Showing papers in "Omega-journal of Death and Dying in 2011"

Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief.

Abstract: Following perinatal loss, a type of ambiguous loss, bereaved couples struggle with and experience distress due to various forms of ambiguity. Moreover, the juxtaposition of their grief with society's minimization often disenfranchises them from traditional grieving processes. The purpose of this study was to explore sources of ambiguity and disenfranchised grief related to perinatal loss. Audio-taped interviews with 13 bereaved couples at 2, 6, and 13 months following the death of their fetus or infant were analyzed. Several categories of ambiguity and disenfranchised grief emerged, pertaining to: (a) the viability of the pregnancy; (b) the physical process of pregnancy loss; (c) making arrangements for the remains; and (d) sharing the news. This study uncovers the many sources of ambiguity and disenfranchised grief that bereaved couples face in interactions with family, friends, society, and healthcare professionals. These insights may inform healthcare professionals in their attempts to ease distress related to perinatal loss.

Parental grief after a child's drug death compared to other death causes: investigating a greatly neglected bereavement population

Abstract: This comparative survey contrasted 571 parents who lost children to various death causes: 48 to drug-related deaths and overdoses, 462 to suicide, 24 to natural death cases, and 37 to mostly accidental death cases. Groups were compared in terms of grief difficulties, mental health problems, posttraumatic stress, and stigmatization. Results did not show any appreciable differences in these respects between the suicide bereaved parents and those losing children to drug-related deaths. However, when the suicide and drug-related death survivors were specifically contrasted against accidental and natural death loss cases, a consistent pattern emerged showing the former group was consistently more troubled by grief and mental health problems than the latter two sub-groups. These differences remained when controls of time since the loss and gender differences were employed as covariates. These findings suggest that the powerful and intense stigma against drug use and mental illness, shared among the public-at-large, imposes challenges in healing of immense proportion for these parents as they find less compassionate responses from their significant others, following their losses.

Surviving Grief: An Analysis of the Exchange of Hope in Online Grief Communities:

Abstract: Online grief communities represent relatively new forms of peer support. However, the degree to which they are helpful for individual grieving processes is unknown. To date, no research has evaluated the type or quality of support exchanged in online grief communities. To begin to address these questions, this study analyzed 564 messages from internet grief websites to: (1) classify the type of helping skills used, and (2) extract themes contained in the content of the messages. Messages selected for analysis were the first response to an original post, assuming they would be the first effort to provide support to a grieving individual. Results revealed a majority of responses contained self-disclosure. Themes in the messages suggested provision of more than "one-way" support; messages themes also included exchanging hope for the future by sharing one's own story, validating the grief experience, providing resources, and exchanging psychosocial support. Clinical implications and research recommendations are discussed.

Coping with the ultimate deprivation: narrative themes in a parental bereavement support group.

Abstract: Support groups are often used to help individuals cope with challenging and unusual life circumstances through narration. Yet, little is known about specific meta-communication within a support group setting and in what ways these interactions may benefit participants. This study uncovers narrative themes that were expressed during a series of support group meetings specific to bereaved parents. Three central narratives were revealed in the analysis including the death story narrative, coping/negotiating narrative, and connecting through communication with others narrative. This research underscores the vital outlet that the support group serves for participants and the communicative means by which subjective healing can occur.

Spousal Bereavement: The Lived Experience of Young Canadian Widows:

Abstract: A phenomenological study was conducted to understand the lived experience of spousal bereavement from the perspective of young Canadian widows. Five themes emerged following inductive analysis of i...

A Space for Mothers: Grief as Identity Construction on Memorial Websites Created by Sids Parents:

Abstract: In this article we conduct a textual analysis of memorial websites created by mothers who have experienced a loss due to sudden infant death syndrome (SIDS). Using an online Internet ethnographic a...

