Experience Of Bereavement Research Articles

Factors Influencing Coping with Death Competence Among Chinese Oncology Nurses: A National Cross-Sectional Study.

To identify the factors affecting Chinese oncology nurses' competency in coping with death, and their relationship with death attitudes and educational needs. A national cross-sectional descriptive study was conducted using an online survey of Chinese oncology nurses. Data were collected using the Coping with Death, Death Attitude Profile-Revised, and Death Education Needs Scales. A Pearson's correlation analysis was used to examine the relationships among the research variables. A multiple linear regression analysis was used to analyze the factors influencing coping with death. The total score of coping with death was 133.57±26.78, showing a moderate coping level among Chinese oncology nurses. The Pearson's correlation analysis showed that death attitude was significantly and positively correlated with coping with death competence, and there was a statistically significant positive relationship between coping with death competence and death education needs. Years of oncology care experience, bereavement experience, death attitude, and death education needs were identified as statistically significant factors influencing competency in coping with death. These factors explained 30.6% of the differences in coping with death. This study found that oncology nurses in China exhibited moderate levels of death coping competence, which needs to be improved to provide higher-quality end-of-life care. Further, death attitude and education needs were important factors affecting participants' coping with death competence. Tailored death education programs and continuing education on death should be provided for oncology nurses, to encourage them to actively participate in death competence-related training and promote an attitude of natural acceptance of death and positive care for terminally ill patients. In the future, virtual reality technology could complete course implementation designs with immersive, conceptual, and interactive characteristics, to enhance the death-coping education program. Nurses with less experience in oncology care and bereavement should improve their competency in coping with death.

The associations of grief-related rumination with prolonged grief and posttraumatic stress symptoms: A longitudinal study of bereaved after the 2011 terror attack in Norway.

After the sudden and violent death of a loved one, many bereaved experience symptoms of prolonged grief (PG) and posttraumatic stress (PTS). The present study investigated the cross-sectional and longitudinal associations of grief-related rumination with PG and PTS symptoms among bereaved parents and siblings after the Utøya terror attack in Norway on 22 July 2011 (N = 110, Mage = 43.2 years, 59.1% female). Participants' responses on the Rumination Scale, the Inventory of Complicated Grief and the Impact of Event Scale-Revised 28, 40 and 102 months after the loss were analysed. Cross-sectionally and longitudinally, grief-related rumination was positively and strongly linked with PG and PTS symptoms. When controlling for the baseline levels of PG and PTS symptoms and demographics of the sample, grief-related rumination predicted PG symptoms after 12 months but not after 74 months. Further, grief-related rumination predicted significantly the PTS symptoms of avoidance after 12 and 74 months and hyperarousal after 74 months beyond sample demographics and baseline symptoms. The results suggest that grief-related rumination is an important factor in PG and PTS symptoms after traumatic bereavement.

Integrity vs Despair: A Phenomenological Study on Filipino Widowed Elderly Lived Experiences

This phenomenological study elucidated the lived experiences of seven Filipino widowed elderly in Bulacan through in-depth interviews. Interpretative phenomenological analysis of transcribed interviews yielded multifaceted insights. Findings revealed three domains that were deemed vital in the study: (1) relationship of the widowed elders with their family; (2) aging experience of widowed elders in relation to widowhood; and (3) perception of widowed elders on dying in relation to widowhood. The participants cherished spousal bonds that provided meaning amidst occasional conflicts. Spousal loss impacted physical health, mental well-being, emotions, and social connections. Participants displayed resilience anchored in familial support, faith, and inner contentment, yet regrets and vulnerabilities persisted during bereavement. Reflections on mortality revealed acceptance of death, valuing familial harmony, and aspiring for loved ones’ well-being. This study offers qualitative insights into nuances, challenges, and sources of strength shaping elderly Filipino bereavement experiences. It contributes to scholarly understanding of marginalized elderly Filipinos’ needs, informing supportive interventions, community engagement, and social welfare policies. Recommendations include strengthening support systems and implementing community elderly programs. Further, research on male elderly and mixed-method approaches would be beneficial. The knowledge produced can guide evidence-based services addressing multifaceted demands in grieving spousal loss amidst aging.

