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Bereavement is often accompanied by a deterioration in physical and emotional well-being. Nurses often find it difficult to deal with bereaved people, and avoid involvement with them. Understanding the bereavement process can help nurses to provide effective care and support for bereaved people.
Emotional health of bereaving parents (N = 62; control N = 56) were explored 5 years after the death of a child (age 0-12) in Israel. The Symptom Check List-90 was utilized as the primary measurement instrument. Comparisons to controls according to geographic area of birth indicated more interpersonal (over)sensitivity, obsessive-compulsiveness and anxiety among Asia/African born parents as compared to either European/American or Israeli-born. All geographical groupings of bereaving parents indicated significantly greater somatic concerns than their respective controls. The college-educated Israeli-born bereaving parents indicated significantly healthier SCL-90 scores than similarly educated European/American-born bereaving parents. This was in contrast to the trend in which European-American-born parents (regardless of educational level) exhibited scores indicating the least symptomatology.
Examined the contribution of membership in bereavement support groups (BSGs) to bereavement adaptation in a sample of 127 widows and widowers, 37 of whom participated in BSGs, during the first 18 months of their bereavement. Both BSG members and nonmembers exhibited significant declines in depression, anger, anxiety, subjective stress, and psychotropic medication usage over the 18-month course. Multiple regression analyses revealed that neither group membership nor level of group involvement was associated with significantly greater declines in these variables, after demographic variables, initial levels of distress, and levels of perceived social support were accounted for. In further exploratory analyses, however, the number of BSG meetings attended accounted for significant amounts of variance in levels of anger and psychotropic medication usage and interacted with perceived social support in accounting for variance in subjective stress. The extent to which these findings call into question common assumptions regarding the efficacy of BSGs and implications for future research are discussed.
This article presents an experimental evaluation of the Family Bereavement Program (FBP), a 2-component group intervention for parentally bereaved children ages 8-16. The program involved separate groups for caregivers, adolescents, and children, which were designed to change potentially modifiable risk and protective factors for bereaved children. The evaluation involved random assignment of 156 families (244 children and adolescents) to the FBP or a self-study condition. Families participated in assessments at pretest, posttest, and 11-month follow-up. Results indicated that the FBP led to improved parenting, coping, and caregiver mental health and to reductions in stressful events at posttest. At follow-up, the FBP led to reduced internalizing and externalizing problems, but only for girls and those who had higher problem scores at baseline.
Ratings of grief reactions, post-bereavement hallucinations and illusions and quality of life were made during the first year after the death of a spouse among 14 men and 36 women in their early seventies. In both sexes, the reactions were generally moderate or mild and characterized by loneliness, low mood, fatigue, anxiety and cognitive dysfunctioning. Feeling lonely was the most persistent problem during the year. Post-bereavement hallucinations or illusions were very frequent and considered helpful. Half of the subjects felt the presence of the deceased (illusions); about one third reported seeing, hearing and talking to the deceased (hallucinations). Former marital harmony was found to make a person more prone to loneliness, crying and hallucinations or illusions. The quality of life was significantly lower among the bereaved than among married people and those who never married, but equalled that found among divorcees.
OBJECTIVE: This study sought to determine whether a set of symptoms interpreted as complicated grief could be identified and distinguished from bereavement-related depression and whether the presence of complicated grief would predict enduring functional impairments. METHOD: Data were derived from a study group of 82 recently widowed elderly individuals recruited for an investigation of physiological changes in bereaved persons. Baseline data were collected 3-6 months after the deaths of the subjects' spouses, and follow-up data were collected from 56 of the subjects 18 months after the baseline assessments. Candidate items for assessing complicated grief came from a variety of scales used to evaluate emotional functioning (e.g., the Hamilton Depression Rating Scale, the Brief Symptom Inventory). The outcome variables measured were global functioning, medical illness burden, sleep, mood, self-esteem, and anxiety. RESULTS: A principal-components analysis conducted on intake data (N = 82) revealed a complicated grief factor and a bereavement-depression factor. Seven symptoms constituted complicated grief: searching, yearning, preoccupation with thoughts of the deceased, crying, disbelief regarding the death, feeling stunned by the death, and lack of acceptance of the death. Baseline complicated grief scores were significantly associated with impairments in global functioning, mood, sleep, and self-esteem in the 56 subjects available for follow-up. CONCLUSIONS: The symptoms of complicated grief may be distinct from depressive symptoms and appear to be associated with enduring functional impairments. The symptoms of complicated grief, therefore, appear to define a unique disorder deserving of specialized treatment.
This study compared bereavement experiences of suicide survivors with those of other survivors. The primary focus of investigation was upon grief reactions suggested to be unique to suicide bereavement and upon quality of grief resolution 2-4 years after death. Fifty-seven women and men, between the ages of 24 and 48, who had experienced the death of a marital partner were interviewed. Subjects were assigned to one of four groups by mode of death (suicide, accident, unanticipated natural, and expected natural). Analyses of variance and Scheffe procedures indicated no significant differences among survivors on frequencies of grief reactions considered common to all bereavements. The suicide survivors were significantly different from all others on certain grief measures, including rejection and unique grief reactions. On various other grief measures, significant differences were indicated among the groups of survivors. Four primary conclusions, implications of the findings, and limitations of the study are discussed.