Indicators of family resilience after the death of a child

Abstract: The aim of this study was to identify and describe resilience qualities in families after losing a child. Questionnaires, including an open-ended question, were utilized to collect data independently from the parents and siblings of the deceased in 89 Belgian families. The results indicate that family strengths in general, and commitment to the family in particular, helped the families' adaptation after the loss. In addition, the adaptation process after the loss was aided if the family members viewed the crisis as a challenge. Both the siblings and the parents indicated that the extent to which a family experienced support from the community was directly related to family adaptation after the loss. Redefining the situation and utilizing social support from friends and family were underlined as effective family coping strategies. The findings could be used in interventions to promote family resilience, thereby affirming the reparative potential of families.

Psychologists' Experiences of Grief after Client Suicide: A Qualitative Study

Abstract: Six clinical psychologists were interviewed regarding their experiences with client suicide. Interviewee's responses offered the following insights: (a) all their experiences met the criteria for prolonged grief; (b) the respective work settings significantly influenced the clinician's recovery process; and (c) male clinicians (in contrast to female respondents) reported no personal impact from the client's suicide. Finally and surprisingly, all participating psychologists did not question their clinical skills after the suicide, citing rather their understanding of the client's choice to suicide being outside of their control. Implications for clinical training, practice, and research are addressed.

Deathbed visions from India: a study of family observations in northern Kerala.

Abstract: This is an interview-based study of 104 families and their observations of the last weeks and days of a dying family member. Forty families reported "unusual experiences and behaviors" from the dying person in their last period of life. Thirty of these dying persons displayed behavior consistent with deathbed visions-interacting or speaking with deceased relatives, mostly their dead parents. There were six cases of reported premonitions of death and five possible confusional states with one patient reported to have had both a deathbed vision and confusional experiences. Socio-demographic factors such as gender, age, occupation, or cause and place of death were not found to be significant. Hindu patients appeared to be more likely than Muslim patients to report these experiences. Use of opiates (or not) did not appear to influence reports. The findings are discussed with reference to past studies of deathbed visions as well as their implications for the future pastoral care of dying people and their families.

A Qualitative Study of Attitudes toward Suicide and Suicide Prevention among Psychology Students in Ghana

Abstract: The purpose of the present study was to investigate attitudes toward suicide and suicide prevention among psychology students in Ghana by means of a qualitative analysis of open-ended questions abo...

Images of Heaven and the Spiritual Afterlife: Qualitative Analysis of Children’s Storybooks About Death, Dying, Grief, and Bereavement

Abstract: Many parents turn to picture books and storybooks to help explain issues surrounding death and dying to their young children. In addition to dealing with topics such as death, funerals, memories, and grief, a number of the books also mention the concept of heaven and what our loved ones might experience after they die. This article uses qualitative research methods to analyze 49 children's storybooks that touch on the existence of heaven or a spiritual afterlife. Results show that heaven is portrayed in a simplistic fashion, as a place high in the sky with bright lights, angels, and clouds. Even as heaven is presented in a relatively simple way, there are also patterned differences in depictions of the spiritual afterlife depending upon whether the decedent in the book was a family pet, a child, a parent, or a grandparent. The article concludes with a discussion of how these depictions of heaven and the afterlife might help young children cope with death-related grief.

Relationship to the bereaved and perceptions of severity of trauma differentiate elements of posttraumatic growth.

Abstract: The field of bereavement and grief has been expanding to recognise the potential for growth following the loss of a loved one. This study sought to examine the effect of the relationship to the deceased and perceptions of the severity of the trauma on dimensions of posttraumatic growth. Participants were 146 people who had lost either: a) a first degree relative, b) a second degree relative, or c) a non-related friend. Results demonstrated that both severity and the relationship to the bereaved differentiate posttraumatic growth outcomes. For example, participants who had lost a first degree relative reported higher levels of growth than those who had lost a second degree relative. Consistent with previous research in general trauma populations, the more severe the loss was rated, the higher the levels of growth. Implications for practice are discussed.

