Grief Counseling Research Articles

Factors affecting nurses' willingness and competency to provide anticipatory grief counseling for family caregivers of patients with terminal cancer.

To explore factors associated with nurses' willingness and competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer. Family caregivers often experience anticipatory grief due to the imminence of a loved one's death. However, few studies have identified factors associated with nurses' willingness or competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer. This descriptive correlational study recruited a convenience sample of nurses from cancer-related wards at a regional teaching hospital in Taiwan. The Anticipatory Grief Counseling Willingness Scale and Anticipatory Grief Counseling Competency Scale were employed. This cross-sectional study followed the STROBE checklist. The nurses' average scores for willingness and competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer were 44.28±8.36 and 171.84±30.83, respectively. Multivariate linear regression revealed that interest in participating in anticipatory grief counselling for the family caregivers of patients with terminal cancer was significantly associated with the nurses' willingness to provide such counselling. Similarly, their willingness to provide such counselling was significantly associated with their counselling competency. Nurses' willingness and competency to provide anticipatory grief counselling for the family caregivers of patients with terminal cancer can be enhanced through in-service education programmes, including bedside teaching and scenario simulation. To improve nurses' competency in anticipatory grief counselling for the family caregivers of patients with terminal cancer, factors related to nurses' willingness to provide such grief counselling must be addressed. Diverse strategies of in-service education can be adopted to promote nurses' competency in anticipatory grief counselling.

The Effect of Trauma Counseling Support and Social Protection on Enhancing Social Economic Resilience in Vulnerable Communities: A Natural Experiment in Northern Uganda

The Effect of Trauma Counseling Support and Social Protection on Enhancing Social Economic Resilience in Vulnerable Communities: A Natural Experiment in Northern Uganda

Challenges encountered by mental health workers in Kigali, Rwanda


 
 
 
 
 
 
 Being a mental health worker in Rwanda is very difficult as many endure traumatic stress as a result of working with trauma survivors and other psychiatric patients. This phenomenon has been described as Secondary Traumatic Stress (STS). This study aimed to explore the mental health workers' experiences of STS when working with mental health clients in Kigali, Rwanda. Using a qualitative approach with an exploratory design, mental health workers from four mental health services in Kigali City were invited to participate in the study. A total of 30 participants were interviewed and included nurse managers, medical doctors, social workers, trauma counsellors, psychologists and psychiatric nurses. Four categories emerged from the data, namely; feelings while experiencing STS; factors contributing to STS; strategies used to cope with STS; and support systems which limit STS. Mental health workers in Rwanda could experience immediate and long-term STS responses which might affect them emotionally and physically. Although there are a few positive aspects to working with traumatised clients in Rwanda, the effects of STS impact negatively on the professional functioning and interpersonal relationships of mental health workers in that country. Mental health institutions should consider implementing protective strategies such as structured supervision and peer support groups to mitigate STS. Mental health professionals working with traumatised clients need to tend to their own self-care by examining within themselves any unresolved trauma issues of their own.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Experience of women on the Irish National Gestational Trophoblastic Disease Registry

ObjectiveGestational Trophoblastic Disease (GTD) is a rare pregnancy related disorder and the most curable of all gynaecological malignancies. GTD comprises the premalignant conditions of complete or partial hydatidiform mole known as molar pregnancy and a spectrum of malignant disorders termed gestational trophoblastic neoplasia. Clinical management and treatment in specialist centres is essential to achieve high cure rates and clinical guidelines recommend registration with a GTD centre as a minimum standard of care. National GTD registries are valuable repositories of epidemiological data and facilitate clinical audit, centralised pathology review and human chorionic gonadotropin (hCG) monitoring. This study sought the opinion of women enrolled on the Irish National GTD registry to inform future service development and establish a knowledge base for molar pregnancy in Ireland. Study designA cross-sectional survey using an anonymised questionnaire was distributed by post to all women on the GTD registry. The questionnaire was designed by a multidisciplinary team and consisted of twenty-five closed-ended questions and two open-ended questions to facilitate feedback. Data collected in the survey included information on the patient experience of registration, knowledge of molar pregnancy, diagnosis at their local hospital, hCG monitoring and overall satisfaction with the service. ResultsThe survey had a successful participation rate of 42.6% (215/504). Forty-nine percent (n = 106) of respondents rated a rapid hCG result as their top priority. Forty percent (n = 84) of women had concerns about future pregnancies but acknowledged that these were largely addressed by the GTD specialist nurses. A quarter of respondents reported that other medical professionals with whom they interacted during follow-up treatment did not understand their condition. Many women commented on the emotional stress of attending their local maternity unit for phlebotomy while dealing with pregnancy loss. ConclusionThis study is unique in being the first survey of women on the Irish National GTD registry. It highlights the specific needs of women with molar pregnancy in terms of psychological support, bereavement counselling and peer support groups. It reveals a knowledge gap in molar pregnancy amongst healthcare professionals which should be considered in future planning of medical and nursing curricula.

