Search Results (90)

Objectives: This study aims to explore the experiences of bereaved family members during and after the loss of a relative in an intensive care unit (ICU) during the COVID-19 pandemic-related visitation restrictions, as well as to assess their perceptions of a nurse-led bereavement support programme. Methods: Ten participants with a relative who had died in an ICU were recruited in September 2020 during a follow-up bereavement meeting at a tertiary cardiac centre in Switzerland. Descriptive qualitative research was conducted. Face-to-face nurse-led follow-up bereavement meetings, adapted to the pandemic circumstances and conducted as semi-structured interviews, were analysed by a thematic analysis. Findings: Fifteen sub-themes and three main categories were identified. The motivation behind the family members’ participation in the meetings was to ask and learn about their experiences regarding the death of their relative during this abnormal time. The reactions to the meetings varied among the families. Many expressed that the experience of bereavement was particularly challenging and painful, and that the absence of a final farewell to their loved one, as well as the impossibility of having a formally held funeral, made the deaths harder to accept. The families appreciated the interview as it gave them clarification, information, and an awareness of the facts and the care provided, and for several of them it was also a chance to share their emotions and express any difficulties they might have encountered both during and after the patient’s death. Conclusion: The COVID-19 pandemic’s restrictions had a profound impact on families who lost a loved one in an ICU. The nurse-led bereavement support service responded to the needs of grieving families, providing valuable emotional and practical support and re-establishing a healthy relationship between the families and the caregivers that was hindered by pandemic restrictions. The study also shows that a nurse-led bereavement support service can be a valuable component of family-centred care. Full article

Music therapy in paediatric palliative care offers a unique opportunity for emotional support, legacy creation, and therapeutic connection for children and their families. This paper describes the Heartbeats Intervention, as delivered by a paediatric palliative care music therapist at Sydney Children’s Hospital Australia. This intervention involves recording and creatively integrating the heartbeats of children and family members into personalised musical compositions. Originally inspired by music therapist Brian Schreck’s work, the intervention has evolved to meet diverse therapeutic goals, from soothing children with serious illnesses (including cancer) with recordings of their families’ heartbeats to creating legacy song tracks that support families through bereavement. Despite some logistical and resource challenges, the intervention has been well-received and continues to expand, including the integration of environmental soundscapes and broader community involvement, which allows the intervention to be experienced by a greater number of families. This paper contributes to the limited but growing literature on music therapy in paediatric palliative care, highlighting the Heartbeats Intervention as a flexible and meaningful way to enhance psychosocial support and connection for children and their families. Further research to evaluate its long-term impact and to explore children’s direct experiences of the intervention is needed. Full article

The COVID-19 pandemic has resulted in countless losses around the world, profoundly affecting the lives of many people, especially those who faced the death of family members, bringing several negative repercussions to these families and constraining the experience of grief. This study aimed to understand the experience of loss and grief among bereaved individuals who lost family members during the COVID-19 pandemic. This qualitative study was guided by Charmaz’s constructivist grounded theory as a methodological framework. The study adhered to the Criteria for REporting Qualitative research (COREQ) checklist. Data collection took place between May and November 2023 through telephone interviews that were audio-recorded and later transcribed in full. The purposive sample consisted of 21 bereaved family members who had lost their loved ones during the COVID-19 pandemic. Participants were mainly female (n = 16) with a mean age of 55.5 (SD = 16.2). The loss of their family members occurred 12 to 24 months before data collection. The following central phenomenon was identified through the analytical process: “Family experience of loss and grief: between the unspoken goodbye and post-loss adjustment”. This was anchored in the following three categories: (1) Anguish and fear of the unknown; (2) Death by COVID-19—communication of death and lack of goodbyes; and (3) (Re)construction of meaning—support networks and the grieving process. Our findings recommend that policymakers allocate additional resources to grief support services to better prepare for future pandemic events. Furthermore, it is necessary to invest in the implementation of relevant training programs for healthcare professionals, with a family centered approach. Full article

