Grieving Process Research Articles

Loss of a Parent in Disney and Pixar Films: What We Can Learn?

Early parental loss is a tragic experience for children causing complex reactions to the loss. Providing a supportive environment where they can express their feelings is crucial to help them cope with this challenging experience. This study analyses the depiction of parental death in animated films by Disney and Pixar using a multimethod design and including the QUAGOL approach. We identified 13 films showing the death of one or both parents. The qualitative analysis of the films, published from 1937 until 2022, revealed seven concepts that potentially affect the way children see their grieving process reflected in the films: The representational techniques, finding protection and relationships, searching for identity, being different and having alternative skills, talking about death, dealing with emotions and coping with the loss. The identified films can be used to open a conversation with children who have lost one or both parents to discuss their situation.

Our grief matters – loss, grief, and mourning in Black vertically infected HIV-positive adolescents

Within the South African context, psychoanalysis as praxis and research has not located itself outside of the country’s long, violent, and oppressive socio-political past. A major area in which psychoanalysis continues to demonstrate a deficit is in its lack of attention to race as constitutive of psychological development and a site of intense psychological pain. A further area that is often overlooked in both the theory and praxis of psychoanalysis in South Africa is the diseased body as a site of socio-political violence and oppression, and the subsequent impact of this trauma on intrapsychic development. This situation is particularly applicable in the development of Black children who are vertically infected with HIV. The focus of this article, the fourth in a series of five articles, is on the process of grief and mourning in three vertically infected HIV-positive adolescents. Findings indicate that children who are vertically infected with HIV suffer multiple losses leaving them with intense unprocessed grief despite having access to individual therapy. In addition, their raced subjectivities add to experiences of non-being leading to grief which remains minimised and overlooked within the psychoanalytic canon, keeping the mourning process hidden in historically oppressive systems as melancholia.

Perceived Dying Experience and Compassion in Oncology Patients and Nurses Following Implementation of the Forever Heart Program: A Pilot Study.

This pilot study explored the feasibility of a Forever Heart Program and the impact it has on oncology nurses' perception of the dying experience and their own compassion competence. Guided by Kubler-Ross's framework, the Forever Heart Program consists of a gemstone keepsake offered to patients and families during end-of-life care to support the grieving process. A mixed-methods approach utilized pretest/posttest design in a convenience sample of oncology nurses in an academic medical center over a 3-month period. The study collected demographics, Compassion Competence Scale scores, and qualitative responses via survey and an optional focus group. Twenty-five nurses participated in the presurvey, and 14 participated in the postsurvey. Seven nurses attended the focus groups. Overall, compassion competence scores were high, both pre and post. Qualitative themes included appreciation, connection, positive nursing, patient and family experience/relationships, grieving guidance, program benefits, and process opportunities. Although the study did not show statistically significant differences in compassion, it did show program feasibility and the potential positive impact that keepsakes like the Forever Heart Program can have on nurses and their role in the dying experience.

Translation and cross-cultural adaptation of the Posthumous Dignity Therapy Schedule of Questions to Brazilian Portuguese.

Dignity Therapy (DT) is a brief form of psychotherapy that helps people with life-threatening illnesses and their loved ones cope with emotional pain and demoralization. Unfortunately, not everyone has the opportunity to receive DT during their lifetime. Posthumous Dignity Therapy (PDT) was then devised to be administered to bereaved family members. However, PDT has not yet been validated or studied in the specific cultural and linguistic context of Portuguese-Brazilians. This study aims to fill this gap by validating PDT for the Portuguese (Brazilian) context. Using Beaton's methodology, including the processes of translation, synthesis, back-translation, evaluation by an expert committee, and pre-testing, the PDT Schedule of Questions underwent validation and cultural adaptation. The research was conducted in a Palliative Care Unit at a tertiary cancer hospital in Brazil. The questionnaire was translated, back-translated, and evaluated by the panel of experts, obtaining a Content Validity Index of 0.97. During the pretest phase, it was observed that the participant's interview method needed to be changed from remote (telephone or videoconference) to in-person. Additionally, it was necessary to modify some terms related to death and dying, as they caused discomfort to the participants. As a result of this process, the PDT was modified, and adapted to the Brazilian cultural and linguistic reality. This validation study will be significant for future DT research from the caregivers' perspective and for projects aiming to implement this therapeutic modality in palliative care units, in addition to helping participants remember their loved ones better by providing a tangible legacy document that assists them emotionally and materially in coping with the grieving process.