The successful planning and implementation of a Bereavement Program in the Emergency Departments of two of Melbourne's major metropolitan teaching hospitals, Monash Medical Centre (MMC) and Dandenong Hospital (DH) was in response to staff dissatisfaction regarding their capacity to care for bereaved families and involved staff. Key influencing factors were identified and literature evidence was sought. A multidisciplinary team was brought together to form a Planning Group and guidelines were developed. The aim was to improve the care of all those involved with a death in the Emergency Department, both family and staff. Fundamental to facilitating these improvements was the need for staff education in the needs of families, self and staff and a grief education program was arranged, and provided through multiple sources, utilising the expertise of the Centre for Grief Education. The extremely positive feedback, which has been received from families and ED staff is testimony to the care delivered and the difference the Program is making at Southern Health, to those experiencing a death in the Emergency Department.
The general public's view of bereavement in Israel was studied by means of a series of vignettes describing various reactions of a man at mid-life alternately to the death of an adult son and then to the death of a spouse. Respondents believed that the bereaved were particularly affected when the deceased was an adult child; functioning was impaired; and the relationship to the deceased was conflictual. A continuing relationship to the deceased was considered normative five years after death. Implications for theory and clinical practice are offered.
Although professionals can do little to cushion the emotional trauma for parents and family when an infant dies, many institutions have implemented bereavement programs to offer counseling, support, and assistance. Included in such programs are photographs of the deceased infant. The value of such photographs has been documented in the literature. Some institutions provide parents with instantly developed photos of the deceased infant. Unfortunately, instant prints may blue and often fade with time. To improve services to bereaved families at a hospital in Massachusetts, a program was implemented to use the skills of the hospital's professional biomedical photographers and the nursing team. The perinatal clinical nurse specialist or her designee takes a 35-mm black-and-white photograph of the infant. The biomedical photographers process the negatives and use hand coloring techniques and matting to produce professional-quality photographs. The response by parents and families to the improved photographs has been positive. As the number of photographs taken has increased, the staff have continued to improve the service.
OBJECTIVE: Earlier studies have shown that symptoms of traumatic grief are distinct from those of bereavement-related depression and anxiety. This study was an attempt to replicate that finding. METHOD: Data were derived from 103 patients. Traumatic grief was measured with the Inventory of Traumatic Grief. Depression and anxiety were measured with the Symptom Checklist. The distinctiveness of the three symptom clusters was determined with principal axis factoring. RESULTS: Symptoms of traumatic grief, depression, and anxiety clustered together in three distinct factors. CONCLUSIONS: These results confirm the previous finding of a distinction between symptoms of traumatic grief and symptoms of bereavement-related depression and anxiety.
The present study examined whether the Sex of the participant, Cause of death (natural causes or suicide) and Sex of the bereaved were related to the perceived helpfulness of the behaviors and comments of support providers. After reading one of four scenarios in which a parent's cause of death and the sex of the grieving child were varied, 198 college students (112 women, 86 men) rated the helpfulness of 34 statements. Significant main effects for sex of the participant and cause of death were both found. While no significant main effect for sex of the bereaved was found, this variable did interact with sex of the participant and with cause of death for the variable of Provision of physical comfort. Significant interactions for sex of the participant x cause of death were found for the variables of Provision of physical comfort and Identification with the situation. The results underscore the value of multiple providers of support during grieving.
This study presents an analysis of mediation of the effects of the Family Bereavement Program (FBP) to improve mental health outcomes of girls at 11 months following program participation. The FBP was designed based on a theory that program-induced change in multiple child and family level mediators would lead to reductions in children's mental health problems. Mediational models were tested using a three wave and a two wave longitudinal design. Using a three wave longitudinal design, FBP effects on three variables at T2 (increased positive parenting, decreased negative events, and decreased inhibition of emotional expression) were found to mediate the effects of the FBP on mental health problems at 11-month follow-up. Using a two-wave longitudinal design, support was found for FBP effects on three additional variables at 11-month follow-up (increased positive coping, decreased negative thoughts about stressors, and decreased unknown control beliefs) to mediate program effects to reduce mental health problems at 11-month follow-up. The discussion focuses on theoretical explanations for the mediational effects and on implications for identifying "core components" of the FBP that are responsible for its effects to reduce mental health problems of girls.
Losing loved ones through death is a common experience for children. Children living in urban centers may be at greater risk for death of family members as a result of increased daily stress and poverty. Children who experience permanent loss of family members without support to grieve are at greater risk for mental health problems. Manifestations of grief that frequently occur in children are psychosomatic complaints and affective distress. This study investigates the prevalence of loss by death among two groups of inner city youths, and the impact of a bereavement group experience on subjects' affective distress and somatic complaints. A significant difference was found between pretest and post-test scores on somatic complaints for the elementary school aged group.
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