Subsequent Grief Research Articles

ORGAN DONATION: KEY FACTORS INFLUENCING FAMILIES’ DECISION-MAKING

Aim To clarify the decision-making and bereavement needs of family members who had organ donation discussed with them; to provide a rationale for further preparation of professionals involved in this sensitive work. Methods This work used a 3-year longitudinal design. A sample of 49 family members who had donation discussed with them, were recruited. At 3 to 5, 13 to 15, and 18 to 26 months postbereavement, face-to-face interviews and two, self-completed; psychometric measures, the Beck Depression Inventory II and the Grief Experience Inventory, were used with participants who chose to donate. Single interviews were carried out with participants who declined donation. Data were analyzed using a comparative, thematic approach and multivariate statistics, focusing on detection of important similarities and differences between cases. Findings Four main categories were identified that illustrated the issues that influenced families' ability to agree or decline donation and their perception of the decision-making process. The categories were concerns about knowledge of the deceased's donation wish, views held by the extended family about donation, giving meaning to the death and events that occurred in the hospital that were perceived as positive or negative. The role of children in the decision-making about organ donation was highlighted. In conclusion, hospital care affected participants' donation decision-making and appeared to impact on subsequent grief. To facilitate decision-making and bereavement that is uncomplicated by questions about brain injury and subsequent death, families needed time to understand the information given, care in the way and context that information was shared and attention to their emotional needs.

Miscarriage: Is vividness of visual imagery a factor in the grief reaction of the partner?

Objectives. In the context of recent findings concerning the unexpressed psychological reactions of men to their partner's miscarriage, this study explores the role of visual imagery in mediating this reaction.Design. Questionnaire data from 158 male partners of women who had miscarried prior to the start of the 25th week of pregnancy were collected with a view to exploring the relation of vividness of visual imagery within this cohort to their subsequent grief response.Methods. Volunteers recruited via referrals from general hospitals and general practices in the North East and Midlands regions of England, were administered the Vividness of Visual Imagery Questionnaire, a modified object‐specific form, i.e. the Baby Vividness of Visual Imagery Questionnaire, and the Perinatal Grief Scale.Results. It was found that men with ‘unvivid’ visual imagery were less likely to have seen an ultrasound scan of their unborn child. When men were compared by the length of gestation at which the miscarriage occurred there was not a significant difference in vividness of visual imagery. Those men exhibiting vivid imagery exhibited significantly higher levels of measured grief when their partner miscarried than those of lower or unvivid imagery.Conclusions. These findings suggest that vivid visual imagery assisted or oriented men towards a sense of baby (or perceived foetal ontology) early in pregnancy, and in consequence they appeared at greater risk of negative impact following their partner's miscarriage.

The effects of group therapy on bereaved extended family of children with cancer.

The impact of the death of a child from cancer and subsequent grief on the extended family members has not been documented. Additionally, the effect of a support group for these individuals has not been explored. Therefore, this one group pretest/post-test study sought to determine the effects of participation in a support group for bereaved extended family members whose child died from cancer. Extended family members completed the Emotions Profile Index before and after the group sessions. Descriptive data were collected from the cotherapists' process log and the participants' evaluation. No significant differences were found between pretest and post-test scores for any emotional state. However, the group process log showed significant clinical data related to the intensity of the grief experienced and ways of coping with the loss. The Bereaved Extended Family Group Evaluation demonstrated the usefulness of the group experience. Tentative conclusions support the value of such a group in providing a forum for the bereaved extended family to ventilate feelings of anger and sadness and find ways to cope with the future.

Expectation of Death, Participation in Funeral Arrangements, and Grief Adjustment

This research investigated the hypotheses that prior expectation of death and participation of the bereaved in planning and conducting funeral rituals will facilitate grief adjustment. Fifty primary survivors were interviewed twelve to eighteen months after the death. The hypothesis that participation in funeral rituals will facilitate grief adjustment was not confirmed. Prior expectation of death was significantly related to subsequent grief adjustment. This led to further speculation that participation in funeral rituals is important in facilitating grief adjustment in those cases in which death was not expected. Evidence regarding this hypothesis is discussed.