Grief Care Research Articles

Perinatal Grief Counseling and Its Effect on Grief Levels in Women Who Underwent Pregnancy Termination: A Comparative Experimental Study.

This study was designed as a two-group pre-test post-test comparative experimental study to examine the effects of grief counseling on perinatal grief levels in women who underwent pregnancy termination before discharge from the clinic. This study was conducted with 70 women who underwent medical termination of pregnancy. The intervention group (n = 35) received perinatal grief care, while the control group (n = 35) received only routine hospital care. In this study, the Introductory Information Form, Perinatal Grief Scale, and evaluation form of the care received were completed. While the perinatal grief level of the intervention group decreased after the application of grief care, a significant difference between the groups was detected only in women with a history of medical termination according to obstetric characteristics (p < .05). The findings obtained from this study showed that perinatal grief care support decreased grief scores on perinatal grief instruments and their sub-dimensions in the intervention group.

Relationship among death conferences, willingness and confidence in end-of-life care, and practice of grief care in Japanese home-visit nursing stations

Relationship among death conferences, willingness and confidence in end-of-life care, and practice of grief care in Japanese home-visit nursing stations

Living Networks in Health during the covid-19 pandemic: Evaluation of the multiprofessional training course "Nós da Linha de Frente" in Manaus, Amazonas, Brazil

This article presents the evaluation of the therapeutic intervention course in situations of traumatic loss and grief, offered online by the Universidade do Estado do Amazonas, between April and August 2021, for volunteer professionals. A semi-structured questionnaire with open and closed questions was administered. The analysis of the 55 responses from volunteer professionals and 14 responses from individuals who received the intervention was based on the Kirkpatrick evaluation model. The results demonstrate the theoretical and practical success of the course, with a positive assessment at the reaction, learning, behavior, and results levels, emphasizing collective work and the motivation of the course speakers. The main acquired knowledge pertained to topics related to death and grief care. The behaviors resulting from the course fall within the affective-social and technical-professional domains. Regarding impact, there was a predominance of satisfaction among the individuals who received the intervention, as well as identification of changes brought about by the training.

Postintensive care syndrome family: A comprehensive review.

Families of critically ill patients are predisposed to tremendous burdens when their relatives are admitted to the intensive care unit (ICU). Postintensive care syndrome family (PICS-F) can be described as a devastated life, encompassing psychological, physical, and socioeconomical burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. PICS-F was primarily proposed as a clinically significant psychological impairment, but it needs to be extended beyond the psychological impairment of the family to include physical and socioeconomical impairments in the future. The prevalence of physiological problems including depression, anxiety and post-traumatic syndrome is 20-40%, and that of non-physiological problems including fatigue is 15% at 6 months after the ICU stay. Assessment of PICS-F was frequently conducted at 3- or 6-month points, although the beginning of the evaluation was based on different assessment points among each of the studies. Families of ICU patients need to be given and understand accurate information, such as the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up, for the patient and families from during the ICU stay to after discharge from the ICU. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F.

P193: Participation of faith-based organizations in the secular health- and welfare- care system for the older people in Japan: evidence and challenges

Objective:Due to longevity, universal health coverage, declining population, and a stable society, it is estimated that the number of people with dementia will reach 10 million by the mid-21st century, accounting for 10% of the total population in Japan. To move toward a dementia-friendly community, it is essential to develop innovative and effective dementia care. However, human and economic resources are limited. Therefore, we focused on traditional Buddhist denominations that have organizations, educational systems, human resources, networks, and care venues. The fundamental question of this study is: Japanese Buddhism has created basis for mindfulness-based cognitive therapy, but is it also innovative in the care of older people?Methods:We looked for papers that 1) were written in a medical rather than a religious context, 2) were written in English, and 3) dealt with the care of the older people in Japan.Results:1) Institutional care workers’ need for Buddhist priests for helping anxiety of older residents was reported. 2) Effectiveness of community cafés for the family caregivers of people with dementia in the Buddhist temples were reported. 3) Potentials of monthly visit to bereaved families, Buddhist priests’ tradition, as the outreach of grief care was suggested. 4) Care workers’ own ideas about death after working in the landscape of dying and death was reported by the interview which used Buddhist priests as the interviewers.Conclusion:Participation of Buddhist priests as 1) spiritual cares for the residents in the institutions, 2) carers for the family carers in the community, 3) carers of the bereaved families in the outreach activity, and 4) carers for the care workers, were reported. However, robust evidence was not enough. From the standpoint of Japanese clinicians, there are too few papers compared to the actual contributions. More studies should be done which might also work as external monitoring. Traditional Buddhism in Japan has a closed membership system which is based on the family gravesite system and is generally not enthusiastic about propagation, which would also be compatible with a secular care system.

