• Title/Summary/Keyword: Bereavement Care

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Practical Considerations in Providing End-of-Life Care for Dying Patients and Their Family in the Era of COVID-19

  • Kim, Yejin;Yoo, Shin Hye;Shin, Jeong Mi;Han, Hyoung Suk;Hong, Jinui;Kim, Hyun Jee;Choi, Wonho;Kim, Min Sun;Park, Hye Yoon;Keam, Bhumsuk
    • Journal of Hospice and Palliative Care
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    • v.24 no.2
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    • pp.130-134
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    • 2021
  • In the era of coronavirus disease 2019 (COVID-19), social distancing and strict visitation policies at hospitals have made it difficult for medical staff to provide high-quality end-of-life (EOL) care to dying patients and their families. There are various issues related to EOL care, including psychological problems of patients and their families, difficulties in EOL decision-making, the complicated grief of the bereaved family, moral distress, and exhaustion of medical staff. In relation to these issues, we aimed to discuss practical considerations in providing high-quality EOL care in the COVID-19 pandemic. First, medical staff should discuss advance care planning as early as possible and use the parallel planning strategy. Second, medical staff should play a role in facilitating patient-family communication. Third, medical staff should actively and proactively evaluate and alleviate dying patients' symptoms using non-verbal communication. Lastly, medical staff should provide care for family members of the dying patient, who may be particularly vulnerable to post-bereavement problems in the COVID-19 era. Establishing a system of screening high-risk individuals for complicated grief and connecting them to bereavement support services might be considered. Despite the challenging and limited environment, providing EOL care is essential for patients to die with dignity in peace and for the remaining family to return to life after the loved one's death. Efforts considering the practical issues faced by all medical staff and healthcare institutions caring for dying patients should be made.

Nurses' attitudes and stress related to perinatal bereavement care in Korea: a cross-sectional survey

  • Kim, Eunhui;Kim, Hae Won
    • Women's Health Nursing
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    • v.28 no.2
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    • pp.134-144
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    • 2022
  • Purpose: A descriptive correlational survey was conducted to examine nurses' attitudes and stress related to perinatal bereavement care (PBC) and their relationships, with the ultimate goal of improving nurses' capabilities related to PBC. Methods: Korean nurses (N=136) who had experienced perinatal death at least once were recruited from seven hospitals. Data were analyzed using descriptive statistics. The Korean version of Nurses' Attitudes towards Perinatal Bereavement Support was assessed in terms of three subdomains (attitudes to PBC, importance of policies related to PBC, and importance of training related to PBC), and nurses' stress was measured. Results: The participants gave high scores for the attitude-related items of "giving sufficient time to bereaved parents to mourn for their dead baby" (4.54 points) and "nurses should treat bereaved parents with respect and dignity" (4.51 points), and they perceived a high level of importance for the policy-related items of "every staff member in the hospital should understand the policies relevant for PBC" and "when nurses feel emotional exhaustion, they should seek support" (4.58 points). Nurses' attitude toward PBC was associated with the perceived importance of policies (r=.40, p<.001), the perceived importance of PBC-related training (r=.61, p<.001), and stress related to PBC (r=.29, p<.001). Nurses' perceived importance of PBC-related training was associated with stress related to PBC (r=.38, p<.001). Conclusion: Establishing hospital policies related to PBC and providing PBC training for nurses could positively affect nurses' attitudes toward PBC. A stress management program for nurses could reduce the stress caused by PBC.

A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE (세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구)

  • Wang, Mae-Ryeon
    • The Korean Nurse
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    • v.31 no.2
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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Experiences of Spousal Bereavement in Middle Aged Men (중년남성의 배우자 사별경험)