This study uses a public health approach to identify the comorbid risk factors and protective factors that influence the likelihood of an officer-involved shooting (OIS). Methods: We analyzed 7.5 years of hospital inpatient data obtained from the state of Texas. The OIS subjects (n = 177) were civilians who were shot during a legal intervention involving law enforcement. The control group (n = 33,539) included persons who were hospitalized due to injuries from a car accident. Logistic regression models were used to identify the predictors of an OIS incident. The data included information on chronic diseases, vulnerable population status, health insurance, mental health diagnoses, substance use disorders, and recent trauma. Results: About one-fourth (24.3%) of OIS subjects had a diagnosed mental illness, compared to 8.4% of control subjects (p < 0.001). Factors that greatly increased the risk for an OIS included the following: schizophrenia (AOR = 2.7; CI: 1.6, 4.6), methamphetamine use disorder (AOR = 3.5; CI: 2.2, 5.5), and recent family bereavement (AOR = 8.5; CI: 1.8, 39.6). Six subjects (3.4%) were persons experiencing homelessness (PEH). Protective factors that lowered the risk for an OIS included commercial health insurance (AOR = 0.27; CI: 0.17, 0.45) and Medicaid insurance (AOR = 0.61; CI: 0.11, 0.93). Conclusions: These findings underscore the preventable nature of many OIS incidents, especially those that involve untreated mental illness, homelessness, substance use disorders, and recent trauma. Addressing the root causes of these incidents will likely require interdisciplinary collaboration among law enforcement, public health agencies, and social services. Full article

In October 2023, a Knowledge Exchange Forum was established, bringing together arts therapies staff and students from three different palliative and end-of-life care (PEoLC) settings: St Columba’s Hospice Care in Edinburgh, the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Hospital and the Mount Sinai Kravis Children’s Hospital in New York. Adopting a practice-led approach, the Forum offers a space to unpack questions and challenges that arts therapists face in PEoLC. In this dialogical paper, we outline the development of the Forum and share emerging insights from our cross-cultural discussions. When working in PEoLC settings, arts therapists are commonly required to work across a continuum of care. This continuum extends from individual sessions with patients, families and bereaved carers, to groups and community-oriented initiatives. It often requires a capacity to work flexibly and fluidly with regard to, for example, therapeutic boundaries, consistency of location, and time. Discussion of emerging insights leads to a consideration of their implications for education and practice, and for future directions in professional networking and knowledge exchange. Full article

Loneliness is one of the most prevalent problems faced by older nursing homes (NHs) residents. Technical Directors (TDs) of NHs can play an important role in combating loneliness, so it is important to understand how they perceive this phenomenon. This study aimed to describe the perceptions of TDs about factors associated with loneliness and relevant areas of training and intervention. A total of 163 TDs (mean age = 42 years; 90% female) filled an online survey. The main NHs factors related to loneliness were residents’ mental and physical health problems; mistreatment in care provision; poor relationships between residents, with staff and family/friends; loss of loved ones; and family members’ work schedules and their geographical distance. Intervention domains that need to be improved were the policy of greater proximity to families and community, partnerships with the outside world, civic participation by residents, technical team diversity, and increase of staff/resident ratio. Dementia care, stress management, crisis intervention, person-centered care, and coping with death/bereavement were identified as relevant themes in professional training. This study appears as a relevant contribution to the deepening of knowledge not only about the phenomenon of loneliness among older residents in NHs, but also about the perceptions of TDs regarding this problem. Full article

Social media use is commonplace for journalists in newsgathering, including reporting newsworthy deaths. Journalists have revised their death knock practice of physically doorknocking bereaved families to a preference for digital methods to solicit comment and context for stories about fatal incidents. This is gleaned from social media. A 2021–2022 Australian mixed-methods study, including a survey and semi-structured interviews, found that journalists use social media as a tool to find, contact, and interview people, and as a source of facts, photographs, and comments for stories. Journalists are at risk of moral injury, which occurs when they breach their own moral code, including through institutional betrayal. This article argues the digital death knock increases the risk of moral injury because unfettered access to, and sanctioned use of, social media material creates new ethical complexities. It proposes that fundamental to the journalist’s risk of moral injury is their view of the journalist–source relationship, which might in turn reflect their underlying ethical framework. The journalist who preferences utilitarian ethics—the greatest good for the greatest number—may see a source as means to an end; however, the journalist who preferences deontological ethics—respect for persons as an end in themselves—may owe the source a greater duty of care, which, if breached, may make them vulnerable to moral injury. Full article

The Dual Process Model of Coping with Bereavement (DPM, by Stroebe and Schut) is a well-known framework in contemporary grief research and counselling. It depicts how mourners oscillate between various tasks and reactions. There is a need to engage more with the intense feelings of loss (Loss-Oriented tasks), but also with other things in life and other parts of the adjustment process after a loss (Restoration-Oriented tasks). This interdisciplinary article applies the framework to ecological grief and extends it to collective levels. While the DPM has been broadened to family dynamics, many subjects of grief are even more collective and require mourning from whole communities or societies. Religious communities can play an important role in this. This article provides a new application called the DPM-EcoSocial and discusses the various tasks named in it, which are ultimately based on the grief researcher Worden’s work. The particularities of ecological grief are discussed, such as the complications caused by guilt dynamics, climate change denial, attribution differences about climate disasters, and nonfinite losses. Grief and grievance are intimately connected in ecological grief, and (religious) communities have important tasks for remembrance, mourning, and witness. The collective processes can lead to meaning reconstruction, transilience, and adversarial growth. Full article

