burnout and feelings of professional bereavement. However, if a nurse perceives that the patient had a "good death," it may have a positive impact on them and reduce their emotional distress. The purpose of this project is to reduce nurses' feelings of professional bereavement by implementing a Bereavement Care Team (BCT) in the intensive care unit (ICU). This study is a pre-post quasi-experimental design. The Chen and Chow bereavement subscales Factor 1 and Factor 2 measured elements of a nurse's professional bereavement, and 5 items were statistically significant. Nurses felt a reduction in their exhaustion, frustration, and feeling fatigue in their job, reduced feelings about being nervous and worried about potential professional/patient conflicts, and nurses were moved by the patient's family's understanding of the patient's death. Implementing a BCT in the ICU provided an environment that created a "good death" for the patient and their loved ones. These findings supported the need for the BCT as they demonstrated an improvement in the ICU nurses' feelings of professional bereavement.

"It's like an epidemic, we don't know what to do": The perceived need for and benefits of a suicide prevention programme in UK schools.

Despite emerging evidence for the effectiveness of school-based suicide prevention programmes worldwide, there are few being implemented in the United Kingdom, and their social validity (i.e., the feasibility, acceptability, and utility) is not yet known. We aimed to conduct a scoping study to determine: (1) the social validity and potential benefits of school-based suicide prevention interventions, (2) the perceived need for such interventions, and (3) barriers and facilitators to implementation. A total of 46 participants took part. Semi-structured interviews were conducted with mental health professionals (N = 8), school staff (N = 8), and parents whose children had experienced suicidal ideation/behaviours (N = 3) in England. Focus groups were also completed with children and young people (N = 27) aged 15-18 across three state secondary schools. Data were analysed using thematic framework analysis. Three themes were identified: (1) the need for and importance of suicide prevention in children and young people, (2) schools as a setting for delivery, and (3) key components of suicide prevention programmes. Participants overwhelmingly agreed that there is a need for a greater and more consistent emphasis on school-based suicide prevention. School appears to be an acceptable location for suicide prevention, and participants felt discussions about suicide should begin at the start of secondary school. However, there are potential barriers that need to be considered, including tailoring for neurodiversity, challenging cultural/family beliefs and stigma, managing personal experiences of suicidal thoughts or previous bereavement from suicide, and a lack of existing training for school staff.

Lived Experiences of Suicide-Bereaved Siblings in Pakistan: A Qualitative Approach

The perspective of siblings who are suicide-bereaved in Pakistan denote a rather underexplored but significant part of mental wellbeing. This qualitative research reconnoiters the feeling of people whose siblings have been lost in the event of a suicide while also aiming to bring light to the different facets of the grieving journey that they have navigated through. Using techniques of thematic analysis, data was collected using semi-structured interviews involving 8 participants who were siblings and belonging to a wide range of backgrounds, each of them offering a different and unique viewpoint that was shaped by their experiences and backgrounds. The analysis discovered seven predominant themes, each of which contained several subthemes. From these, a universal and main aspect of the bereavement process was emotional distress which was interlinked with coping mechanisms and resilience portrayed by siblings while undergoing that journey of grief. Furthermore, posttraumatic growth as a phenomenon came forth as an intricate interconnection of transformation of the individual due to huge loss. The research also revealed the extensive effect of stigmatization in Pakistani society regarding suicide. Nevertheless, the significance of Environmental Reward, complexities of stressed relationships and social support dynamics came forth as important features that shaped the experience of bereavement. The discoveries highlight the need for specialized interventions and support services that cater to individualized needs of individuals in Pakistan who are suicide bereaved. By identifying and authenticating their experiences, officials involved in making policies and mental health professionals can nurture a more effective and sympathetic method for helping those who are currently experiencing loss of a sibling due to suicide. This research contributes important discernments to the increasing literature on the topic of bereavement and emphasizes the importance of cultural bound and contextual helping strategies for catering mental health problems in Pakistan.