Support forComplicated Grief inMilitary Primary Care: Associations, Challenges, andOpportunities.

This study examined whether service members and their families engage in communication with their primary care managers (PCMs) regarding their losses and to what extent PCMs provide counseling or referrals for grief-related concerns. Additionally, the study explored the potential associations between ethnicity, age, military status (dependent, service member, or veteran), gender, patients' disclosure of loss to their PCM, receipt of referrals for grief-related services, and treatment seeking. A survey was administered to 161 patients enrolled in primary care at William Beaumont Army Medical Center, with 138 reporting a significant loss. Bereaved respondents completed the Inventory of Complicated Grief and the Prolonged Grief Disorder-13 Revised scale (PG-13). Respondents were also asked questions related to their loss and their interactions with their PCM related to the loss. One hundred twenty-five bereaved respondents completed the measures, 13 had missing information related to PCM interactions. Twenty-nine percent (n = 36) of the 112 respondents reported a significant loss to their PCM. These respondents exhibited significantly higher symptom severity, as indicated by their total mean scores on the Inventory of Complicated Grief and the PG13. Seventeen percent (n = 6) of these respondents reported receiving counseling on topics related to grief or a referral for grief care from their PCM. A moderate relationship was identified between military status and communication with PCM, such that current service members were least likely to report, followed by veterans, then dependents. A moderate relationship was also found between ethnicity and treatment seeking. The study's findings have implications for primary care and highlight opportunities for improved outcomes, including the development of appropriate assessment protocols, interventions, and educational initiatives to address grief-related concerns within the military healthcare system. Future research should further investigate the specific needs and preferences of military personnel and their families to enhance the delivery of targeted and effective healthcare services.

Exploring grief and loss among COVID-19 orphaned adolescents

ABSTRACT Background: In the context of the pandemic, sudden, unanticipated deaths occurring due to COVID-19 are traumatizing for children and left families ill-prepared to navigate psychological consequences. Aim: The study aims to explore the impact of the death of loved ones due to COVID-19 on children and adolescents in India. Methodology: The study was conducted in Bangalore District of Karnataka using qualitative multiple in-depth case study method with seven children and adolescents who lost their family members due to COVID-19. The convenience sampling technique was adopted to collect the data. Results: The results revealed persistent sadness, yearning for the loved ones who passed away, feeling of guilt, anger, crying spells, stigma, loneliness, social neglect, loss of family support, financial difficulties, and poverty due to the death of parent(s) and multiple family members due to COVID-19. Conclusion: There is a need to have comprehensive grief care and support for the children and adolescents who lost their loved ones due to COVID-19. The comprehensive response to this phenomenon must be adaptable to the varying needs of children and adolescents keeping in view of their developmental and socioeconomic needs.

The educational value of sense of coherence for grief care.

The educational value of sense of coherence for grief care.

Providing End-of-Life Care for Patients Dying of COVID-19 and Their Families in Isolated Death During the Pandemic in Japan: The Providing End-of-life Care for COVID-19 Project