Predictors of prolonged grief in an internet-based grief therapy for people bereaved by suicide

Internet-based cognitive-behavioural grief therapy (ICBGT) has proven to be effective for people bereaved by suicide, however the extent to which patients can benefit from therapy seems to differ. This study investigates predictors of initial grief as well as change in grief severity following treatment in an ICBGT for people bereaved by suicide. Data was gathered from a randomized control trial including 57 people participating in a 5-week intervention. Change in grief symptoms was calculated using absolute change scores of grief. In order to examine best overall combination of independent variables, best subset regressions were conducted. Higher levels of pre-test grief were associated with worse sleep quality (β = 0.32, p = .002), lower self-esteem (β = −0.37, p = .002), lower support seeking (β = −0.38, p = .006), and a higher need for social support (β = 0.28, p = .028). A greater reduction in grief severity was associated with higher self-efficacy (β = −0.49, p = .001), higher attachment anxiety (β = −0.31, p = .017) and higher pre-test grief symptoms (β = −0.39, p = .006). Attention should be paid to the intensity of grief, the attachment style and a positive self-image, as these variables seem to influence the extent, to which patients’ symptoms of PGD subside following ICBGT. To specifically target factors of patients that require improvement, further studies are needed.

Telemental Health

Telemental Health

Are Mindfulness-Based Interventions as Effective as Cognitive Behavioral Therapy in Reducing Symptoms of Complicated Perinatal Grief? A Systematic Review.

Perinatal loss can be a devastating experience for parents that can result in complicated grief symptoms that include depression, anxiety, and posttraumatic stress. Perinatal bereavement care pathways have been developed internationally within health care services; however, there is an apparent lack of recommendations and guidance on grief-focused interventions specifically for complicated perinatal grief. Studies have analyzed the effectiveness of cognitive behavioral therapy (CBT) for perinatal grief, and more recent research has emerged on the use of mindfulness-based interventions (MBIs) for perinatal grief symptoms. The purpose of this study was to conduct a systematic review and present the effectiveness of CBT and MBIs for perinatal grief, to report patient experiences of the interventions, and to determine which intervention can be more effective in managing symptoms of complicated perinatal grief. A systematic search was conducted of 5 academic databases: PsycINFO, CINAHL, MEDLINE, Social Science, and ASSIA. No limits on publication date, language, or geographic location were set because of the paucity of research published on this subject. Quality appraisal was conducted for each included study. Findings are reported in accordance with the PRISMA statement. This systematic review identified 8 eligible studies with a total of 681 bereaved participants. The results were examined for effectiveness of CBT and MBIs for grief; effectiveness of CBT and MBIs for depression, anxiety, and posttraumatic stress; and participant experiences. Both interventions produced favorable reductions of perinatal grief symptoms, depression, and posttraumatic stress. However, a true comparison between the 2 interventions' effect on complicated perinatal grief symptoms could not be made because of the limited studies in this area and the heterogeneity of the included studies' methods and outcomes. Both MBIs and CBT interventions can be effective in reducing symptoms of complicated perinatal grief. The findings of this review are heavily weighted in quantitative outcome measurements. More qualitative research and randomized controlled trials with larger sample sizes are needed in this area of perinatal bereavement care.

Coping with Animal Companion Loss: A Thematic Analysis of Pet Bereavement Counselling.

Face-to-face 'Pet Bereavement Counselling' (PBC) has been established in private practice to support bereaved animal companion owners, however, to date no research has been conducted on PBC. This study aimed to contribute to the existing knowledge base on animal companion loss and provide a preliminary research base on the potential salience of PBC. Six qualified and accredited PBC therapists were recruited and took part in semi-structured interviews. An inductive thematic analysis revealed participants' perspectives on the acknowledgement of animal companion loss societally and within counselling professions, the diverse ways animal companion loss can impact on bereaved owners, as well as the distinctive attributes and delivery of PBC. The findings have implications for how animal companion loss is conceptualised within counselling professions, teaching and research. Future research recommendations include exploring how bereaved owners experience PBC and how mental health professionals can build upon the support provided to bereaved owners.

Disorganized attachment and prolonged grief.