  • Park, Kyung-Bok;Kim, Boon-Han
    • Asian Oncology Nursing
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    • v.4 no.2
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    • pp.143-153
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    • 2004
  • Death of spouse is the most heartbreaking stressful and inevitable tragic life event. In middle aged men who belong to the social middle class and accomplished their occupational success, experiences of spousal bereavement are great shock. The aim of this study was to find out how they overcome their mental and physical pain and to obtain the basic materials to develop suitable nursing care programs for them. The methodological approach of this study is Giorgi's phenomenological analysis meaning unit. This method also makes theme focal meaning, situated structural description and create general structural description grasped by participator's experience through situated structure description. This study performed from November 2002 to May 2004, and participators were four men. Data collected through in-depth personal interviews. which had been tapped and analysed the Giorgi's method. Finally, the five focal meaning below have been abstracted. Theme 1. Physical symptom loss of appetite, fatigue, insomnia. outbreak of illness, weight loss. Theme 2. life of spiritless lack of desire, sense of emptiness, unstableness, prosaic life. wandering. indifference of appearances, avoidance of meeting people. Theme 3. life of retrospction reflection for his wife, yearning, grief, muttering to himself, never-to-be forgotten wife, leading a lonely life. Theme 4. negative emotion reproaching, feeling hurt, marriage of daughter, feeling heavy, getting angry, sexual desire, awareness of his sinfulness. loneliness Theme 5. social support and adjustment getting his wife off his mind, curring favor with children, support and consolation by his daughter-in-law, appreciation for hospice nurse, considering remarriage, taking care of himself, good relation with his children. The result of this study showed that middle aged men bereaved of their wife by cancer need other's concern. And we have to study further to understand their experience. Until now hospice nursing is concentrated on cancer patients But from now we have to provide their families suitable nursing care programs to adjust themselves to social life before and after death of patients.

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A Narrative Inquiry on the Experience of Bereavement to an Elderly Male (남성 노인의 사별 경험에 관한 내러티브 탐구)

  • Kim, Seo Hyun
    • 한국노년학
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    • v.38 no.1
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    • pp.103-123
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    • 2018
  • The purpose of this research is to study how an elderly male lives after the experience of bereavement, and to understand the experience's essence. The researcher picked 3 elderly men living alone after separation by death as test subjects and gathered information through in-depth interviews. The analysis of the information was done based on the three-dimensional space of narrative presented by Clandinin and Connely(2000), and it restructures the common experience under five meanings. The mutual themes of 'It's the life of a sinner, but not wanting to be seen as a widower to others', 'The fear for death, and the preparation for after death', 'Trying to stay alive for the children', 'Entering the world to find meaning in a gloomy life', and 'A lone goose lost in search of social warmth' came from the research results. The essence of the experience studied with the mutual themes as basis came out to be 'A struggle to take flight again after one broken wing'. This research has a major significance in that elderly males' experience of bereavement was studied in the dimension of time continuity, and that individual social interactions that are made by elderly males to continue their lives after the experience of bereavement were studied.

An Analysis of John Bowlby's Mourning Stages in Family Art Therapy as a Way to Help the Family Mourning Process

  • Seon Ah Yang;Sung Hee An;Cho Hee Kim;Min-Sun Kim
    • Journal of Hospice and Palliative Care
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    • v.26 no.2
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    • pp.27-41
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    • 2023
  • 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.

Study on Remarriage of Bereaved or Divorced Old People -Emphasis on successful remarriage in Chonju Area- (사별 및 이혼한 노인의 재혼에 관한 연구 I -전주시 거주 재혼한 노인의 성공사례를 중심으로-)

  • 이정덕
    • Journal of the Korean Home Economics Association
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    • v.35 no.2
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    • pp.255-272
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    • 1997
  • In the point of view, this study aims to examine the life of remarriaged old people after divorce and bereavement. therefore, the purpose of this study is to increase the understanding of married couple's relationship and remarriage in old age and help old people who want to be abused about their remarriage as a coping response of lire for widowhood in old aged. the subject were 14 old people who married over 53 years old bereavement and divorce residing in Chonju, Chonbuk and they had indepth interviews. 1. Most of subject would married with help of matchmaker under the consent a children and relative 2. The main motivation of remarriage was lone lies, however, for men being taken care and for women economic security were also important. 3. Premarriage experience seemed to help spouse adjustment between couples. 4. They matintained close relationship with there biological children. 5. There show a tendency to the bereavement woman remarriage life was happier than divorce woman. 6. When one of the couple had regular income, little economic conflict was there. In most case, wifes were younger than husband and economic stability after husband's death was their main concern and when the husband didn't show definite will to inherit asset to his wife, conflict got bigger.