Personal Pilgrimage Aids in Processing of Traumatic Grief in Survivors of Parent Suicide

A twenty-six-year-old female suffers traumatic loss after her father’s suicide. Client has endured approximately four months of complicated grief to date. She experiences, among other things, preoccupation with the end story, intense sorrow, sleeplessness, and appetite issues. Embarking on a series of 45-minute weekly sessions just two weeks prior, Client and I have thus far addressed her grief through re-membering exercises and an experiential therapy tactic called the Personal Pilgrimage.

Grief, the Creative Process, and Making a Poem

The process of coping with grief through creative expression is explored in a poem dedicated to a late friend, David. By engaging with poetry, both as a creator and a reader, the grieving process is facilitated, promoting a sense of closure and acceptance. This poster examines how, through vivid imagery and introspective reflections, the poet navigates through themes of silence, nature, and memory, culminating in a heartfelt tribute to the departed friend. Ultimately, the creative process becomes a pathway towards understanding and processing the complexities of grief, allowing for a sense of closure and healing. From the UB RISE 2023 forum.

"Grief Explodes all Relationships": Experiences of Grief and Coping Among Parents and Siblings Following the Death of a Child.

The death of a child is an intense loss for families, which impacts the wellbeing of parents, surviving siblings, and the family as a whole. This study expanded on existing literature by collecting qualitative accounts from bereaved parents and siblings about their experiences before, during, and after the death of a child in their family. In total, 15 participants from 9 families completed semi-structured interviews. Findings highlighted three periods of the grieving process, which were not linear but rather ongoing and often happening simultaneously: (1) Crisis; (2) Learning to cope; and (3) Establishment of a new equilibrium. Parents and siblings reported experiences unique to their role in the family and developmental stage, as well as shared experiences within the family system. Findings have implications for palliative care and bereavement professionals in terms of supporting parent, sibling, and family coping before, during, and after the death of a child.

Is COVID-19 loss more associated with prolonged grief disorder than other losses?

The COVID-19 pandemic raised fears about a rise in prolonged grief rates. To determine if these fears are justified, we examined an online sample of 329 Turkish adults for their level of prolonged grief symptoms (as well as probable Prolonged Grief Disorder-PGD) and associated factors in relation to losses during the pandemic. Respondents completed measures of prolonged grief, post-traumatic stress disorder, and depression. Overall, 10% of participants reported symptoms indicating a probable PGD diagnosis. Surprisingly, loss due to COVID-19 or disruption of the natural mourning process did not relate to higher levels of prolonged grief. Our findings suggest that although levels of prolonged grief (and rates of PGD) may have increased during the pandemic, prolonged grief (or PGD) during this time is likely not linked to losses due to COVID-19 or to disruptions in the normal grieving process.

Nursing Interventions in Primary Care for the Management of Maladaptive Grief: A Scoping Review.

