Professional Bereavement Research Articles

Professional Bereavement in Nursing: An Evolutionary Concept Analysis.

Clarify and define the concept of professional bereavement in nursing. Rodgers' evolutionary method was used to identify the attributes, antecedents, and consequences of professional bereavement in nursing. Literature from inception to May 20, 2024, was searched from PubMed, Embase, Web of Science, CINAHL, PsycINFO, Scopus, Medline, EBSCO host, Proquest, Ovid, and Cochrane. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were adopted. The 32 articles included in the study provided data on the concept of professional bereavement in nursing. We propose the concept of professional bereavement in nursing as follows: Professional bereavement in nursing is the experience of a patient or colleague's death in the workplace, influenced by contextual, internal, and external factors. Nurses perceive personal and professional losses, exhibit a multidimensional liminal state, and experience personal impacts (life and worldview) and professional impacts (health-related productivity and professional ability). We developed a preliminary conceptual model of professional bereavement in nursing based on its attributes, antecedents, and consequences. This conceptual model promotes the development of theories related to professional bereavement. This is the first article to clarify and define professional bereavement in nursing. We have clarified the antecedents, attributes, and consequences of professional bereavement, which provides a conceptual framework for understanding professional bereavement. The conceptual framework guides the content of interventions and suggests future professional bereavement interventions from a dialectical perspective. Not applicable.

Changes Due to Patient Deaths: Medical Students’ Expectations vs. Health Professionals’ Experiences

ContextPreparing healthcare professionals for inevitable encounters with patient deaths is crucial to preventing maladaptive professional bereavement outcomes. ObjectivesThis study aimed to explore the discrepancies between medical students’ pre-patient death expectations and healthcare professionals’ post-patient death experiences regarding accumulated global changes due to patient deaths (AGC), identify heterogeneous expectation patterns among students, and reveal risk factors for worthy-of-concern expectation patterns. MethodsCross-sectional survey data from 231 professional caregivers and 405 medical and nursing students were used. Independent t tests and analyses of covariance were run for staff-student AGC comparisons. Latent profile analysis (LPA) among students was followed by logistic regression. ResultsThe students scored higher than did the staff in two AGC factors: more acceptance of limitations and more death-related anxiety. LPA identified four latent expectation patterns, with the “overoptimistic” (27.8%) group being worthy of concern, as students overestimated positive changes and underestimated negative changes. The overoptimistic pattern was predicted by students' motivations to study medicine, which were driven by “interests,” “career opportunities,” and “improving medical services in the hometown,” rather than “by chance,” and higher scores on the death attitude of "neutral acceptance." ConclusionIn general, students tend to overestimate the long-term impacts of patient deaths. However, approximately 1/4 of students hold overly optimistic expectations, which are predicted by motivations to study medicine and death attitudes.

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

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

Bereavement Counsellors' Experiences Supporting the Families of Deceased Children Within a German Bereavement Network- A Qualitative Interview Study.

Background: The "Bereavement Network Lower Saxony" (BNLS) provides professional bereavement support to families grieving for a child. The present study aimed at exploring the experiences of BNLS bereavement counsellors in providing bereavement support to affected families. Methods: 12 semi-structured qualitative interviews were conducted with bereavement counsellors of the BNLS between June and August 2022. Interviews were recorded, transcribed and analysed using qualitative content analysis, according to Mayring (2010). Results: Bereavement counsellors perceived that grief could be experienced very differently, and thus bereavement support must always be based on the individual needs and resources of bereaved family members. Bereavement counsellors appreciated exchange within the network and supervision to cope with emotional load that arises from compassion for those affected. Conclusions: Bereavement support within a network structure may improve the accessibility of individual support and enable exchange between counsellors, thus ensuring better bereavement support. Public outreach and strategic partnerships with clinics may amplify the positive impact of this support service.