While the relationship between attachment anxiety and avoidance and the severity of prolonged grief disorder (PGD) has been well-studied, less is known about the relationship between disorganized attachment and PGD. We test the associations between disorganized attachment and the interaction between it and attachment avoidance and anxiety on PGD. Participants (N = 258) who had lost a family member from 0.5 to 8.0 years before the survey completed the experiences in close relationships-revised, the adult disorganized attachment scale, and the PGD-13 scale. The model explaining PGD symptoms through attachment, taking into account the level of disorganized attachment, explained variance in PGD significantly better than the model taking into account only the level of attachment anxiety and avoidance as predictors. Additionally, the relationships between attachment avoidance and PGD were positive, negative, or neither, depending on the configuration of the levels of disorganized attachment and attachment anxiety. Future research into the relationships between attachment and PGD should take into account disorganized attachment. Attachment-informed grief therapy focused on insecure styles of attachment - including the disorganized style - to the deceased person and other loved ones may prove a promising approach for bereaved persons who experience PGD.

Trauma Exposure and Prolonged Grief Disorder Among Persons Receiving Community Mental Health Services: Rates and Correlates.

BackgroundPersons with serious mental illnesses (SMIs) are at increased risk for exposure to trauma and posttraumatic stress disorder (PTSD). Prolonged Grief Disorder (PGD) may also impact this population but has been seldom studied.AimsThe present study investigated the rate of both PTSD and PGD among clients receiving community mental health services, and the clinical correlates of co-occurring PTSD/PGD.MethodsTrauma history, PTSD and PGD were assessed among 536 individuals receiving community mental health services (Study 1). A subsample of 127 individuals from Study 1 who met DSM-5 criteria for PTSD based on diagnostic interview completed measures of psychiatric symptoms (Study 2).ResultsIn Study 1, 92.4% of participants receiving community mental health services had experienced a traumatic event, 49.6% met criteria for probable and provisional PTSD, 14.7% scored positive for probable PGD, and 11.9% met criteria for probable and provisional PTSD as well as probable PGD. In Study 2, participants meeting diagnostic DSM-5 criteria for PTSD and probable PGD had more self-reported PTSD symptoms, but did not differ on other outcomes.ConclusionsFindings highlight the need for trauma informed services including grief counseling for persons with SMI.

Lost Opportunities for Cornea Retrieval: A Cross-sectional Study from District Hospital, Tumakuru, Karnataka

Introduction: Corneal blindness in developing countries mainly affects the younger population. About 95% of corneal blindness can be avoided. The economic burden to society is much higher with corneal blindness compared to cataracts. Corneal transplant (Keratoplasty) is the primary vision restoring procedure to rehabilitate patients with corneal blindness. The procedure requires viable corneal tissue. The corneal tissues are procured either by voluntary eye donations or through the Hospital Cornea Retrieval Programme (HCRP). The objective of HCRP is to encourage potential eye donations from hospital deaths by utilising a combined method of motivation and grief counselling. Aim: To find the possibility of cornea retrieval in the district hospital of Tumakuru, Karnataka. Materials and Methods: This cross-sectional study analysed the number of hospital deaths at district hospital, Tumakuru, Karnataka, India, between January 2016 and December 2016. The study was conducted at the same hospital from May 2017 to July 2017. Patient demographics, systemic illnesses, treatment received, and cause of death were obtained from the 757 medical records. Analysis was done for potential corneal donors as per the National Programme for Control of Blindness (NPCB) guidelines. Results: The total number of deaths was 679, which included 375 (55.23%) males and 304 (44.77%) females with maximum death in age group 71-80 years. Of the total deaths, those between 3 and 40 years of age were 196 (28.86%). After excluding the contraindications of cornea retrieval as per NPCB guidelines, 1016 corneas could have been retrieved out of 508 (74.8%) deceased. Conclusion: Hospital cornea retrieval programme can immensely contribute to fill the deficiency of donor corneal tissue. The present study concluded that upto 74.8% of corneas could have been potentially retrieved and indicates a vast potential to reduce the deficit of corneal tissues.

Sobreviventes enlutados por suicídio e as possibilidades para posvenção no contexto da saúde pública brasileira

Abstract Death by suicide leaves many people negatively affected in its wake. Many so-called bereaved survivors will at some point need care and support, known as suicide postvention. This theoretical essay, based on the corresponding literature, institutional documents, and legal frameworks, seeks to discuss possibilities for suicide postvention within Brazilian public health. Suicide postvention is better structured internationally than in Brazil, which currently focuses on support groups for bereaved survivors centered in non-governmental organizations. We must look to territorial and community-based health services, like the Psychosocial Care Centers, and envisage affordable and resolute postvention actions, such as free prevention lines, early home visits, therapeutic listening and grief counseling.