Motivation for Research Participation among People Bereaved by Suicide

Abstract: Few studies directly address vulnerable populations' motivation for participating in research. Often motives are expressed spontaneously and typically given post-interview. This article investigates motivation for research participation among informants who have been bereaved by suicide. Informants were specifically asked for their motivation either prior to, or directly after the interview. Four categories of motivations were identified: 1) Helping Others, 2) Venting, 3) Insight, and 4) Just Because. Sixty percent of informants gave more than one motivation. The majority was altruistically motivated; they hoped that by taking part they could play a role in helping to prevent suicide, improving services for the bereaved or moving research forward. Close family members were more likely to be motivated by a desire to help others than more distant family members. Findings are discussed in the context of suicide-related bereavements. Information about research participation as beneficial to others should be g...

The characteristics of those who do and do not leave suicide notes: Is the method of residuals valid?

Abstract: Examination of 1,051 completed suicides from an Australian state showed that 33% left a suicide note. Those leaving a suicide note were more involved in interpersonal conflicts (including divorce), were less often psychiatrically disturbed, and were less likely to be under medical supervision. The large number of differences suggests that it may not be possible to learn about suicide in general from a study of suicide notes alone.

Predictors of per Capita Alcohol Consumption and Gender-Specific Liver Cirrhosis Mortality Rates: Thirteen European Countries, Circa 1970–1984 and 1995–2007:

Abstract: Regression models of cross-national differences in social and economic predictors of per capita alcohol consumption and gender-specific cirrhosis mortality rates are developed for 13 European countries, first using 1970–1984 (period 1) data and then replicating with 1995–2007 (period 2) data. Regression analysis finds that stronger alcohol control policy laws and income inequality are highly significant predictors of consumption in both periods. Further, results show that alcohol consumption is a significant predictor of male mortality rates in both periods, while it is significant only in the second period for female cirrhosis mortality rates. Psychological well-being is a significant predictor for male and female cirrhosis mortality rates in both periods.

Perceived Benefits and Psychosocial Outcomes of a Brief Existential Family Intervention for Cancer Patients/Survivors:

Abstract: This study assessed a range of benefits from participation in a brief existential intervention consisting of a semi-structured videotaped interview with cancer patients and their families designed to illuminate a life legacy for the family (the Life Tape Project [LTP]). Results indicated the majority reported intervention-specific benefits, especially in the areas of symbolic immortality (passing on personal values and philosophy), self-reflection and growth, and improved family cohesion and communication. Participants, particularly those who had perceived their cancer as a threat of death, serious injury, or threat to their physical integrity, and responded with intense fear or helplessness, also reported more general reductions in mood disturbance, improvements in aspects of well-being (including overall quality of life), satisfaction with the understanding they received, and enhanced cancer-related posttraumatic growth. In short, the LTP is a brief, inexpensive, existential intervention that can yield ...

Sad to say: is it time for sorrow management theory?

Abstract: Terror Management Theory (TMT) research often asks respondents to describe their personal death. This exposure enables the testing of hypotheses regarding defenses (“buffers”) against the anxious awareness of death. Curiously, though, the respondents' narratives are not analyzed or reported. The present study offers a qualitative analysis of 209 college student narrative responses provided for this purpose by TMT researchers Jeff Greenberg and Nathan Heflick. The narratives are reviewed with attention to affect (adjectives), semantic structure, and theme. Many responses are marked by anxiety, but sorrow is also pervasive. Individual differences in response substance and structure invite further exploration. It is suggested that our understanding of the response to personal death threat could be enhanced by encompassing sorrow as well as anxiety within the same conceptual framework. Several specific hypotheses and suggestions are offered.