Subjective rather than objective patient death experiences link with physicians’ and nurses’ professional quality of life

BackgroundPatient deaths are impactful events for professional caregivers in both their professional and personal lives. The present study aims to explore how both subjective and objective patient death experiences are related to various aspects of professional quality of life (ProQOL) among physicians and nurses.MethodsSecondary analyses of cross-sectional data were conducted, and 306 Chinese physicians and nurses whose most recent patient death experience was more than one month prior were included. Objective and subjective patient death experiences were measured based on the number of past patient deaths and the Accumulated Global Changes (AGC) subscale of the Professional Bereavement Scale, respectively. ProQOL was measured with the Professional Quality of Life Scale. Regressions were run following bivariate analyses.ResultsThe number of past patient deaths was not significantly linked with any of the three ProQOL scores in either the bivariate analyses or regressions. Meanwhile, higher AGC scores were associated with higher burnout, secondary traumatic stress, and compassion satisfaction scores after participants’ age, occupation (physician/nurse), department, work experience, job commitment, and sense of mission were controlled.ConclusionSubjective rather than objective past patient death experiences link significantly with all three aspects of physicians’ and nurses’ ProQOL. The more professional caregivers think that they have been changed by all past patient deaths in their career, the more they experience burnout and secondary traumatic stress, but, the more satisfied they are with their job and the helping itself.

Short-term professional bereavement reactions and their links with the meaning of patient death: Evidence from network analyses.

Taking a dimensional view, this study aims to understand, among professional caregivers after patient deaths, the symptom distribution and development of the short-term bereavement reaction (SBR) network and the node-level links between the meaning of patient death (MPD) and the SBR network. A cross-sectional secondary analysis was conducted with existing data from 220 Chinese urban hospital nurses and physicians who experienced the most recent patient death within a month. MPD was measured by the 10 formative items of the meaning of patient death model, and SBR was measured by the Short-term Bereavement Reactions Subscale of the Professional Bereavement Scale. Both Gaussian graphical network analysis and Bayesian network analysis were applied to the SBR network, and Gaussian graphical network analysis was used to estimate the MPD-SBR network. Frustrated and guilty are central nodes in the regularized partial correlation SBR network. Meanwhile, a traumatic event and failure at work are important bridge nodes between the MPD network and the SBR network. In the Bayesian SBR network, moved by the family's understanding, moved by the family's gratitude and sad mainly drive other nodes. After a patient death, nurses' and physicians' SBR networks feature professional-dimension symptoms at their core, while they follow 'personal to professional' and 'concrete to abstract' symptom development patterns. The personal meaning of a traumatic event and the professional meaning of a failure at work play key roles in bridging the MPD and SBR networks, and meanings of both the personal and the professional dimensions can link to professional-dimension reactions. The manuscript followed the STROBE checklist for reporting cross-sectional studies. No patient or public contribution.

Professional bereavement photography for perinatal loss: A mixed-methods study

This study addresses research gaps regarding the impact of professional bereavement photography for perinatal loss. Utilizing a mixed-methods research design, 504 parents completed an online survey measuring their attitudes toward bereavement photography and its impact. Thirty-one parents participated in semi-structured interviews. The results indicate a high level of acceptability and satisfaction for professional bereavement photography by parents (including those from more diverse backgrounds). Data triangulation confirmed that photos are valuable in enfranchising grief, validating parental and babies’ identities and facilitating connections with others. Significant correlations were found for sharing of photos with both positive attitudes toward photography and for continuing bonds. The expression of continuing bonds in public social media spaces suggests increased social acceptance and validation for grieving perinatal losses. The findings from this study further inform practice guidelines for supporting perinatal loss.

Influencing factors of nurses’ short-term bereavement reactions after patient death

An online cross-sectional survey was performed among 181 nurses in mainland China who experienced their most recent patient death within the last month. Multivariate linear regressions were used following bivariate analysis to identify influencing factors for their short-term professional bereavement reactions. More intensive reactions were associated with the nurse’s fewer experiences of patient death; the nurse’s employment in the intensive care unit rather than the emergency, oncology, geriatrics, or internal medicine departments; and the patient experiencing more pain in the last few days. Higher reaction scores were also reported by nurses who lost the patient more than 1 week prior.

The meaning of patient deaths for professional caregivers: A quantitative construct validation

The meaning of patient deaths is key to understanding professional bereavement. To validate its construct, we applied partial least square structural equation modeling (PLS-SEM) to online survey data from 563 Chinese physicians and nurses. Both the personal meaning and professional meaning contribute significantly while not interchangeably to the meaning of patient deaths. In addition to the loss of an acquaintance, the loss of a valuable life, and the loss of a professional goal, patient deaths can also mean trauma, bad luck, identity crisis, a warning, a learning opportunity, and a time to empathize with others’ sufferings.