Support needs of Australians bereaved during the COVID-19 pandemic: A cross-sectional survey study.

COVID-19 disrupted access to bereavement support. The objective of this study was to identify the bereavement supports used by Australians during the COVID-19 pandemic, perceived helpfulness of supports used, prevalence and areas of unmet support need, and characteristics of those with unmet support needs. A convenience sample of bereaved adults completed an online questionnaire (April 2021-April 2022) about their bereavement experiences including support use and perceived helpfulness, unmet support needs and mental health. Multiple logistic regression was conducted to determine sociodemographic correlates of unmet needs. Open-ended responses were examined using content analysis to determine key themes. 1,878 bereaved Australians completed the questionnaire. Participants were mostly women (94.9%) living in major cities (68%) and reported the death of a parent (45%), with an average age of 55.1 years (SD = 12.2). The five most used supports were family and friends, self-help resources, general practitioners, psychologists, and internet/online community groups. Notably, each was nominated as most helpful and most unhelpful by participants. Two-thirds (66%) reported specific unmet support needs. Those with unmet needs scored lower on mental health measures. Correlates of unmet needs included being of younger age, being a spouse or parent to the deceased; reporting more impacts from public health measures, and not reporting family and friends as supports. The most frequent unmet need was for social support after the death and during lockdown. This study demonstrates the complexity of bereavement support needs during a pandemic. Specialised grief therapy needs to be more readily available to the minority of grievers who would benefit from it. A clear recommendation for a bereavement support action plan is to bolster the ability of social networks to provide support in times of loss. The fostering of social support in the wake of bereavement is a major gap that needs to be addressed in practice, policy, and research.

The experience of drug-related client loss for healthcare professionals who support people in addiction

IntroductionAddiction support and recovery is a multi-faceted support context in which practitioners work with clients who present with increased mortality risks. Drug-related deaths are understood to be a risk factor for complicated grief-reactions but, to date, research has neglected to explore the intricacies of drug-related client loss for practitioners who work with clients experiencing addiction. Due to wider expectations of professional endurance and the demanding nature of health care, grief-related reactions associated with the loss of a client may go unprocessed and, therefore, result in long-term health implications. MethodFifteen health care professionals took part in individual semi-structured interviews, which were analyzed using reflexive thematic analysis. Participants represented various disciplines in addiction support and recovery, including homelessness, inclusion health, addiction, and emergency medicine. ResultsThree core themes emerged encapsulating the experience of drug-related bereavement for HCPs who support people experiencing addiction, as follows: (i) Grief Beneath the Surface, (ii) The Cost of Caring, and (iii) Finding Closure. The findings identified acute grief-related reactions in HCPs such as self-blame and shame, alongside fears of litigation and questions of clinical competency. Participants' accounts of drug-related client loss emphasized a deep professional connection with those that they work with, with grief-responses akin to the loss of peers, family members, and other close connections. The bereavement experience was complicated by unique compounding variables associated with drug-related deaths, but also by incongruity between their emotional responses to death and their professional responsibilities. ConclusionsThis article highlights the complex nature of drug-related client loss, and despite their social positioning as experts in their field, HCPs' reactions to client deaths were predominantly human responses to loss. The article identified a need for targeted postvention protocols that address complicated grief while also allowing staff to resume occupational functioning in a measured manner.

Bereavement and the veterinary nurse

Bereavement is an issue that all pet owners and animal care staff face. Veterinary nurses frequently face not only the bereavement of clients, but also their own as pet owners, or from taking part in euthanasia. As a result, veterinary nurses are at risk of further challenges such as disenfranchised or complicated grief. This article discusses what is known about the experience of bereavement, methods to support those experiencing bereavement, and how these may affect practicing veterinary nurses.

P97: Can Death Cafés contribute to the creation of a “death-inclusive society” that will be the ground for the Advance care planning?