Mortality risk following end-of-life caregiving: A population-based analysis of hospice users and their families

Experiencing the death of a family member and providing end-of-life caregiving can be stressful on families – this is well-documented in both the caregiving and bereavement literatures. Adopting a linked-lived theoretical perspective, exposure to the death and dying of one family member could be conceptualized as a significant life stressor that produces short and long-term health consequences for surviving family members. This study uses familial-linked administrative records from the Utah Population Database to assess how variations in family hospice experiences affect mortality risk for surviving spouses and children. A cohort of hospice decedents living in Utah between 1998 and 2016 linked to their spouses and adult children (n = 37,271 pairs) provides an ideal study population because 1) hospice typically involves family members in the planning and delivery of end-of-life care, and 2) hospice admission represents a conscious awareness and acknowledgment that the decedent is entering an end-of-life experience. Thus, hospice duration (measured as the time between admission and death) is a precise measure of the family's exposure to an end-of-life stressor. Linking medical records, vital statistics, and other administrative microdata to describe decedent-kin pairs, event-history models assessed how hospice duration and characteristics of the family, including familial network size and coresidence with the decedent, were associated with long-term mortality risk of surviving daughters, sons, wives (widows), and husbands (widowers). Longer hospice duration increased mortality risk for daughters and husbands, but not sons or wives. Having other family members in the state was protective, and living in the same household as the decedent prior to death was a risk factor for sons. We conclude that relationship type and sex likely modify the how of end-of-life stressors (i.e., potential caregiving demands and bereavement experiences) affect health because of normative gender roles. Furthermore, exposure to dementia deaths may be particularly stressful, especially for women.

Drug-Death Related Bereavement and Social Support.

The loss of a close one to drug-related death (DRD) has been characterized as a form of stigmatized bereavement, and research has shown that there is a high risk of bereavement complications. Social support can be a buffer against bereavement complications, but because of stigma, DRD bereaved persons access to social support can be challenged. Based on data from a Norwegian sample of DRD bereaved persons (N = 252) the present study examines (1) bereaved persons' perceived access to different aspects of social support, and (2) the association between bereaved persons' experiences of societal stigma, own withdrawal, self-blame, and their perceptions of social support. Results show (1) that bereaved persons' access to contact with persons in the same situation is particularly low compared to other support aspects, and (2) that perceived stigma (4%) and own withdrawal (5%) predict variations in drug-related death bereaved persons' perception of social support.

Family members’ experiences of bereavement in the emergency department: A meta-synthesis of qualitative studies

The emergency department (ED) is one of the places where patient deaths frequently occur. Understanding family members’ experiences of bereavement would help provide individualized bereavement care. We conducted a meta-synthesis to synthesize family members’ experiences of bereavement in the ED and assess the impact of bereavement on their lives. We searched seven international electronic databases. Five studies were selected and critically appraised. Thematic analysis was employed. Five themes (with 13 subthemes) were derived: suffering sudden changes and are severely impacted, multiple feelings and needs of waiting, final farewell, personal and family difficulties after leaving the ED, and journey through grief. Family members endured agonizing waits to see and learn more about their family members’ condition. Family members reported the need for effective follow-up resources. Findings revealed that it would be helpful if the EDs could provide sensitive and respectful care to family members.

"Trying to Find North": Fathers Voice the Nature of Their Bereavement.

Fathers' lived experience of bereavement is not well understood. This article presents findings from a Heidegerrian phenomenological study, which aimed to describe fathers' bereavement. Fathers' bereavement is a life-long journey along which a father navigates through devastating and traumatic loss with great strength; has profound grief that mirrors the profound love he has for his child; chooses to live life with intention and engages in meaningful activities that create purpose aimed at honoring his child, continuing his child's legacy, and using his own suffering for the good of others; is anchored by a continuing bond of love that fuels an ongoing relationship with his child; and needs a supportive community to sustain him as he travels down the healing road where it is possible to find faith, hope, and love while being forever transformed by loss. Findings amplify fathers' voice so nurses gain a deeper understanding of their experience.