Shared Death Experiences: A Little-Known Type of End-of-Life Phenomena Reported by Caregivers and Loved Ones.

Anecdotal evidence suggests that some loved ones and caregivers of dying patients undergo a type of end-of-life phenomena known as a shared death experience or SDE, whereby one feels that one has participated in a dying person's transition to a post-mortem existence. Anecdotal evidence also suggests that SDEs can have a range of profound psycho-spiritual-emotional effects. However, SDEs have been all but ignored in hospice and palliative medicine, leaving professional bereavement services uninformed about SDEs and leaving individuals who report SDEs without adequate professional support to process and integrate them. To better understand the features and effects of SDEs, an inductive content analysis was performed on written accounts and transcripts of semi-structured interviews with 107 persons reporting a total of 164 SDEs. Analysis revealed 4 distinct though non-exclusive modes of an SDE: remotely sensing a death, witnessing unusual phenomena, feelings of accompanying the dying, and feelings of assisting the dying. Analysis also revealed 3 major domains of SDE effects: changes in belief, the reconciliation of grief, and the perception of continued relational bonds with the deceased. Interviews highlighted both difficulties and therapeutic value in people openly discussing their experiences with health professionals. We believe that integration of information about SDEs offers an opportunity to add to the breadth and quality of psychological, spiritual, and bereavement care.

Assessment of professional bereavement: The development and validation of the Professional Bereavement Scale.

To develop and validate Professional Bereavement Scale (PBS), a specific measurement tool for professional bereavement experiences. An online cross-sectional survey collected data from 563 physicians and nurses from urban hospitals in Mainland China. Item consistency analysis, component factor analysis, exploratory factor analysis, and confirmatory factor analysis were run to develop and validate the scale. Correlational analysis was conducted to evaluate the psychometric property of the scale. Two subscales of the PBS were developed: the 17-item Short-term Bereavement Reactions Subscale (PBS-SBR) and the 15-item Accumulated Global Changes Subscale (PBS-AGC). Four factors, namely, frustration and trauma, guilt, grief, and being moved, are involved in PBS-SBR. Five factors are involved in PBS-AGC, which are new insights, more acceptance of limitations, more death-related anxiety, less influenced by patient deaths, and better coping with patient deaths. Both subscales have good content validity, construct validity, and criterion validity, as well as satisfactory internal consistency and split-half reliability. PBS is a specific assessment tool for professional bereavement which is clearly defined, comprehensive, rigorously tested, and generalizable to different professional caregivers from various departments. Unveiled constructs illustrate that professional bereavement experiences contain a professional dimension in addition to a personal dimension both in an event-specific and a global perspective, which distinguishes them from familial bereavement experiences.

Bereavement After Patient Deaths Among Chinese Physicians and Nurses: A Qualitative Description Study.

In order to achieve an in-depth understanding of professional caregivers' experiences of bereavement after patient deaths in Mainland China, qualitative description was employed. 24 physicians and nurses from hospitals in Nanjing, China, participated in one-to-one, semi-structured interviews. Thematic analysis was adopted for data analysis. Five themes were generated: the nature of professional bereavement experiences, the meaning of patient deaths, immediate bereavement reactions, long-term changes, and coping strategies. Each theme included personal and professional dimensions. Professional bereavement experiences in Mainland China were found to be influenced by workplace violence against professional caregivers, traditional Chinese medical ethics, the strong death taboo, and inadequacies of the healthcare system. Professional bereavement experiences are meaning-driven, comprehensive, and usually disenfranchised. They involve multidimensional reactions and have both short-term and long-lasting, both event-specific and accumulated impacts. Cultural and systemic factors could shape professional bereavement experiences.

Informing mothers of neonatal death and the need for family-centered bereavement care: A phenomenological qualitative study.