Objective:The aim of this study was to examine the potential contribution of Death Cafés to the creation of a society that is inclusive of death, which is necessary for ACP, through an analysis of the motivations and orientations of Death Cafés hosts to run Death Cafés.Methods:Interviews were conducted with 16 host of Death Cafés. Interview transcripts were segmented, coded and categorized, focusing on motivations and orientations for running Death Cafés.Results:Motivation for running Death Cafés were categorized into four categories: “The bereavement experience of the host”, “The identity crisis of the host”, “Dissatisfaction with a society in which death is taboo”, and “Unlocking new possibilities for Buddhist temples”The orientation of Death Cafés was categorized into two categories. Namely, “Personal growth” and “Community development”.Attitudes towards the attendees with grief were categorized in two categories. “Not mentioned” and ” Welcome participation/refer to more appropriate projects “.The characteristics of the host and venue were categorized as “Buddhist monk and/or Buddhist temple” and “Other”.The relationship between these four factors was examined. When the host's bereavement experience was the motivation for starting the Death Cafés, they tended to regard death as an overwhelming experience and to run an individually oriented Death Cafés with the intention of personal growth. When the motivation for starting the Death Cafés was dissatisfaction with a society that considered death a taboo subject, attitudes towards death tended to be neutral and the café tended to be socially oriented with the intention of community development. Where the motivation for starting the Death Cafés was to expand the possibilities of the Buddhist temple, which was one of the subcategories of “Community development”, attitudes towards death were neutral and café tended to be both individual and socially oriented.Conclusion:Death Cafés held in Buddhist temples may have the potential to contribute to the creation of a death-inclusive society in Japan and could be an ACP implementation strategy.

How compassionate is your neighborhood? Results of a cross-sectional survey on neighborhood participation regarding serious illness, death, and loss

We conducted a cross-sectional survey measuring the extent and nature of neighborhood participation regarding serious illness, death and loss and the factors that are associated with it. We distributed the survey to 2324 adult citizens in two neighborhoods in Flanders, Belgium, to which 714 citizens responded (response rate 30.7%). Of the respondents, 42.4% participated in at least one action in their neighborhood around serious illness, death, or loss, for 30.8% of them this participation was sporadic. Most of the respondents participated by helping neighbors (32.4%) or by volunteering (10.3%). We found a positive association between perceived neighborhood social cohesion (β = 0.100; CI = 0.003-0.040), previous experiences with serious illness, death, and loss (β = 0.158; CI = 0.204-0.586) and neighborhood participation around serious illness, death and loss. Future research should investigate strategies on how to move from death literacy developed through illness, caregiving and bereavement experiences to neighborhood participation around these topics.

An Unprecedented Experience of Collective Bereavement: The Story of Xylella Fastidiosa in Apulia

An Unprecedented Experience of Collective Bereavement: The Story of Xylella Fastidiosa in Apulia

The COVID-19 Pandemic: Bereavement Experiences Between Hospital and Home Deaths in Palliative Care

BackgroundAustralian COVID-19 public health measures reduced opportunities for people to communicate with healthcare professionals and be present at the death of family members/friends. AimTo understand if pandemic-specific challenges and public health measures during the COVID-19 pandemic impacted end-of-life and bereavement experiences differently if the death, supported by palliative care, occurred in a hospital or at home. DesignA cross-sectional online survey was completed by bereaved adults during 2020–2022. Analyses compared home and in-patient palliative care deaths and bereavement outcomes. Additional analyses compared health communication outcomes for those identified as persons responsible or next of kin. Setting/participantsOf 744 bereaved people; 69% (n = 514) had a death in hospital and 31% (n = 220) at home. ResultsThe COVID-19 public health measures influenced people's decision to die at home. Compared to hospital deaths, the home death group had higher levels of grief severity and grief-related functional impairment. Only 37% of bereaved people received information about bereavement and support services. 38% of participants who were at least 12 months postdeath scored at a level suggestive of possible prolonged grief disorder. Levels of depression and anxiety between the two groups were not significantly different. ConclusionsThese findings highlight the need for health services to recognize bereavement as fundamental to palliative and health care and provide pre- and post death grief and bereavement care to ensure supports are available particularly for those managing end-of-life at home, and that such supports are in place prior to as well as at the time of the death.