Grief is a natural and self-limited adaptation process to a new reality that emerges after a significant loss (whether real or perceived), with a broad variety of manifestations that exert an impact on a grieving person's health. The study aim was to synthesize the evidence available about the interventions carried out by Primary Health Care nurses, by means of an individual approach to reduce maladaptive grief or maladaptive grief risk. A scoping review was conducted (November and December 2023) through searches in Medline, Cinahl, Web of Science, ProQuest and Scopus using MeSH terms combined with Booleans. Primary research of any design in adult people undergoing grief situations and receiving professional assistance by nurses in the primary, home and community care contexts published after 2009 in English, Spanish or Portuguese languages were included. Excluded publications were those conducted in in-hospital clinical settings and which did not correspond to research designs or the gray literature. The screening process was carried out by two reviewers using the appropriate JBI critical appraisal tools for each design and discrepancies were resolved by a third reviewer. A total of n = 10 studies were included (n = 4 qualitative, n = 2 RCTs, n = 1 quasi-experimental, n = 2 cross-sectional observational, and n = 2 mixed methods). The qualitative studies identified topics and subtopics of professionals' and families' experiences of grief. The observational studies analyzed symptoms and factors associated with the grieving process. Interventions consisted of cognitive-behavioral therapies delivered by psychological specialists who assessed the severity of grief in a range of cultural contexts using different instruments. The evidence retrieved from the studies that address the reduction in maladaptive grief or maladaptive grief risk is not conclusive. There is a need to increase both the number and the methodological quality of studies assessing the effectiveness of Nursing care in Primary Health Care for individuals experiencing maladaptive grief or maladaptive grief risk. Further research should focus on experimental studies, developing specific interventions conducted by nurses to address individual's grief and prevent maladaptive grief.

Meaning-making in psychotherapy after traumatic loss: therapists’ perspectives

ABSTRACT Sudden, unexpected loss can be particularly devastating for the bereaved as they struggle to make sense of their loss. We interviewed 11 therapists who specialized in loss/trauma about how each of them helped one client make meaning after a traumatic loss. Data, analyzed using Consensual Qualitative Research (CQR), revealed that the traumatic loss had negatively impacted clients’ relationships, mental health, and beliefs/religion/spirituality; therapists utilized a range of interventions to facilitate meaning-making, including supporting clients through the grief process, as well as helping them experience/regulate emotion and change their narratives around the loss; clients made meaning in diverse ways that could be broadly categorized under meaning-as-comprehensibility and meaning-as-significance; and clients experienced positive adjustment (in mental health, relationships, etc.) through the meaning-making work. Implications for counseling psychology research and practice are discussed.

Prolonged Grief, Posttraumatic Stress and Depression Symptoms Before and After COVID-19 in Brazil.

This study aims to explore the differences in prolonged grief (PDG), posttraumatic stress (PTSD), and depression symptoms (MDD) following the loss of a loved one before and after the COVID-19 pandemic. Using a cross-sectional design, 888 bereaved individuals were classified on different groups according to the cause of death. Results indicate that participants who experienced a loss during the pandemic, regardless of the cause, presented higher levels of prolonged grief, posttraumatic stress and depression when compared to those who lost a loved one before the pandemic. This study sheds light on the environmental influences (ex: the COVID-19 pandemic) on the grieving process, emphasizing the need to take the context into account when tailoring interventions in bereavement and mental health care.

Psychological Healing process of Grief Resolution: Nepali (Hindu) Cultural Perspective

Grief is a natural reaction to the loss; mainly due to the death of a loved one. Sometimes, such reactions may be problematic or complicated. Culture serves as a buffer to deal with such losses, and supports the mature way of coping. Nepali cultural practices or the death rituals favor the restoration-oriented grieving process and are prophylactic approach in order to prevent any form of grief-related psychological reactions. This paper provides a narrative approach in which the writer shares his experiences as a Psychiatrist in dealing with grief-related problems of the clients in his own clinical practice. In addition, he also shares his own personal experience of losing his father and illustrates how the traditional practices followed by himself and his family during that time facilitated the grief-resolution process. He is very much convinced that the Nepali cultural approach during death rituals is very much scientific and psychotherapeutic.

Losing a child with a severe developmental intellectual disability: Israeli mothers' accounts.

Caring for a child with a severe developmental intellectual disability is often extremely challenging. Consequently, if such a child passes away, the grieving process may be complex. In the present study, we sought to characterize Israeli mothers' meaning (re)construction in the face of such loss. Eight mothers who lost a child with severe developmental intellectual disability participated in in-depth semistructured interviews. Employing Interpretative Phenomenological Analysis, three primary meaning templates were identified from their narratives: regrieving the lost child, the duality of grief and relief, and continuous disenfranchisement. The findings revealed a distinctive rupture in the self-narratives of grieving mothers and depicted the intricately intertwined reality of living with and losing a severely disabled child. The interplay between personal and social aspects of this unique grief experience is highlighted, and practical implications are considered. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Excruciating existential suffering and complicated grief: The essence of surviving the suicide of a son or daughter.