Qualitative Psychological Autopsy Interviews on Suicide in Post-Conflict Northern Uganda: The Participants' Perceptions

Abstract: Participants' perceptions of psychological autopsy interviews were investigated in post-conflict Northern Uganda. Data were derived out of their responses in the debriefing session after the formal interviews. These responses were subjected to Interpretative Phenomenological Analysis (IPA). The majority of the participants were positive about the interview as reflected in the two broad themes: positivation of the situation through the possibility of helping others and opportunity for personal development through sharing. To some few participants the interview aroused guilt, self-reproach, and anger and reactivated painful memories. As regards suicide postvention, the findings implied that not much has been done to help the bereaved by suicide in this region, and few resources for such efforts are currently available. However, the bereaved are ready to contribute toward the fight against suicide in their communities. Hence, it is argued that a community-based mental health and Primary Health Care approaches should be encouraged in this context.

Gardens of stone: searching for evidence of secularization and acceptance of death in grave inscriptions from 1900-2009.

Abstract: From the magnificent to the mundane to the sublime, grave inscriptions serve as remembrances of the dead and provide concrete evidence of the thoughts and values of the day. In this study, 1,214 grave inscriptions (N = 1,214) dated 1900 to 2009 were examined for evidence of secularization and changes in attitude toward death. Using set criteria, the researchers categorized grave inscriptions in terms of language used (sacred/secular) and acceptance of death (acceptance/other). Binary logistic regression models revealed significantly more use of sacred language and significantly less acceptance of death over the past 110 years. Findings from these analyses suggest that: (a) secularization may not be as pervasive as thought, particularly with respect to death; and (b) as death has become increasingly medicalized and marginalized, society has grown less accepting of the finitude of life. These findings are further discussed in light of the continued evolution of death memorials.

Perspectives of community members regarding tube feeding in patients with end-stage dementia: findings from African-American and Caucasian focus groups.

Abstract: Research has demonstrated that placement of permanent feeding tubes to provide artificial nutrition is more common among non-white populations, but there is a scarcity of research regarding why those differences may exist. The purpose of this study is to describe and understand community members' attitudes toward tube feeding and end-of-life decision-making. Four focus groups were convened in Greenville, NC. The 28 focus group participants were 11 African American and 17 Caucasian community members between ages 51 and 81. Two focus groups were held with Caucasian participants and two with African-American participants. Focus groups were recorded and transcribed, and qualitative analysis was performed using NVivo software.

Quality insights of university students on dying, death, and death education--a preliminary study in Hong Kong.

Abstract: Death is a subject seldom studied in school and often misunderstood and feared by many people. Children often learn about death from their family and mass media. From the literature review on dying, death, and death education, it may be concluded that people are generally ignorant about the issues of death and dying. There is a need to investigate what young people, such as university students, know about death and dying, and their attitudes toward them. Eight university students were recruited for this study. Most participants have had death experiences. They seldom talked about death and loss. Some of these experiences were quite pleasant but some of them were not. Most participants addressed the need to have “life and death” education in schools at their young age. Such a need is further supported by the incidents of two participants who attempted suicide unsuccessfully when they encountered a life problem which they could not solve.

A sociocultural analysis of death anxiety among older Japanese urbanites in a citizens' movement.

Abstract: By examining the experiences of death anxiety and attitudes toward personal deaths among members of a citizens' movement, the Grave-Free Promotion Society (GFPS), this study considers the applicability of the view that culture and high self-esteem serve as defenses against death anxiety in Japan's changing society. The GFPS promotes the scattering of ashes over the conventional interment of cremated remains in a family grave. GFPS members often lack descendants to care for a family grave, the neglect of which is thought to endanger the deceased's peaceful rest. By returning the dead to nature through ash scattering, the GFPS provides an alternative strategy of managing its members' posthumous well-being. GFPS members often report that their choice of ash scattering has reduced their anxiety about their personal deaths and improved the quality of their lives. Based upon these findings, this study offers some suggestions for increasing cultural sensitivities of test instruments commonly used to examine deat...