아버지 사별 경험에 대한 자전적 내러티브 탐구

Objectives This study was conducted to understand the impact and meaning of the experience of bereavement of a father due to a sudden accident in adulthood and the prolonged grief that followed.
 Methods To this end, the narrative inquiry method of Clandinin and Connelly was used. As a researcher and re-search participant, I collected data through memory recall and self-analysis journals, SNS data, personal counsel-ing records, and interviews with family members to explore my experiential meaning, and through in-depth writ-ing that deeply reveals the emotions after bereavement.
 Results These are the attempt to validate the research. As for the research data, the death of my father, whom I identified with, was the same as my death, which made me face painful feelings that could not be resolved for a long time. I re-explored death, which I had suppressed, on an emotional level, and in the process, I reflected on the meaning of sadness and pain and had a self-healing experience. As a result, I was able to express the sadness of my father's bereavement as it is without suppressing my sadness any longer.
 Conclusions In the conclusion and recommendations, based on the research results, counseling solutions and tasks, such as counselors' opinions on bereavement counseling and the degree of acceptance and approach, are described and the significance of the research is addressed.

Balancing pandemic public health restrictions and family support at the end of life: palliative care and bereavement experiences of parents whose child died during the COVID-19 pandemic

BackgroundLittle is known about the impact of the COVID-19 pandemic on families of children with chronic life-limiting conditions who died during the COVID-19 pandemic.MethodsIn this qualitative study, parents of a child (< 18 years) who died during the COVID-19 pandemic from an underlying chronic medical condition were interviewed to explore how the pandemic impacted end-of-life care and bereavement experiences. Parents of children followed by the pediatric palliative care service were recruited from a large children’s hospital in eastern Canada.ResultsTwenty bereaved parents, consisting of 12 mothers and 8 fathers, participated in individual interviews between January and December 2021. Findings identified impacts of the COVID-19 pandemic on children’s end-of-life care, experiences in hospital and at home, and family bereavement processes and experiences. Most parents experienced substantial worry about their child’s physical status and the additional risk of COVID-19 given her/his vulnerability. Parents also struggled to navigate public health protocols as they attended to their child’s needs and their family’s desire for engagement and support. Key facilitators that helped families cope included a strong network of formal and informal supports.ConclusionImplications highlight the need to critically reflect on pandemic care in the context of co-occurring end-of-life processes. Findings amplify the need to balance necessary infection control practices with access to essential supports for families.

8.G. Workshop: Developments in patient experience surveys: how do we maintain relevance and maximise impact?

Abstract Background Patient and service-user experiences of healthcare are a vital component of the monitoring and assessment of the quality and performance of health and social care services and systems, as well as an important predictor of patient outcomes. The National Care Experience Programme (NCEP) is a partnership between the Irish health and social care regulator (Health Information and Quality Authority, HIQA), the national public healthcare provider (Health Service Executive, HSE), and policy makers (Department of Health). The NCEP conducts national care experience surveys with the aim of learning from people's experiences in order to improve the quality of health and social care services in Ireland. The programme includes surveys of acute hospital inpatient, maternity, maternity bereavement, nursing home and end-of-life care. Additional surveys of cancer care and mental health services are currently in development. Objectives Regular review and adaptation of existing surveys, expansion into new areas of care, and development of new methods of data collection, analysis and dissemination of survey findings and stakeholder engagement are required in order to remain agile and responsive to evolving health and social care landscapes and the changing needs of stakeholders, as well as harnessing technological advances and ensuring sustainability. The aim of this workshop is to bring together experts in patient experience from across the health system to stimulate discussion, knowledge sharing and cross-fertilisation of ideas. Presentations will focus on international developments and trends in patient experience, as well as considerations for surveying bereaved parents and families on their experiences of maternity bereavement and end-of-life care. The use of new technologies, including computational text analytics and predictive modelling to facilitate qualitative data analysis and maximise the use of survey findings will be outlined, followed by case studies of how care experience data are used to inform health and social care legislation, policy and practice in Ireland. Experiences from other jurisdictions and potential implications will be discussed with the audience. The workshop will contribute to a better understanding of the value and impact of collecting patient experience feedback and explore how new technologies can be used to generate insights and maximise the use of survey data. Format of the workshop The workshop will include a brief introduction on patient experience and the Irish National Care Experience Programme, followed by five presentations with time for audience contributions and questions after each speaker. The workshop will conclude with a discussion with the audience and presenters. Key messages • Patient experiences are a key component of the monitoring and assessment of the quality and performance of health and social care services and systems. • Regular review and adaptation of surveys and development of new methods are required to remain responsive to evolving health and social care landscapes and ensure sustainability.