‘I’ve tried not to show it too much, and not burden others with my problems’: A discourse analysis of understandings of grief among siblings bereaved by drug-related deaths

This article explores discourses of grief and loss among siblings bereaved by drug-related deaths. Although sociocultural context influences how grief is expressed and understood, there is a lack of knowledge about how prevailing discourses on grief provide conditions for dealing with grief. The aim of this study was to draw attention to cultural understandings of grief with the research question: ‘Following a drug-related death, how do bereaved siblings draw on discourses in their talk about grief and how do they position themselves accordingly as bereaved?’ We also examined some social consequences of siblings’ positionings. The data were obtained from in-depth interviews with 10 bereaved adult siblings talking about their experiences. The data were analysed using the interpretative repertoires and positioning perspectives from discourse psychology. Findings revealed four interpretative repertoires displaying a variety of talk about grief: grief as being visibly affected; grief as a hierarchy; grief as something to be managed; grief as a reaction which follows death. These repertoires portray different understandings of grief used by siblings in meaning-making relating to their own experiences of bereavement. The positions produced by the repertoires have consequences for bereaved siblings’ access to help and support. Siblings frequently placed themselves or were placed in positions that produced a lack of social recognition of their grief and hence they were deprived of help and support.

The Role of Animal Companions in the Bereavement Experiences of Australian Lesbians and Gay Men.

All too often, humans who experience the death of a partner are directed towards other humans for support, ignoring the important role that animal companions play in the lives of many humans. For lesbians and gay men specifically - whose grief may be disenfranchised - animal companions may play a particularly important role. This paper reports on a secondary analysis of interviews with 10 Australian lesbians or gay men who had lost a partner due to non-HIV related issues. Six of the participants spoke impromptu about the importance of animal companions following the death of a partner. Thematic analysis resulted in the development of three themes: (1) animals provide comfort and company, (2) animals serve as a reminder of partners, and (3) animals give people a reason to go on. The paper concludes by considering the importance of speaking about animals in the context of research and practice related to human bereavement.

‘There’s a huge hole left in the middle of the family’: locating family practices within the context of (sibling) bereavement

Family life is permanently and irrevocably changed by death, requiring those bereaved to adopt new ways of ‘doing’ family. Drawing on data from a qualitative study of sibling bereavement experiences, this article demonstrates that death can retain a powerful presence for the living, shaping the way that family members relate to one another. It is argued that bereavement can influence the establishment, and enactment, of family practices, thus highlighting that family practices can be subtly couched in the context of bereavement. This article expands Morgan’s concept of family practices in a direction that has yet to be explored. It will conclude that sociologists can learn more about the dynamic intricacies of family life by recognising the potential influence of death and bereavement on the way that relationships are navigated and negotiated over time.

Maternal experienced bereavement and offspring mental health in early adulthood: the role of modifiable parental factors.

It is estimated that 78% of children experience the death of a close friend or family member by 16 years of age, yet longitudinal research examining the mental health outcomes of wider experiences of bereavement is scarce. We conducted a longitudinal investigation of the association between maternal experienced bereavement before the age of 11 years and offspring depressive and anxiety disorders at age 18 and examined moderation of this association by modifiable parental factors. We analysed data from the Avon Longitudinal Study of Parents and Children, a UK-based birth cohort, including 9,088 child participants with data available on bereavement. Bereavement was measured via maternal report at eight timepoints until children were 11 years. Offspring depressive and anxiety-related disorders were self-reported at 18 years old using the Clinical Interview Schedule-Revised (CIS-R). The potential moderating roles of maternal anxiety, maternal depression, parental monitoring, positive parenting and negative parenting practices were examined. Maternal experienced bereavement was not associated with depression or anxiety-related disorders in early adulthood among offspring. In addition, no support was found for negative parenting practices, parental monitoring or maternal anxiety and depression as moderators of the relationship between maternal experienced bereavement and offspring mental health problems at 18 years old. Findings in relation to the moderating role of positive parenting practices were inconsistent. Findings suggest that a large number of children are exposed to maternal experienced bereavement. We found no evidence that maternal experienced bereavement during childhood increases the risk for offspring psychiatric disorders in early adulthood. Several methodological considerations prudent to bereavement research are discussed.