To understand the lived experience of mothers surrounding the time of being informed of neonatal deaths in intensive care units. A phenomenological qualitative approach was employed. Twelve mothers (age 24-41 years) were identified from the neonatal mortality records of two large neonatal intensive care units with high neonate turnover rates in Amman, Jordan. Data were collected using semistructured interviews with the participants. Interpretive phenomenology was used to generate themes regarding the essence of the mother's experience. Critical analyses of mothers' accounts revealed three major themes: (a) Minimize the hurt, which described how mothers intuited overprotection by their families while the news was conveyed indirectly to them; (b) The striking reality of death, which captured mothers' distressing experiences while realizing the loss of their neonates; and (c) Farwell my baby, which accentuated mothers' needs and experiences while neonates' bodies were honored and prepared for burial per the cultural norms in Jordan. Our findings highlighted the complex dynamics of familial interactions and cultural influences on mothers' bereavement experiences at the time of neonatal death. The grieving mothers expressed unfulfilled needs of receiving professional bereavement support at the time of neonatal death. Strategies are needed to optimize the supportive role of specialized nurses in providing family-centered bereavement care to mothers and their families who experience neonatal death.

Factors Influencing Chinese Professional Caregivers' Bereavement Experiences After Patient Deaths: A Secondary Qualitative Study.

This study aims to identify the factors that influence Chinese professional caregivers' bereavement experiences after patient deaths. Through a content analysis, the study reanalyzed the qualitative data initially collected to understand the lived experiences of professional bereavement in Mainland China. Specifically, the study assessed semi-structured interview transcripts conducted with 24 Chinese physicians and nurses and generated 15 open codes, reflecting the influencing factors. These were further categorized into four themes: dying and death conditions, professional caregivers' characteristics, professional caregivers' involvement, and the bereaved family. The results revealed that professional bereavement experiences and the unveiled factors relate to both the personal and professional lives of the interviewees. Overall, the health care system and cultural backgrounds should be listed as influencing factors for professional bereavement experiences in addition to the aforementioned four.

Chapter 32 - End of life care for patients with meningioma

Palliative care (PC) supports patient with serious illnesses and can help patients with meningioma through the phases of their clinical trajectory, from initial diagnosis through the last hours of life. The PC team implements a multimodal transdisciplinary approach to address physical, psychosocial, and spiritual suffering with patients and their families, while also fostering constructive communication with the many health care providers involved. To achieve these goals the PC core team is comprised of physicians, nurse practitioners, physician assistants, nurses, social workers, and spiritual care providers who are trained to take care of patients with serious illnesses and to provide support to their families. The PC intervention can be instituted concurrently with all other treatments including those with a curative intent, and symptom management can be implemented while at the same time addressing reversible causes of distress. PC is practiced in acute care centers and long-term care facilities, usually by a consulting team, but other settings include outpatient clinics and home. When patients experience recurrence of their tumor and their life expectancy is shortened to 6 months or less, a hospice can provide the same transdisciplinary support by focusing on quality of life and symptom management for the patient while assisting the family through the clinical course and providing professional bereavement services after the patient's death.

Moderating effects of stress coping on bereavement stress and depression in middle-aged women

본 연구는 중년여성의 사별스트레스와 우울과의 관계에서 스트레스 대처의 조절효과를 알아보고 사별스트레스 관리 향상을 위한 교육 방안 등 중재에 기초자료를 마련하는데 연구의 목적을 두고 있다. 이를 위해 S시, I시, C시 및 G도에 거주하는 남편, 부모, 자녀, 형제의 사별을 경험한 40세∼64세의 중년여성 301명을 대상으로 자기기입식 설문조사를 실시하였다. 연구 결과 사별경험이 있는 중년여성은 사별스트레스와 우울감이 있었으며, 적극적인 스트레스 대처로 우울감이 감소함을 알 수 있었다. 이에 효과적 사별가족 관리를 위한 대상별 사별 돌봄 전략을 개발하고 지역사회에서 연계기관과 협력하여 전문적 사별스트레스 관리를 제공함으로 그들의 삶의 질 향상에 기여 할 수 있을 것이다. 그러나 본 연구는 횡단적 단일시점의 조사연구이었으므로 이후 연구에서는 보다 다양한 설계와 종단적인 연구가 필요하다고 본다.The purpose of this study was to investigate the moderating effect of stress coping on bereavement stress and depression in middle - aged women and to provide basic data for intervention such as educational plan to improve bereavement stress management. For this purpose, 301 middle - aged women between 40 to 64 years who experienced bereavement of husband, parents, children, brothers and sisters living in S, I, and C city and G Province were surveyed. The results of the study showed that middle - aged women with bereaved experience had bereavement stress and depression, and depression was actively reduced by stress coping. Therefore, it is possible to contribute to improvement of quality of life by developing individualized care strategies for effective bereavement family management and by providing professional bereavement stress management in cooperation with relevant agencies in the community. However, since this study was a survey of the single - viewpoint, it is necessary to design more and more for researches in the future.