“The worst has already happened”: communicating sensitively with bereaved survey participants

Abstract Issue The National Care Experience Programme asks people about their experiences of health and social care services, including maternity bereavement and end-of-life care. The surveys aim to identify areas of good experience, as well as areas requiring improvement. Implementing surveys on sensitive topics involves a duty of care to participants to ensure the highest ethical standards and sensitive communication with bereaved parents and relatives. Description of the problem Under General Data Protection Regulation, there is an obligation to be transparent with people in the event that they are invited to participate in a survey. This must be balanced with sensitive and respectful communication with those who have experienced a loss. The mode of contact and timing of surveys requires careful consideration. Results Bereaved parents and relatives, support organisations and subject matter experts were engaged with extensively to inform the National End of Life Survey and National Maternity Bereavement Experience Survey, including the mode of contact with eligible parents and relatives and the timing of surveys. A detailed communications plan was developed to share information across social media platforms, radio and relevant websites. Communication about the survey balanced key messages on the aims, methods and eligibility criteria with a sensitive and time-appropriate delivery. Lessons Both surveys asked about the lived experiences of significant, traumatic life events. Participation had the potential to place an emotional burden on participants, who had to relive their experiences of loss. In order to limit the potential harm, bereaved parents and relatives were involved in all stages of the survey development process. Information on support services was included with all survey invitations and documentation. Strong response rates highlight a willingness amongst bereaved parents and families to share their experiences to inform improvements to care.

Memory making in critical care: A qualitative thematic synthesis.

Caring for bereaved families is an important aspect of the nursing role in critical care. Memory making practices are one way in which dying, death and bereavement can be acknowledged and supported within critical care. Memory making was introduced into the care of stillborn babies and neonatal deaths to improve parents' experiences of bereavement, and has since become common practice in adult critical care. The aim of this qualitative thematic synthesis was to explore families' experiences of memory making in critical care, with a view of gaining greater understanding of the ways in which memory making impacts bereaved families. A systematic search strategy was developed, and five databases were searched (Medline, CINAHL, PsychINFO, Embase and ASSIA). Seven qualitative studies were included: four were conducted in adult and three in paediatric critical care settings in which memory making was initiated between 2014 and 2020. Memory making practices included, patient diaries, general keepsakes, word clouds and photography. The thematic synthesis generated four main themes to describe families' experience of memory making in critical care: 'connection', 'compassion', 'engagement and creation' and 'continuation'. Memory making is a meaningful activity for families whose loved one dies in critical care; it brings focus and meaning during a devastating process in a highly technical environment. Families rely heavily on nursing staff for support and guidance. The creation of memories and/or keepsakes can have a positive impact on the bereavement experience for families and can facilitate a continuing bond with their loved one. Memory making is a worthwhile practice to support and guide family bereavement within critical care. It can provide structure and purpose during an emotionally challenging transition, by supporting families to focus on a meaningful activity during a devasting time.

Relatives' Experiences of Being Involved in Assisted Dying: A Qualitative Study.

Recent literature demonstrates an interdependence between relatives and healthcare providers throughout euthanasia processes. Yet, current guidelines and literature scarcely specify the interactions between healthcare providers and bereaved relatives. The aim of this work consisted of providing an insight into bereaved relatives' experiences (1) of being involved in euthanasia processes and (2) of their interactions with healthcare providers before, during, and after the euthanasia. The research process was guided by the principles of constructivist grounded theory. Nineteen Dutch-speaking bereaved relatives of oncological patients, who received euthanasia at home or in a hospital less than 24months ago, participated via semi-structured interviews. These interviews were conducted between May 2021 and June 2022. Due to the intensity of euthanasia processes, relatives wanted to be involved as early as possible, in order to receive time, space, and access to professionals' support whilst preparing themselves for the upcoming loss of a family member with cancer. Being at peace with the euthanasia request facilitated taking a supportive attitude, subsequently aiding in achieving a serene atmosphere. A serene atmosphere facilitated relatives' grief process because it helped them in creating and preserving good memories. Relatives appreciated support from healthcare providers, as long as overinvolvement on their part was not occurring. This study advocates for a relational approach in the context of euthanasia and provides useful complements to the existing euthanasia guidelines.