Suicide is the fourth most common cause of death for the 15-29 age group. Research on the impact of suicide on parents is scarce and, therefore, poorly understood. To explore parents' experiences who have lost a son or a daughter due to suicide and their experience of the services available to them. This phenomenological study involved 1-2 interviews with ten parents aged 40-65, seven mothers and three fathers in all 13 interviews. The age range of their sons and daughters was 17-37 years when they died. For the parents, losing a son or a daughter to suicide is an overwhelming life experience characterised by Excruciating existential suffering and complicated grief where they are confronted with deep meaning-making and existential questions without answers since the person who can answer most of them is no longer alive. They, therefore, felt stuck in their grief for up to 4 years. The initial experience was an immense paralysing shock and sense of unreality. The subsequent period was a blur, and they were numb. Then, their psyche and bodies collapsed, and for a long time, they felt no grief processing was taking place. They sorely needed long-term professional trauma-informed support and felt that, in too many cases, they had to reach out for help themselves. They would have liked to see the healthcare system embrace them with more open arms, offer help and be met with information and individualised support. Standard operating procedures must be installed to support suicide-bereaved parents better. Long-term professional support and trauma-focused care are required following such major trauma, and providing such support could help to reduce their adverse health impacts. Nurses and other health professionals must be better educated on existential suffering in this context.

The Reciprocal Relationship Between Social Support in Bereavement and Posttraumatic Growth-A Random Intercept Cross-Lagged Analysis.

Social support can promote posttraumatic growth (PTG) in the general trauma population. However, evidence on the reciprocal predictive relationship between social support and PTG is lacking, particularly among the bereaved. In this longitudinal study, we surveyed 181 adults who had lost first-degree relatives within 1 year at three intervals, each 6 months apart. The study utilized The Scale of Social Support in Bereavement (SSB), which distinguishes four domains of social support for the bereaved: living support, economic support, grief processing and emotion restoration. Additionally, The Posttraumatic Growth Inventory (PTGI) was used to measure PTG. Random intercepts cross-lagged panel model analyses revealed that social support and PTG were positively correlated at each time point at the within-person level. Moreover, at the within-person level, the total social support, as well as social support in the restoration-oriented domains at Time 2, positively predicted PTG at Time 3, but this relationship was not observed for grief processing support. Additionally, PTG at Time 1 positively predicted the receipt of emotion restoration support at Time 2 at the within-person level. The mutual influence between PTG and social support, as well as the differential relationship between types of support and PTG, enriches our understanding of ways to promote positive changes among the bereaved. The findings underscore the importance of restoration-oriented social support for bereaved individuals in facilitating PTG.

Experiences and needs of Chinese women after a stillbirth: a qualitative phenomenological study

ObjectivesWe aimed to explore the lived experiences and needs of women after a recent stillbirth event.DesignQualitative phenomenological study.SettingThe current study was conducted in a tertiary obstetric hospital in East China...

Parental Grief After the Unexpected Death of a Child: A Scoping Review About the Impact on Parent's Social Networks and the Function of Self-Help Groups.

The unexpected death of a child, whether due to accident, sudden death syndrome, suicide, or homicide, causes profound parental grief that endures for years. Often, this grief is not fully understood by the social environment, leading parents to feel increasingly misunderstood and isolated. While initial support may be provided, it can become insufficient over time. Therefore, many parents turn to support groups, finding multiple benefits such as validation of their feelings, a safe space to discuss their children and express emotions, strengthening of their social identity, and a platform for reconstructing meaning in their lives. A scoping review was carried on to review the state of knowledge regarding the role that self-help groups can play in case of bereavement due to the unexpected death of a child and regarding the impact on social relationships referred to in these contexts. The search was conducted on 11 databases and grey literature and provided 22 final results. Reviewed studies confirm the impact of this loss, particularly on mothers, and suggest that self-help groups contribute to a more favorable development of the grieving process. Despite the scarcity of research, future studies could leverage newer theoretical models and measurement tools to confirm protective, predictive, and risk factors.