Professional Bereavement Photography in the Setting of Perinatal Loss: A Qualitative Analysis.

Perinatal loss, including fetal and infant death, is a devastating experience for parents, resulting in long-term adverse physical and psychosocial outcomes. However, little is known about what services might best support grieving parents. We aimed to understand the role of professional bereavement photography in assisting the grieving process of parents who have lost a fetus or infant, by examining the perspectives of bereaved parents, professional photographers, and health care professionals. Twenty semistructured interviews were conducted, and interview transcripts were analyzed using modified grounded theory. Twenty-three individuals participated, including 6 bereaved parents, 8 photographers, and 9 health care professionals. Analyses generated 5 major themes describing ways in which the photographs were valuable to parents: validation of the experience, permission to share, creation of a permanent and tangible legacy, creation of positive memories, and moving forward after the loss. Hospitals should consider incorporation of professional bereavement photography services into palliative care and bereavement programs.

Professional caregivers’ bereavement after patients’ deaths: A scoping review of quantitative studies

We conducted a scoping review of quantitative studies on professional caregivers’ bereavement after patients’ deaths following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found 12 studies involving 1317 professional caregivers that met inclusion criteria. Professional caregivers commonly had moderate, and sometimes long-term, bereavement reactions after patients’ death. The evidence of factors affecting profession grief is inconclusive. Previous researchers extensively used the framework of understanding familial bereavement for analyzing the professional caregivers’ bereavement, which we found to be inadequate. We call for a clear definition of professional bereavement and the development of a specific measurement tool.

‘But I do believe you've got to accept that that's what life's about’: older adults living in New Zealand talk about their experiences of loss and bereavement support

This paper explores older people's views, experiences and sources of bereavement support following the death of a spouse, family member or other significant individual. Telephone interviews were conducted with 28 bereaved older adults recruited from the Brief Risk Identification Geriatric Health Tool trial participants in three geographically diverse District Health Boards in New Zealand. Analysis adhered to the principles of grounded theory and followed the National Centre for Social Research 'Framework' approach. Findings indicate that family and friends play a fundamental role supporting older bereaved adults, both emotionally and practically. Existing community-based organisations were identified as an important source of support following bereavement. Despite the emotional, financial and practical challenges associated with bereavement, the majority of participants questioned the role of, need for and value of formal bereavement support services. Instead, study participants cited a combination of being older and previous life experiences as factors that had enabled them to cope with these largely 'expected' events. Moreover, they demonstrated considerable resilience in managing the emotional and practical changes associated with loss and bereavement. This study poses a challenge to the argument that the growing secularisation of society has led to an increase in the use of professional bereavement services over more 'traditional' forms of support, such as family, friends and community and religious organisations. The paper highlights the value of adopting a public health-based approach as a way of optimising bereavement support via the use of existing community organisations previously known to older people. This is particularly important in those countries where the provision of bereavement support is limited due to resource constraints.

Professional Bereavement: A Qualitative Examination of Rehabilitation Counselors in Grief

This article describes qualitative research related to rehabilitation counselor bereavement. Nine rehabilitation counselors who had experienced the death of a client volunteered to participate in structured interviews. The results were transcribed, analyzed, and found to contain six major themes. The themes were (a) profound impact, (b) self-questioning, (c) need for support, (d) questions regarding etiquette, (e) counselor preparation for the death of a client, and (f) need for self-care. Participants also offered suggestions for rehabilitation educators and administrators of State-Federal vocational rehabilitation programs.