Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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An Analysis of John Bowlby's Mourning Stages in Family Art Therapy as a Way to Help the Family Mourning Process

  • Seon Ah Yang (Graduate School of Education, Hongik University) ;
  • Sung Hee An (Graduate School of Education, Hongik University) ;
  • Cho Hee Kim (Department of Nursing, College of Nursing, Kangwon National University) ;
  • Min-Sun Kim (Integrated Care Center, Seoul National University Children's Hospital)
  • Received : 2022.10.20
  • Accepted : 2023.03.13
  • Published : 2023.06.01
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Abstract

Purpose: Pediatric palliative care is a rapidly developing multidisciplinary approach that supports children with life-limiting conditions and their families. However, there is limited evidence on how to effectively support bereaved parents and siblings. The purpose of this study is to explore the therapeutic impact of art therapy for bereaved families, in accordance with John Bowlby's four-stage theory of mourning. Methods: This single-case study employed the consensual qualitative research method. Art therapy records of bereaved families were reviewed individually, and records from one case were selected. Verbal statements made during the art therapy sessions and photocopies of the artworks were analyzed to understand the mourning process of the family. Results: A total of 113 statements and 12 artworks from 19 art therapy sessions were analyzed. As the art therapy progressed, each family member exhibited a pattern of engaging in more positive and healthy conversations in daily life, demonstrating the final stage of mourning: reorganization and recovery. The family dynamics also revealed that they reconstructed their inner world and redefined the meaning of loss, which is the final stage of mourning. The art therapy provided a safe environment for the family, allowing them to fulfill their wishes and regain the strength needed for recovery. Conclusion: This study suggests that art therapy supports bereaved families in alleviating their psychological difficulties, engaging in a healthy mourning process, and functioning as members of society. Further research is needed to better understand the effect of art therapy as a bereavement support tool in pediatric palliative care.

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References

  1. Kim CH, Kim MS, Shin HY, Song IG, Moon YJ. How to implement quality pediatric palliative care services in South Korea: lessons from other countries. J Hosp Palliat Care 2019;22:105-16.  https://doi.org/10.14475/kjhpc.2019.22.3.105
  2. Hartley J, Bluebond-Langner M, Candy B, Downie J, Henderson EM. The physical health of caregivers of children with life-limiting conditions: a systematic review. Pediatrics 2021;148:e2020014423. 
  3. Cha YR. Current status on studies of bereaved family in Korea: research trends for 1994-2013. J Hosp Palliat Care 2014;17:134-41.  https://doi.org/10.14475/kjhpc.2014.17.3.134
  4. Lykke C, Sjogren P, Ekholm O. Losing a child due to a life-limiting diagnosis-parental well-being and quality of life: nationwide survey. BMJ Support Palliat Care 2021:bmjspcare-2021-003251. Epup 2021 Dec 30. 
  5. Kim CG. Bereavement care in hospice and palliative care. Korean J Hosp Palliat Care 2007;10:120-7. 
  6. Hileman JW, Lackey NR. Self-identified needs of patients with cancer at home and their home caregivers: a descriptive study. Oncol Nurs Forum 1990;17:907-13. 
  7. Laizner AM, Yost LM, Barg FK, McCorkle R. Needs of family caregivers of persons with cancer: a review. Semin Oncol Nurs 1993;9:114-20.  https://doi.org/10.1016/S0749-2081(05)80107-X
  8. Yates P. Family coping: issues and challenges for cancer nursing. Cancer Nurs 1999;22:63-71.  https://doi.org/10.1097/00002820-199902000-00012
  9. Kristjanson LJ, Ashcroft T. The family's cancer journey: a literature review. Cancer Nurs 1994;17:1-17.  https://doi.org/10.1097/00002820-199402000-00001
  10. Park EH, Kim SH. The effects of family art therapy on mourning and emotional stability in bereaved families. Korean J Art Ther 2019;26:83-109.  https://doi.org/10.35594/kata.2019.26.1.004
  11. Jeon HJ, Park JY, Bang JE, Min SJ, Kim TE. A qualitative meta-synthesis of the mourning art therapy for overcoming bereavement. Korean J Art Ther 2021;28:1479-95. 
  12. Ryckoff IM. Family therapy and evaluation through art, by Hanna Yaxa Kwaitkowska (Book Review). Psychiatry 1979;42:285. 
  13. Choi HJ, Kim HS. A case study of effect family therapy in art on the family function of mentally retarded youth family. Korean J Art Ther 2009;9:33-56. 
  14. Bowlby J. Attachment and loss. Vol. 3. Loss: sadness and depression. London:Hogarth;1980. 
  15. Holmes J. John Bowlby and attachment theory. Lee GS, Translator. Seoul:Hakjisa;2005. 
  16. Chang SK. A case study on art-therapy for overcoming grief with the bereaved families. Korean J Christ Couns 2010;20:227-64. 
  17. Hill CE. Consensual qualitative research: a practical resource for investigating social science phenomena. Ju ES, Translator. Seoul:Hakjisa; 2016. 
  18. Sandelowski M. The problem of rigor in qualitative research. ANS Adv Nurs Sci 1986;8:27-37.  https://doi.org/10.1097/00012272-198604000-00005
  19. Oh YJ. The study of symbol of mourning on the mandala of bereavement adult - the case study of Mandala art therapy for the reduction of depression. Korean J Art Ther 2008;8:1-21. 
  20. Lee KM. Dictionary for symbol. Seoul:Hakjisa;2017. 
  21. Jung HJ. Qualitative case study on 3D tree making through single art therapy session for female with depression In early adulthood [master' s thesis]. Seoul: Ewha Womans Univ.; 2019. Korean. 
  22. Yoon HW. A study on Frida Kahlo's self-portrait from the perspective of art therapy [master's thesis]. Youngin: Dankook Univ.; 2012. Korean. 
  23. Choi WS, Jung EJ, Kim KS, Jung KS. Art therapy technic 2. Seoul:Hakjisa;2013. 
  24. WON HR. The therapeutic factor and clinical application of plaster in art therapy. Korean J Art Ther 2007;14:151-72.  https://doi.org/10.35594/kata.2007.14.1.008
  25. Kim MA, Kim CK, Jung DH. Needs and preferences of bereavement support services from the perspectives of parents who lost a child and adolescents with cancer. Health Soc Welfare Rev 2019;40:360-400. 
  26. Lee WH, Hwang AR. Grief stages and responses of bereaved mother who lost her children with cancer. J Korean Acad Adult Nurs 2003;33:847-55.  https://doi.org/10.4040/jkan.2003.33.6.847