BackgroundDeath from COVID-19 in a hospital during the pandemic has meant death in isolation. Although many healthcare providers have struggled with end-of-life care for these patients, the various strategies across hospitals are not well known.Research QuestionsWhat end-of-life care did healthcare providers give dying COVID-19 patients and their families in hospitals during the COVID-19 pandemic? What were the key themes in care?Study Design and MethodsThis qualitative study used individual, semistructured, internet and face-to-face interviews. We recruited healthcare providers who provided end-of-life care to COVID-19 patients dying in hospitals and their families. Purposive sampling was used through the academic networks at the School of Public Health, Kyoto University. Anonymized verbatim transcripts were thematically analyzed.ResultsFifteen doctors and 18 nurses from 23 hospitals in 13 regions across Japan participated; 16 (48%) were female, with an age range of 20-59 (most were 30-39). Participants described 51 strategies, including providing physical and psychological-spiritual care, making connections, providing death care, and arranging care environments and bereavement care for patients and their families. Four themes emerged as prominent efforts in COVID-19 end-of-life care: maintaining relationships with isolated patients, connecting patients and families, sharing decision-making in isolation, and creating humanistic episodes.InterpretationProper application and awareness of the four themes may help healthcare providers implement better end-of-life care. To compensate for limited memories due to isolation and rapid progression of the disease, communicating and creating humanistic episodes are emphasized. ICU diaries and the HCPs’ arrangements based on cultural funerary procedures could be provided as grief care for the family and to build trust. End-of-life education and building partnerships among palliative care staff and nonmedical personnel on a regular basis may enhance the capacity to deliver the necessary support for end-of-life care.

Strategies for health care providers to help individuals experiencing grief and loss due to spinal cord injury (SCI): A qualitative study.

To explore health care professionals' perceptions of ideal strategies for providers to use in care provision to help individuals with spinal cord injuries (SCI) deal with injury-related grief and loss. This study used a descriptive qualitative design using semistructured interviews with 15 SCI health providers and thematic analysis. The sample included interprofessional health providers who provided SCI care for an average of 10.3 years at six nationally distributed facilities. Participants identified eight themes around strategies that can be used by providers to help individuals with SCI experiencing grief and loss. Strategies/themes included those that are relational, such as (Theme 1) listening and engaging in open discussions, (Theme 2) being empathetic and fostering trust, (Theme 3) normalizing the experience of grief for the individual, and (Theme 4) focusing on the individual with SCI as a whole. Task-oriented themes included providing regular screening/assessments for grief (Theme 5), coordinated care to the individual (Theme 6), support services (Theme 7), and education to help individuals with SCI understand the grief process (Theme 8). Providers identified strategies to facilitate holistic patient-centered grief care that included open communication, empathy, trust, and normalizing the grief experience, where appropriate. Providers believed that regular screenings for feelings of grief and loss are necessary to know where individuals with SCI are at in the grief process and what they need. Ideal grief care would benefit from coordinated care, support services, and patient education. These findings offer steps to guide health provider's approach to addressing grief and loss due to injury among individuals with SCI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Tasked for Compassion: Initiating Reproductive Grief Care in the Neonatal Intensive Care Unit

Tasked for Compassion: Initiating Reproductive Grief Care in the Neonatal Intensive Care Unit

Depression and Complicated Grief, and Associated Factors, of Bereaved Family Members of Patients Who Died of Malignant Pleural Mesothelioma in Japan.

Objectives: we investigated the prevalence and associated factors of depression and complicated grief (CG) among bereaved family members of malignant pleural mesothelioma (MPM) patients in Japan. Methods: Bereaved family members of MPM patients (n = 72) were surveyed. The Japanese version of the Patient Health Questionnaire-9 (PHQ-9) and the Japanese version of the Brief Grief Questionnaire (BGQ) were used to assess depression and complicated grief (CG), respectively. Socio-economic factors, anger toward asbestos, care satisfaction, achievement of good death, and quality of end-of-life care were assessed in relation to depression and CG. Results: In the family members of MPM patients, the frequencies of depression and CG were 19.4% and 15.3%, respectively. The bereaved family members who were not compensated by the asbestos-related health-damage relief system (p = 0.018) and who felt the financial impacts of the patient’s MPM on the family (p = 0.006) had a higher likelihood of depression. The bereaved family members who were not satisfied with the care given when the patient became critical (p = 0.034), who were not compensated by the asbestos-related health-damage relief system (p = 0.020), who felt the financial impact of the patient’s MPM on the family (p = 0.016), and whose deceased relative underwent surgery (p = 0.030) had a higher likelihood of CG. Conclusions: For bereaved family members of MPM patients, routine screening for depression and CG and the provision of grief care are suggested. In addition, for family members of MPM patients, financial support, including the promotion of the asbestos-related health-damage relief system, and improved care for patients who undergo surgery and when patients become critical, are recommended.