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Hospice Volunteer's Experiences in Caring for Cancer Patients (호스피스 자원 봉사자들의 암 환자 돌봄에 대한 경험)

  • Kim, Boon-Han;Kim, Yoon-Sook;Jung, Yun
    • Asian Oncology Nursing
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    • v.5 no.2
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    • pp.79-86
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    • 2005
  • Purpose: This study was explored the meaning of hospice volunteer's experience in caring for cancer patients and tried to understand their experiences. Method: The data was collected from 7 participants living in Seoul and Gyeonggi province from Jan. to Apr. 2005. Collection of data was by means of in-depth interviews. The analysis of the data was made the phenomenological analytic method suggested by Colaizzi(1978). Result: The result is consisted of nine theme-cluster; experienced a fear, limitation of activity, experienced social care, experienced physical care, good death, experienced necessity of recharging, experienced bereavement care. Conclusion: The result above indicated that health professionals must develop the management and education of volunteer of hospice care for various hospice care. Also, We should to encouraged the continuous education and efficient management. And support system should be developed.

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호스피스 자원봉사자의 활동과 영적안녕에 관한 연구

  • Cha, Yeong-Nam;Han, Hye-Sil;Jeong, Jeong-Suk;Yun, Mae-Ok;Choe, Eun-Ju
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.41-57
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    • 2002
  • This study was done to examine spiritual well-being of hospice care service volunteers for the purpose of providing them with programs promoting coping skills in response to the wholistic needs of patient effectively, also providing data for professional or nonprofessional hospice training program. Subjects were 123 volunteers serving in 6 hospice centers in Jeonbuk province at present. Data collection were done from 16 Oct. 2000 to 17 Nov. 2000. questionnairs were consisted of activities of hospice care service volunteer and spiritual well-being. The study results were as follows 1.Mean of activities of hospice care service volunteers were 2.433, those activities were divided into 5 categories such as spiritual, activities of volunteer for themselves, psychosocial, physical area and bereavement. The highest mean score was spiritual area 2.578, activities of volunteers for themselves 2.525, psychosocial area 2.456, physical area was 2.359 and the lowest mean score was bereavement area 2.130. 2.Spiritual well-being of hospice care service volunteers was 5.25, the highest mean. In subcategories of spiritual well-being, religious spiritual well-being was higher than existential spiritual well-being, mean score for each one was 5.41, 5.10. 3.Statistically significant relations among demographic characteristics such as gender(t=2.72, P=.008), status of marriage(t=6.067, P=.003), occupation(F=3.795, P=.025), frequency of visiting for volunteered hospice care(F=3.833, P=.024) were noted. 4.Statistically significant demographic characteristics of hospice service volunteers was religion(t=-4.38, p=0.000), status of marriage(F=3.505, p=0.033), frequency of visiting for volunteered hospice care(F=3.107, p=0.048), level of satisfaction from hospice care volunteer service(F=3.610, p=0.030), hospice service volunteers doing more home visiting(5-9times/month) had higher status of spiritual well being than volunteer with less home visiting(1-4times/month) 5.A significant relationship between activities of hospice service volunteers and status of spiritual well-being was noted(r=.236, p=.004), activities of hospice service volunteers was related to both subcategories of spiritual well-being such as religious well-being(r=.210, p=.010) and existential well-being(r=.208, p=.011). From the results of the study It is noted that status of spiritual well-being for hospice volunteers influences on service activities. It means spiritual well-being should be considered as a essential character for hospice service volunteers, it also means that managing and maintaining of status of spiritual well-being for hospice service volunteers is important. On the base of the study recommendation are made as follows: 1.Considering status of spiritual well-being for hospice care service volunteers is needed to promote hospice care activities. 2.It is necessary to develope spiritual well-being programs for hospice care service volunteers and further study for effect validation of them is needed. 3.Further study to sort out effecting variables for hospice care service volunteer activities is needed. 4.It will be desirable to have spiritual well-being information included in the hospice education program.

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