Grief in the school: A review of a participatory project in Argentina

When a member of the education community (student, teacher, administrator) dies, there have historically been few options to process these distressing experiences inside the education environment. In this viewpoint article, we recount the historical and conceptual journey the organisation Fundación IPA (Palliative Ideas in Action) took to actively intervene in the often silenced (and frequently stigmatised) experiences of grief and bereavement in the City of San Carlos de Bariloche, Argentina.

Developing a best-practice agenda for music therapy research to support informal carers of terminally ill patients pre- and post-death bereavement: a world café approach

BackgroundInformal carers of terminally ill patients play a vital role in providing palliative care at home, which impacts on their pre- and post-death bereavement experience and presents an up to 50% greater risk for mental-health problems. However, developing and implementing effective bereavement support remains challenging. There is a need to build the evidence base for music therapy as a potentially promising bereavement support for this vulnerable population. This study aimed to co-design an international best practice agenda for research into music therapy for informal carers of patients pre- and post-death bereavement.MethodsOnline half day workshop using a World Café approach; an innovative method for harnessing group intelligence within a group of international expert stakeholders (music therapy clinicians and academics with experience of music therapy with informal carers at end-of-life). Demographics, experience, key priorities and methodological challenges were gathered during a pre-workshop survey to inform workshop discussions. The online workshop involved four rounds of rotating, 25-minute, small group parallel discussions using Padlet. One final large group discussion involved a consensus building activity. All data were analysed thematically to identify patterns to inform priorities and recommendations.ResultsTwenty-two consented and completed the pre-event survey (response rate 44%), from countries representing 10 different time zones. Sixteen participated in the workshop and developed the following best practice agenda. The effectiveness of music therapy in supporting informal carers across the bereavement continuum should be prioritised. This should be done using a mixed methods design to draw on the strengths of different methodological approaches to building the evidence base. It should involve service users throughout and should use a core outcome set to guide the choice of clinically important bereavement outcome measures in efficacy/effectiveness research.ConclusionsFindings should inform future pre- and post-death bereavement support research for informal caregivers of terminally ill patients. This is an important step in building the evidence base for commissioners and service providers on how to incorporate more innovative approaches in palliative care bereavement services.

Types of bereavement and depressive symptoms among older adults: Does race/ethnicity matter?

To explore racial/ethnic differences in relation between types of bereavement and depressive symptoms among older adults in the USA. The sample limited to racially/ethnically diverse adults aged ≥55 (n = 879) was drawn from the third wave of the National Social Life, Health, and Aging Project (NSHAP). The NSHAP provides self-identified racial/ethnic categories (non-Hispanic Whites, Blacks, and Hispanics) of respondents who were categorized into three groups by experience of bereavement: non-loss, spousal loss, and parental loss. Using the weights, a two-way analysis of covariance with Bonferroni post-test was conducted to explore the main effect of types of loss and race/ethnicity and their interaction effects on depressive symptoms. Spousal loss reported higher levels of depressive symptoms than non-loss or parental loss. Based on the interaction between types of loss and race/ethnicity; however, distinctive patterns were observed. Blacks and Hispanics who lose a parent reported significantly higher levels of depressive symptoms than non-Hispanic Whites did. An increase in depressive symptoms after bereavement manifested distinctively based on racial/ethnic background and the relationship with the deceased. This implies that it is necessary to develop coping strategies concerning race/ethnicity and whom they lose. Geriatr Gerontol Int 2024; 24: 266-272.