Film-based resources for grief management in medical education

IntroductionGrief and bereavement are commonplace in clinical practice but have become a more pervasive issue because of the coronavirus 2019 pandemic. Consequently, the need for investigations, learning, and education about complicated grief and prolonged grief have been highlighted. Meanwhile, film-based teaching resources concerning grief care have been employed to complement curricula in medical education.ObjectivesTo explore how the grieving experience can be better communicated and mitigated, and explain how a film-based resource can be applied to improve the understanding of this issue.MethodsWe reviewed and analyzed the meaning and cause of complicated, prolonged, disenfranchised grief, as well as related experiences (e.g., survivor guilt) featured in selected films. We discussed the interpretation of these films with medical students and faculty, based on a previously described approach [1].ResultsWe recaptured the roles of empathic communications and resilience skills in grief care. They bring a sense of coherence (SOC) or meaning to life by prompting the sharing of grief experiences, helping to reconstruct and contextualize a person’s loss, and assuaging feelings of worthlessness and hopelessness. Incidentally, recent studies have suggested that complicated and prolonged grief involves alterations in brain functioning of the reward system.ConclusionsThis film-based approach utilizes vicarious experiences to better understand grief management. It allows the learner to more easily recognize that SOC, flexible situation-adjusted empathy, and the sharing of resources for improved communication to promote self-care are essential for patients, their families, as well as psychiatrists themselves. [1] Sondheimer, A. The life stories of children and adolescents. Acad Psychiatry. 2000:24(4):214–24.DisclosureNo significant relationships.

"It Started After Trauma": The Effects of Traumatic Grief on Sleep Paralysis.

Adverse life events are associated with the often-terrifying REM sleep parasomnia of sleep paralysis (SP), but the impact of bereavement on SP has not been specifically examined. This exploratory, mixed-methods study (N = 168) includes qualitative data from 55 participants who described factors they believed led to their SP. Of these, almost half with a traumatic loss listed death-related precipitants. In unadjusted (bivariate) negative binomial regression models, traumatic death, time since death, religiosity, and age estimated increased SP frequency in the prior month, prior year, or both. In multivariable models, traumatic death, time since death, and age estimated increased frequency in the prior month, prior year, or both. Unexpectedly, in all models, as compared to death ≥9years earlier, prior month SP was greater with death 1-6years earlier, but not <1year earlier. Discussion includes the possible role of social constraints in traumatic grief trajectories and care provider recommendations.

Storm homes: support during and after tough times

ABSTRACT Using a metaphor of welcome, respite, and healing – a storm home – readers will be encouraged to consider variations of the metaphor for grief and bereavement care. Limited commentary, research or theory are offered for this practice-focused article so that readers can simply ponder bibliotherapeutic practices for the care of others facing personal, familial or community losses. Think of this article as a case study for examples of welcome, respite and healing during troubling times.

Can We Be at Peace With Unsolvable Suffering? A Qualitative Study Exploring the Effectiveness of Supportive Communication and Resilience Building.

The authors provided six 180-minute interpersonal assistance workshops using teaching materials from the End-of-Life Care Association: 90 minutes each on supportive communication and role-playing. The content included the following:・ Suffering people are “at peace” with someone who understands their suffering, which starts with building a relationship through empathetic listening. The goal is not to “understand them” but for them to “feel understood.”・ Realizing the suffering of others and recognizing the internal moral and emotional strength of those who live with suffering.・ Resilience building: helping caregivers face difficulties even when helpless; remembering one's support networks and valuing oneself.Participants (n = 114) wrote reflective journals after each session. Two domains and 10 key themes were identified through thematic analysis. The domains comprised topics on the importance of using listening techniques, such as repetition, waiting in silence, and asking questions (not to understand but for dialogue). The 3-month postinterviews revealed that participants could ease their sense of weakness by helping suffering people, which is relevant to work, grief care, and daily life. Changes in relationships between participants and patients were also identified. Role-playing can teach supportive communication, such as listening attentively and accepting others, which may help supporters engage with people experiencing incurable suffering.