Evolving Posttraumatic Growth in Family Bereavement: A Post-Intentional Reflexion

ABSTRACT The journey of growth following trauma represents a complex process of finding meaning following loss. Post-intentional phenomenological reflexion on a bereavement experience and collaborative autoethnography provide avenues for continued evolution, multiple meanings, and becoming. This investigation draws from a collaborative autoethnography created during a family bereavement experience. A researcher participant and her family reflect on the loss of a family member one year after his death. This reflection of posttraumatic growth offers themes of healing and continued relationship after a death. Findings include a creative representation of themes in a post-intentional letter.

Stigmatized Bereavement: A Qualitative Study on the Impacts of Stigma for Those Bereaved by a Drug-Related Death.

Research has given limited attention to family and friends bereaved by a drug-overdose death. To examine the ways in which stigma may uniquely impact the grieving processes of the bereaved, a thematic analysis of 35 semistructured in-depth interviews with family members and adult peers who lost a loved one to an overdose was conducted. Our findings demonstrate that the bereaved experience stigmatization after their loss. Specifically, respondents emphasized stigmatizing interactions with law enforcement, alienation from friends and family, a lack of social support, exchanges that enforced feeling rules, and being confronted by narratives of blame and individual choice as contributing to the degrees of stigmatization they experienced. Our findings highlight how bereavement becomes stigmatized to varying degrees through multiple interactions that have a compounding effect on mourners. We refer to this process as stigmatized bereavement, whereby the frequency of such interactions informs the degree of stigmatization the bereaved faces.

Role of Post-Traumatic Growth in Bereavement Outcomes: An Inquiry of Family Caregivers in Hospice.

Background: Family caregivers (FCGs) encounter several physical, psychosocial, and financial struggles while caring for a dying loved one. After their loved one has passed, FCGs face new difficulties as they transition out of the caregiving role and into bereavement. Recent research has focused on the positive adaptive outcomes of bereavement. Objective: This study examined the relationship between core bereavement experiences and post-traumatic growth (PTG) for bereaved hospice FCGs. Design: This is a quantitative cross-sectional mail-in survey. Settings/Subjects: A total of 395 bereaved FCGs of patients who died while under the care of a comprehensive hospice program were surveyed. Measurements: Demographics were collected. Bereavement experiences were assessed using the core bereavement items, and PTG was assessed using the Posttraumatic Growth Inventory (PTGI). Both surveys are validated measures. Results: Two-tailed bivariate correlations were used to analyze the relationships between bereavement experiences and PTG. Significant positive relationships were found between all bereavement experiences and PTG variables (p = <0.01-0.011, r = 0.134-0.290), except for one variable pairing (grief × new possibilities). Participants who reported more intense bereavement experiences also reported greater PTG, especially in the areas relating to others and appreciation of life. Conclusion: FCGs who undergo more intense bereavement experiences tend to experience greater PTG. This information can be used in the future to develop a more comprehensive understanding of the multifaceted nature of grief and loss.

Bereavement Experiences of Families of Elderly Individuals Who Died Due to COVID-19.

This study was conducted to evaluate the bereavement experiences of families of elderly individuals who died due to the COVID-19 pandemic. One of the qualitative research methods, the case study method, was used in the study. The sample of the research consisted of 19 people who agreed to participate in the research between April and July 2022. The research data were collected using a Personal Information Form and a Semi-Structured Interview Form, which was created to conduct individual in-depth interviews. As a result of the descriptive analysis, four main themes, the ability to perform religious rituals related to the bereavement experience, feelings and thoughts about death, attitudes of those around after death, and coping strategies in the COVID-19 process. It was determined that individuals had difficulty accepting death, felt inadequate about spirituality due to limited religious rituals, had feelings of despair and guilt, and limitedly utilized social support systems.