Men's Experiences With Perinatal Loss: An Integrative Review.

Introduction: Perinatal loss is a tremendous loss for many and can have consequences that affect physical and mental health. This topic has been substantially examined among women; however, men's experiences with perinatal loss have lacked attention. Many men report significant grief, self-blame, stigma, loss of self-identity, lack of recognition of their loss, marginalization, and gendered expectations that negate their grieving process. This places men at risk for complicated or disenfranchised grief. Most studies examining perinatal loss have been conducted in countries outside of the United States and outside of the discipline of nursing. As nurses are concerned about holistic care of men and women, the findings resulting from studies with women and other cultural perspectives may not be generalizable to men in the United States. Purpose: The purpose of this integrative review was to examine the current state of science regarding men's experiences with perinatal loss, what is known about this loss within the nursing discipline, to identify gaps in nursing knowledge, and to expose areas for further research. Method: Online databases including CINAHL, PubMed, and Scopus were used to perform the initial search. The search terms included "men," "perinatal loss," "miscarriage," "stillbirth," and "grief." Results: Themes were identified through a review of the literature that included that men experienced a loss of the role of fatherhood and identity. Additionally, men reported expectations about socially and gender-specific behavior that influenced their expressions of grief and their coping process. Finally, the lack of recognition of their loss as fathers in perinatal loss resulted in the marginalization and the use of avoidance and distraction to cope with the loss, as well as risks to the health of the partnered relationship.

The Effect of Psychotherapy Interventions After Stillbirth on the Grief Process and Depression: Systematic Review and Meta-Analysis.

This study aimed to provide a systematic overview of existing quantitative research on the effects of psychotherapy interventions given to women with stillbirth on the grief process and depression in the postpartum period and to analyze the results. Four databases (PubMed (MEDLINE), Cochrane, Google Scholar, Web of Science) were searched between January-March 2024. Risk of bias and precision of evidence were assessed with the Cochrane risk of bias tool ROB-2 and ROBIN-1. Ten studies were included. Meta-analysis results showed that psychotherapeutic interventions significantly reduced the grief adaptations of mothers in the mourning process and there was a significant difference in the assessment of grief adaptation. Sub-group analyzes revealed mothers' depression values and stress levels compared to the control groups and there was a significant difference between the groups. Psychotherapeutic interventions given to women positively affect their grief adaptation and reduce stress, anxiety, and depression.PROSPERO ID: CRD42024516195.

Grief and Loss: Supporting Foster Carer Families Through Placement Terminations

ABSTRACT The importance of acknowledging the grief and loss integral to the experiences of foster carers, has long been understood. However, in a complex area of practice and an increasingly pressured out-of-home care sector, there is a need to refocus foster care program and practitioner attention on supporting carers and their families with the difficult experience of placements ending. This article reports on findings from research that aimed to understand current carer experiences of grief and loss, their coping strategies, their support needs, and the implications for a foster care agency’s duty of care towards its workforce. Through a mixed-methods exploratory methodology, data were collected through an online survey and semistructured interviews with carers affiliated with a foster carer provider operating across three Australian jurisdictions. Carers called for acknowledgement of the deep feelings they develop for the children they look after and help for the grieving process, through training, preparation, and tailored support based on authentic relationships with professionals. The need for well-trained and strongly supported agency workers was emphasised. IMPLICATIONS Providing updates to carers about foster children who have left their care can alleviate the pain of grief and loss. Training, preparation, and step-by-step support for carers can promote healthy grieving processes. Tailored support for grieving carers needs to be founded on authentic relationships with foster care professionals and open and honest communication.