Coronavirus Disease Brings Death without the Opportunity of Saying Goodbye

Coronavirus disease (COVID-19) victims have spread worldwide, and in Japan, 1.5 million people are infected and 16,000 have died from February 2020 until the end of August 2021. The COVID-19 starts from relatively light symptoms such as cold, and then the conditions worsen rapidly in 7 to 10 days, and results in an unexpected sudden death. The major impacts of COVID-19 in the society of the COVID-19 pandemic is the implementation of social distancing strategies and isolation procedures. We cannot provide care and comfort at the end of the patient’s life, share grief with bereaved family members, and hold normal funeral ceremonies. The COVID-19 pandemic causes the absurdity of death without the opportunity of saying goodbye, and ambiguous loss occurs, and continues to cause the prolonged grief disorder. Medical personnel make efforts to prevent ambiguous loss and the prolonged grief disorder using cognitive behavioral therapy and digital transformation. We examined the COVIT-19 pandemic from the viewpoint of an emergency hospital, and showed the experience and results of COVID-19 patients in our hospital, and reconsidered the essence of grief care and bereavement care of family members who lost their loved ones during the COVID-19 pandemic.

Perinatal Loss: Experiences of Midwives and Nurses.

The aim was to determine the experiences of Turkish midwives and nurses when caring for families with perinatal loss. It was a descriptive and qualitative study. One-to-one interviews were conducted with ten midwives and five nurses using a semi-structured interview form. It was found that the nurses and midwives experienced pain and grief during caring for women who had perinatal losses, and they tried to relieve these feelings by using positive thinking and prayer. The nurses and midwives stated that they were unsure how to approach women or family experiencing perinatal loss, and they needed mentoring and training. The results showed that it would be beneficial to plan training for nurses and midwives and to conduct mentoring for those experiencing difficulties. For nurses and midwives frequently facing perinatal loss, there will be benefit in planning grief care training at regular intervals and mentoring for those experiencing difficulties.

Studies of mortuary value system and its behavior: Columbarium Niche burial and natural burial as study cases in Taiwan

Aim: This study focuses on current Taiwanese mortuary behavior and realizes the gap between mortuary value system and mortuary behavior, and explores the two formers relations with grief care. Eventually, this study provide mortuary policy suggestion to Taiwan government for reference.Method: This study adopts secondary analysis, field interview, and data thematic analysis. This study aims family members who lost their beloved within three years. There are 13 participators. 8 of participators adopted columbarium niche burial and 5 adopts natural burial. Findings: 1) The strategy of funeral arrangement is mostly made of lineal relatives; to be environmental friendly and sanitation and not to be troublesome to the bereaved are mainly reasons to choose burial ways. 2) The corpse mostly sent to a funeral home and erect the deceaseds memorial tablet; the number of people who do not send obituary and simplify total ritual to only 7 days have increased; and traditional wiping and bathing rites to the deceased seems losing its real function. 3) It is prejudicial to grief care while there is a gap between mortuary value and mortuary behavior.Implications/Novel Contribution: Overall, the research findings will provide for the Taiwan government to formulate natural burial policy. The government has to consider grief care of the deceaseds family while it considers the goal of environmental protection and sanitation. Besides, this research attempts to arouse funeral business, academy, and the governments attention to the negative influence on time and space compression of mortuary arrangement and then improve current situation.

Lessons From the Field. Family Grief Care and Bibliotherapy: A Call for Models and Studies

ObjectiveFor this Lesson From the Field report, I write as a family and grief educator to advocate for greater attention to bibliotherapy by family scientists, therapists, and educators. Bibliotherapy (also referred to as poetry therapy or therapeutic storytelling) is the use of literary resources, storytelling, or writing with the purpose of healing.BackgroundDisruptive changes can result in altered personal or family stories. Grief educator Tom Attig (1996) reported that after significant changes, such as bereavement, many persons describe a process of relearning their world. Family therapist Karl Tomm (1990) asserted that a human task throughout life is to story and re‐story. Earlier and current models of family development include milestones of changing family stories (see Duvall, 1962; McGoldrick et al., 2011). A current collective example is personal and family disruptions in response to the COVID‐19 pandemic. Despite many accounts, journals like Family Relations have rarely explored the intersection of family changes (for this article, the focus is family changes that result in loss and grief) using the perspectives and tools of bibliotherapy.MethodDisruptive changes and the resulting grief and loss for individuals and families were used as an example of a subject matter worthy of family scientists' attention.Conclusion and ImplicationsFamily grief care includes attention to changing family stories. Enhanced studies of bibliotherapy by family scientists can inform and enrich support for families through times of grief.