Background/Objectives: The objective of this research was to analyze the experiences and factors associated with perinatal grief in mothers in the urban context of Santa Cruz de la Sierra, Bolivia. Methods: The sample consisted of seven mothers who experienced a loss during pregnancy up to the second month after the baby’s birth, occurring between 2015 and 2020 in the city of Santa Cruz de la Sierra. The mean age of the mothers was 34.86 years (SD = 3.13), and they belonged to middle or upper-middle socioeconomic levels. Data were collected through semi-structured interviews and analyzed using descriptive qualitative analysis. Results: The identified characteristics of perinatal grief were sadness, anger, guilt, emotional numbness, social isolation, and anxiety. Factors contributing to grief processing included support from the partner and family, when they accommodated and respected the mother’s needs. Factors hindering the grieving process included social and cultural environments that often silence and minimize the loss, a history of previous losses, the desire to be pregnant, and the mother’s life expectations and projects focused on motherhood. Conclusions: In conclusion, this research suggests that perinatal losses in the Bolivian context may be influenced by factors such as knowledge of the cause of death, previous loss experiences, and their emotional effects. The limitations of the study include the lack of diversity in participants’ educational and socioeconomic backgrounds and the restriction of the sample to an urban area in Bolivia. Emotional interventions to support these bereaved mothers in those complex moments should be integrated in the Bolivian healthcare system. Full article

Background: The death of a child due to complex congenital heart disease (CCHD) in pediatric intensive care units profoundly affects families, often resulting in lasting grief and emotional distress. Despite advancements in pediatric palliative care (PPC), significant gaps persist in communication and end-of-life (EoL) planning. This study explores the experiences and perceptions of bereaved parents to identify areas for improvement in PPC delivery. Methods: A qualitative phenomenological design was used to analyze the lived experiences of 18 bereaved parents whose children died from CCHD at a tertiary cardiac center. Semi-structured telephone interviews were conducted, incorporating five open-ended questions. Data were analyzed inductively using Colaizzi’s method to identify recurring themes and subthemes. Results: Four key thematic areas emerged: communication issues, the parental role, child care, and bereavement support. Parents highlighted inconsistent communication, lack of preparedness for EoL decisions, and emotional isolation as major challenges. Positive experiences often involved compassionate healthcare providers and structured psychological support. A significant proportion of parents identified family support and faith as key coping mechanisms, while others expressed dissatisfaction with post-mortem follow-up and the absence of long-term bereavement care. Conclusions: Bereaved parents’ experiences underscore the need for improved communication strategies, greater parental involvement in care, and enhanced bereavement support. Integrating structured decision-making pathways early in the care trajectory may help mitigate parental distress and improve the quality of EoL experiences for children with CCHD. Full article

Background/Objectives: Perinatal loss is a challenging experience that significantly impacts families and healthcare professionals. This study aimed to explore the perceptions and experiences of the nursing team in the gynecology unit at a Spanish hospital regarding the implementation of a new protocol for perinatal bereavement care. Methods: A qualitative descriptive study was conducted involving a focal group interview with nursing staff from the gynecology unit. Participants were selected through purposive sampling, and data were analyzed using thematic analysis to identify recurring patterns and insights. Results: The findings revealed a disparity in attitudes toward perinatal bereavement care, with some nurses demonstrating empathy and understanding, while others expressed discomfort and avoidance behaviors. Barriers to effective care included a lack of formal training, insufficient emotional support, and practical challenges in implementing the protocol. Participants suggested improvements such as enhanced communication training, the appointment of a bereavement coordinator, and earlier psychological interventions to support both families and staff. Conclusions: The study highlights the need for continuous education and emotional support to facilitate the adoption of perinatal bereavement protocols. Involving nursing staff in protocol development and addressing systemic barriers can improve the quality of care for bereaved families while supporting healthcare professionals’ emotional well-being. Full article