EVALUATION OF PSYCHOSOCIAL STATUS OF HEALTH CARE WORKERS DURING COVID 19 PANDEMIC

Background- Our study aimed to obtain that information in the domain of anxiety and depression among health care workers of India. Methods- It was a cross-sectional, web-based study, conducted to evaluate the effect of quarantine on stress, anxiety, and reaction of a family toward the person. The online survey questionnaire was circulated using e-mail, WhatsApp, text message, etc. Results- A total of 120 responses were recieved. The mean age of the study population was 27.2 (SD: 5.1) years and majority were male (57%). Nearly half (45%) of the participants had depression and almost all patients had anxiety [Table 1]. Conclusion- Supportive psychotherapy, psychoeducation mindfulness techniques, grief counselling, activity scheduling, and sleep hygiene are some of the ways that can ensure the mental sanity of the healthcare workers during this time. The existing health-care system should be boosted in the coming times to push forward the psychological care of everyone for a better future

Mobilizing digital technology to implement a population-based psychological support response during the COVID-19 pandemic in Lima, Peru.

The COVID-19 pandemic caused considerable burden on mental health worldwide. To address this emergency in Peru, Socios en Salud (SES) implemented an innovative digital system for the diagnosis and psychological therapy in vulnerable populations. We describe the development, implementation, and participant outcomes of this intervention. We conducted an intervention in a general population of Lima, Peru using a digital tool, ChatBot-Juntos, incorporating the abbreviated Self-Reporting Questionnaire (SRQ) to screen psychological distress. Participants positive for psychological distress received remote Psychological First Aid (PFA) and grief therapy if needed. Participants with a mental health condition or safety concern were referred to mental health services. SRQ scores were collected 3 months after PFA sessions. Differences between screening and follow-up scores were compared using Wilcoxon sign-rank test. In total, 2027 people were screened; 1581 (77.9%) screened positive for psychological distress. Nine hundred ninety-seven (63%) people with psychological distress received PFA, and 320 (32.1%) of those were also referred for mental health care. At 3 months after follow-up, SRQ scores were collected for 579 (58%) participants. Significant reduction in SRQ scores was observed 3 months after PFA [median SRQ score changed from 9 to 5 (p < 0.001)], and after PFA plus referral to mental health services [median SRQ score changed from 11 to 6 (p < 0.001)]. Digital technology can be used to screen for psychological distress and deliver mental health support for populations affected by the COVID-19 pandemic. More research is needed to determine whether technology contributes to improved mental health outcomes.

Emberi bánásmód veszteségek idején

Abstract. Humane Treatment of People Who Experience Losses. In this paper, we present the grief as a natural response to the losses that people experience. We regard grief as an adaptive mechanism to the new situation that occurs with a loss. In our success-oriented consumerist society, grief has become a taboo: fighting pain in losses became a sign of weakness and failure. This is valid also for Christians, who consider faith as the measure of successful dealing with distress. We present the positive perceptive structures that may help the grief – based on Anil Seth’s theories. Later on, we speak about the toxic positivism, which harms the grieving person and the adequate expression of condolence, which may express our participation in his/her tormented situation. Destructive attitude consists in shaming, abandoning, or betraying the grieving person, whereas constructive attitude means acceptance, condolence, and support. This paper tries to provide a practical guideline to an empathic grief counselling. Keywords: grief, loss, mourning, toxic positivism, positive perceptive structures

Effectiveness and Feasibility of Internet-Based Interventions for Grief After Bereavement: Systematic Review and Meta-analysis.