Religious Beliefs along the Suicidal Path in Northern Taiwan

Abstract: This study aimed to understand the current inclinations toward depression and compulsion for members of four different religious groups, and to predict religious beliefs along the suicide path through analyzing the lifetime prevalence of suicidal ideation and suicide attempts for members of these religious groups. Participants in this cross-sectional study, which adopted purposive sampling, were members of Christianity, Catholicism, Buddhism, and Taoism in northern Taiwan. In the case of suicide experiences, suicides among people one knows, and tendency toward compulsion and depression, there are statistical differences between the four religions. According to the results, some people with suicidal tendency will attend religious activities; therefore, we predict that religious beliefs play an important role in suicide prevention.

Cross-cultural re-entry for missionaries: A new application for the dual process model

Abstract: Susan Selby, Sheila Clark, Annette Braunack-Mayer, Alison Jones, Nicole Moulding, Justin Beilby

The continued lived experience of the unexpected death of a child.

Abstract: The purpose of this qualitative study was to further examine the lived experiences of families that faced the sudden loss of a child. Six mothers that had previously participated approximately 9 years ago in the study entitled “The Lived Experience of the Unexpected Death of a Child” were interviewed. All of the mothers were Caucasian and had achieved a high school or greater level of education. Taped interviews and field notes were transcribed for data display. Together, two raters completed data reduction and coding for theme identification and categorization. Six themes were revealed that described helpful coping behaviors used by the mothers: positive beliefs, faith beliefs, everlasting love, pleasant remembrances, social engagement, and staying connected. Two themes, avoidance and rumination, described the behaviors that did not help the mothers cope with their loss. Finally, answers to the questions regarding acceptance and healing time were also revealed.

What now? Cremation without tradition.

Abstract: Although cremation is an increasingly popular method of body disposal, there is little research on ash disposition, particularly the decisions and negotiations underlying the process. Americans who...

Bereavement and depression: possible changes to the diagnostic and statistical manual of mental disorders: a report from the Scientific Advisory Committee of the Association for Death Education and Counseling.

Abstract: The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is being revised. A proposed revision hotly debated is to remove what is known as the exclusionary criterion and allow clinicians to diagnose a person with a major depressive episode within the early days and weeks following a death. The Executive Committee of the Association for Death Education and Counseling (ADEC) commissioned its Scientific Advisory Committee (SAC) to examine the debate over removing the exclusionary criterion and provide a written report. The DSM-IV-TR classifies bereavement as a clinical condition that is not a mental disorder. The exclusionary criterion states that within the first 2 months of the onset of bereavement a person should not be diagnosed as having major depression unless certain symptoms not characteristic of a normal grief reaction are present. We note these symptoms when discussing the exclusionary criterion. In the report we identify the features that comprise the exclusionary criterion, examine reasons (including research conclusions and clinical concerns) given for retaining and for eliminating the exclusionary criterion, offer extensive comments from experienced licensed clinicians about the issues involved, discuss diagnostic and treatment implications, and offer specific recommendations for ADEC to implement.

Internal Connections and Conversations: The Internalized other Interview in Bereavement Work

Abstract: Much of the work of grief lies in the ways the bereaved learn to maintain connection to the deceased in their lives, while living alongside the physical absence of them. The theory of an Internaliz...

McDonaldization, Islamic teachings, and funerary practices in Kuwait.

Abstract: Drawing on George Ritzer's sociological concept of McDonaldization, this article explores the transformation of burial practices in Kuwait. It is argued that traditional, religious, and private way...

The Attitudes of Socially Marginalized Men toward Physician-Assisted Suicide

Abstract: Bioethics and public policy literature suggests that socially marginalized populations may be at increased risk for overuse of physician-assisted suicide (PAS) were it to become more accepted. Yet the attitudes of socially marginalized populations toward PAS have not been widely studied. The present study surveyed a sample of men in a substance abuse recovery program. Participants completed a PAS attitude questionnaire and a religiosity measure. Support for PAS was fairly evenly split, with 52.2% indicating general opposition to PAS and 46.9% indicating general support. Greater religiosity was associated with more negative attitudes toward PAS. Higher educational level was associated with more acceptance. Overall attitudes toward PAS were considerably more negative than those of Dr. George Domino's (2003) general population sample.