Background: In the intensive care unit, many patients are dying despite advanced therapeutic technology and optimized treatment. The critical care team is expected to deliver end-of-life care for the dying patient and their family. However, it is challenging to provide adequate support to families due to the ideas and emotions associated with the end of life. This can be influenced by different beliefs and cultures among patients and healthcare professionals. Added to this, research about end-of-life practices in intensive care units in Saudi Arabia is limited. Therefore, this study protocol aims to examine: (1) What end-of-life care is provided by healthcare teams in adult intensive care units in Saudi Arabia? (2) What helps or hinders effective end-of-life care in adult intensive care units in Saudi Arabia? Method: This study will use a mixed-methods, sequential, explanatory design consisting of two phases. Phase 1 will include a cross-sectional study design with a convenience sample of approximately 400 healthcare providers who will be invited from three military hospitals in Saud Arabia. the Palliative and End-of-Life Care Index (PEOL Care Index) will be used to assess palliative and end-of-life care education, practice, and perceived competence among the staff. Additionally, a questionnaire on the barriers to optimal end-of-life care and the perceived benefit of potential strategies to improve end-of-life care will be applied to obtain the views of managers. Phase 2 of the study will be a qualitative descriptive design involving semi-structured interviews with healthcare providers, managers, and bereaved family members. Conclusion: The study findings will contribute to understanding current practice in relation to palliative and end-of-life care in intensive care units in Saudi Arabia. It will provide valuable insight into barriers to and facilitators of care, which will help to develop strategies and interventions to improve the quality of end-of-life practices in ICUs. In addition, this research will provide significant information regarding family members’ experiences of end-of-life care provided to their relatives. Full article

(1) Background: Brazil has been severely affected by the COVID-19 pandemic, with over 700,000 deaths and, consequently, a drastic increase in the number of bereaved individuals. This study aims to understand the emotional suffering after the COVID-19 pandemic in Brazilian adults whose family members have died due to COVID-19. (2) Methods: A clinical–qualitative, cross-sectional, descriptive–exploratory study with a sample composed of 10 bereaved family members was used. Data collection took place in July 2021 through individual semi-structured interviews conducted via video call. The interviews were fully transcribed and subjected to thematic analysis. The corpus was analyzed based on Parkes’ theory of mourning, in dialog with research conducted in the pandemic context. (3) Results: The results were organized into three categories: Living the anticipation of loss in an unknown world; Living through grief in a changed world; and Glimpsing a new possibility of living. (4) Conclusions: The rupture of the presumed world in times of the pandemic, the impossibility of bidding farewell to deceased loved ones, and low levels of social support hindered the process of mourning during the health crisis. Full article

Comprehending the significance of legacy in end-of-life (EoL) situations helps palliative care professionals enhance person-centered outcomes for those with a life-threatening illness and their families. Our purpose was to conduct a concept analysis of legacy in EoL care. By employing Walker and Avant’s approach, we identified the concept’s defining characteristics. Subsequently, we established the antecedents, consequences, and empirical referents. After conducting a thorough review of titles and abstracts, a total of 30 publications were analyzed. These articles were sourced from three databases (CINAHL, Medline via PubMed, and Scopus) from 2002 to 2023. Our analysis identified several core attributes of legacy: (a) leave behind something of value that transcends death; (b) determine how people want to be remembered; (c) build and bestow across generations; (d) integrate advance care planning through EoL conversations and shared decision-making; and (e) develop strategies of dignity-conserving care. The consequences are related to improvements in spiritual and subjective well-being; coping with inevitable EoL existential issues; decreases in EoL suffering; engendering self-awareness, hope, gratitude, and peace; achieving and maintaining dignity; creating good memories; promoting mutually constructive and transformative relationships; and fostering the adjustment of bereaved people. Nevertheless, further effort is required to implement the key attributes of legacy that form the basis for creating legacy-oriented interventions near the EoL. Full article

Death is a painful reality that strikes and affects all human beings. Death knows no boundaries, race, age, gender, belief system or status. It affects the family; the social, political and economic networks of the deceased and the community at large. Death comes with different challenges that require coping mechanisms. While Africans from all walks of life use different approaches to help the bereaved deal with death and loss, the church has become the biggest role player in attending to this crisis. Although the church is a latecomer in the lives of African people in general, for the people of Collins Chabane Municipality in particular, it is given priority when death strikes. This article seeks to articulate how the church has become central to the death and burial rituals in that municipality. To that end, the researcher conducted a review of data collected through individual and focus group interviews carried out with traditional community leaders (local chiefs) in the municipality on the theme: The erosion of postcolonial African funeral traditions in rural South Africa (Limpopo). Full article