BackgroundAlthough grief and its symptoms constitute a normal reaction to experiences of loss, some of those affected still report elevated levels of distress after an extended period, often termed complicated grief. Beneficial treatment effects of face-to-face therapies, for example, grief counseling or cognitive behavioral therapy against complicated grief, have been reported. Evaluations of internet- and mobile-based interventions targeting symptoms of grief in bereaved individuals with regard to objective quality criteria are currently lacking.ObjectiveWe aim to conduct a systematic review and meta-analysis on the effectiveness and feasibility of internet- and mobile-based interventions against symptoms of grief after bereavement.MethodsWe conducted systematic literature searches of randomized controlled trials or feasibility studies published before January 9, 2020, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, in PubMed, PsycINFO, Web of Science Core Collection, and the Cochrane Library. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations system. We further assessed aspects of feasibility and rated quality of interventions using criteria suggested by an expert panel on mental health care (German Association for Psychiatry, Psychotherapy, and Psychosomatics). A random-effects meta-analysis was conducted to assess between-group effect sizes.ResultsIn total, 9 trials (N=1349) were included. Of these, 7 studies were analyzed meta-analytically. Significant effects were found for symptoms of grief (g=0.54, 95% CI 0.32-0.77), depression (g=0.44, 95% CI 0.20-0.68), and posttraumatic stress (g=0.82, 95% CI 0.63-1.01). Heterogeneity was moderate for grief and depression (I2=48.75% and 55.19%, respectively) and low for posttraumatic stress symptoms (I2=0%). The overall quality of evidence was graded low (grief and depression) to moderate (posttraumatic stress). User satisfaction with the interventions was high, as was the quality of the interventions assessed using objective quality criteria.ConclusionsInternet- or mobile-based interventions might constitute an effective treatment approach against symptoms of grief in bereaved adults. However, the small sample sizes and limited number of studies included in the review warrant further investigation.Trial RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42012002100; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131428

Long-term care placement: The transitional support needs and preferences of spousal dementia caregivers.

Many spousal caregivers experience stress, depression, loneliness, guilt and grief when placing a partner with dementia into long-term care. However, there is little research about their transitional support experiences, needs and preferences. This study aimed to gain a deeper understanding of these issues from spousal caregiver and long-term care facility staff perspectives, to inform subsequent support and intervention development. Semi-structured interviews and small group discussions were held separately with spousal caregivers (n = 9) and care facility staff (n = 11). Criterion and variation sampling aimed to ensure a range of experiences and perspectives. The 'Framework' approach was utilised for data analysis. Interpretation was with respect to underpinning models of stress-grief process in dementia caregiving. A range of informational, psychoeducational and psychosocial supports were identified to help spousal caregivers cope better with the stressors and losses experienced throughout the transition from home to long-term care. Improved education about disease progression, information relating to long-term care provision, peer support and dementia-specific grief counselling were deemed important. Opportunities for better support within care facilities were also identified. Support should be tailored to individual needs and preferences. The findings suggest a supportive care framework be developed, encompassing the trajectory from assessment for and admission into long-term care to end-of-life and post-bereavement support. Spousal caregivers should have their support needs assessed by trained health or social care professionals and be offered a range of support options as appropriate.

Crafting order and beauty from loss: using found poems as a form of grief therapy

ABSTRACT The death of a loved one can create a tear in the fabric of meaning. Grieving involves remaking meaning. In therapy, events can be emplotted into stories, which can return some sense of coherence to the bereaved. In this paper, I present a way of narrating loss through a narrative therapy approach of retelling. This involved writing found poems, known as rescued speech poems, from the conversations of people who had lost a loved partner. The found poetry sought to bring an order to grieving and to polish the beauty of key moments following loss. For one participant, the found poetry amplified a narrative of the biography of the loved one. For another, the poems added beauty to a memory of her deceased partner. Thus, rescued speech poems—judiciously selected from speech, and sensitively arranged on the page—can provide another way to facilitate vibrant meaning-making of life after loss.

Assimilation in bereavement: charting the process of grief recovery in the case of Sophie

ABSTRACT This theory-building case study examined an application of the Assimilation of Grief Experiences Scale (AGES), a conceptual account of a bereaved person’s process of change in grief recovery, in a case study of a 40-year old woman in bereavement counselling. An assessment session and 44 counselling sessions were analysed intensively, comparing the description provided by the AGES with the details of the case. Results showed how the AGES tracked and described details of Sophie’s recovery.

Surviving the suicide of a loved one: impact and postvention.

Literature review of peer reviewed literature (PubMed, PsycINFO), books about bereavement, suicide, postvention and postvention guidelines. Suicide loss survivors may have an increased risk of developing psychiatric disorders such as post-traumatic stress disorder, depressive disorders, anxiety, and substance abuse; an increased risk of suicide; increased physical complaints; and an increased risk of developing Persistent Complex Bereavement. About postvention, two measures turn out to be very important. An immediate first on-the-spot intervention that includes: specific training for general practitioner and police; to direct survivors to support services; provide proactive and practical support; psychological autopsy. The second intervention is a long-term one and can be delivered in a variety of ways: the most effective therapy for survivors appears to be Complicated Grief Therapy, but in general the therapist must be adequately trained for individual psychotherapy with survivors. Other effective interventions include: writing projects; group psychotherapy; support groups. A public health approach to postvention can allow to tailor interventions to the needs of survivors, and to align postvention with suicide prevention programs.