• Journal of Hospice and Palliative Care
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• 제10권3호
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• pp.120-127
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• 2007

Bereavement is the state of loss resulting from death. Grief is the emotional response associated with loss, intense and acute sorrow resulting from loss. Complicated grief represent a pathological outcome involving social, physical, emotional, cognitive, spiritual morbidity. The common psychiatric disorders associated complicated grief or abnormal grief responses include clinical depression, anxiety disorders, alcohol abuse or other substance abuse, and dependence, psychotic disorders, and post-traumatic stress disorder (PTSD). Grief tasks involve a series of stage or phases following an important loss that gradually permit adjustment and recovery. Three phases of grief involve phase 1 (walking the edges), phase 2 (entering the depths), and phase 3 (reconnecting the world). For intervention to be effective they need to be individually tailored to abnormal grief reaction or unresolved grief reaction. Clear understandings of complicated grief, abnormal responses, factors increasing risk after bereavement will often enable us to prevent psychiatric disorders in bereaved patients.

• 대한간호학회지
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• 제48권1호
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• pp.59-69
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• 2018

Purpose: The purpose of this study was to investigate variables and construct paths that affect complicated grief. Methods: Participants in this cross-sectional, descriptive study were 164 bereaved spouses of cancer patients at least 12 months before the death. Data were collected from October 2016 to February 2017 using self-report structured questionnaires and were analyzed using IBM SPSS 21.0 and AMOS 20.0. Results: The variables affecting complicated grief of bereaved spouses of cancer patients were the quality of end-of-life care (${\gamma}=.15$, p<.001), preparedness for death (${\beta}=-.06$, p=.005), and coping with bereavement (${\beta}=-.24$, p<.001), whereas the quality of death and dying did not show any effects. Preparedness for death had multiple mediating effects in the relationship between the quality of end-of-life care and complicated grief (z=-2.20, p=.028), and in the relationship between the quality of end-of-life care and coping with bereavement (z=2.11, p=.035). Coping with bereavement had a mediating effect on the relationship between preparedness for death and complicated grief (z=-2.39, p=.017). Conclusion: This study revealed that preparedness for death and coping with bereavement play a prominent role in complicated grief. Therefore, it is important to help in preparing for death and enhancing coping with bereavement of spouses providing end-of-life care to cancer patients. In addition, investigating cultural differences in the relationship between the quality of end-of-life care and complicated grief is recommended.

• 한국노년학
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• 제39권1호
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• pp.21-35
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• 2019

본 연구는 배우자 사별여부와 복잡성비애 수준이 노인의 죽음불안에 미치는 영향을 분석하여 죽음불안을 완화할 수 있는 개입방안을 제안하는데 목적을 두고 있다. 분석에 사용된 연구표본은 2014년 춘천노인생활실태 조사 자료의 65세 이상 노인 1,998명이다. 종속변수는 죽음불안(DAS-K), 독립변수는 배우자 사별여부와 복잡성비애(ICG-K) 수준이며, 인구·사회학적 변수와 건강관련 변수를 통제한 후 다중회귀분석을 수행하였다. 연구결과, 배우자 사별경험이 없는 집단에 비해 정상 비애군(normal grief)은 죽음불안 수준이 낮으며(p<.05), 복잡성 비애군(complicated grief)은 죽음불안 수준이 높은 것으로 나타났다(p<.01). 즉, 죽음불안에 가장 위험한 요인은 '배우자 사별'보다는 '복잡성 비애'라고 할 수 있다. 사별 자체는 보편적인 경험이라고 해도 사별 후 나타날 수 있는 증상이나 증상의 심각도 및 지속기간은 보편적이지 않을 수 있다. 그러므로 죽음불안에 직접적인 영향을 미치는 복잡성비애에 대한 관리가 중요하며, 이를 위해서 사별자 대상 상실·애도프로그램과 사별자 자조모임 등이 확산될 필요가 있다.

• 감성과학
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• 제26권3호
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• pp.101-114
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• 2023

반려동물은 점차 인간 삶의 중요한 동반자로 자리매김하고 있다. 이에 연구자들은 반려동물 상실과 이에 따른 애도에 주목하고 있다. 반려동물의 상실은 다른 상실과 달리 대개 그 부적응이 오래 지속되는 복합 애도로 나타나는 경우가 많다. 이러한 현상은 사람(vs. 반려동물)과의 관계가 더 중요하다는 사회적 인식에 기인하며, 이는 반려인이 자신의 상실 경험을 타인에게 제대로 이해받지 못한다고 여기게 만드는 일종의 '제약'으로 작용한다. 즉, 반려인의 지각된 사회적 제약은 이들의 반려동물 상실에 대한 회복을 저해하고 복합 애도를 유발하는 중요한 원인이 된다는 것이다. 따라서 본 연구는 반려동물의 죽음을 경험한 사람들을 대상으로 지각된 사회적 제약이 초기 상실 이후 적응을 방해함으로써 그 충격이 복합 애도로 이어지는 과정을 심화시킬 것이라고 가정하였다. 연구 결과, 예상대로 지각된 사회적 제약은 상실의 충격과 복합 애도의 관계를 조절하는 것으로 나타났다. 구체적으로, 반려동물 상실 충격으로 인한 복합 애도는 사회적 제약을 크게 지각할수록 더 강하게 나타나는 경향이 있었다. 본 연구는 반려동물 상실 경험과 애도를 이해하는 데 지각된 사회적 제약이 중요한 역할을 담당함을 보여줌으로써 사회적 인식 변화 및 개선의 필요성을 제안한다.

• 정신간호학회지
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• 제28권2호
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• pp.156-164
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• 2019

Purpose: The aim of this study was to identify factors influencing on the mental health in bereaved adults. Methods: A descriptive and correlational study was conducted in 160 adults who had experienced bereavement. The collected data was analyzed using descriptive statistics, Pearson's correlation, and hierarchical multiple linear regression analyses with SPSS 26.0. Results: The participants' mental health showed a positive correlation with complicated grief (r=.31, p<.001) and a negative correlation with grief and meaning reconstruction (r=-.30, p<.001). Sex, sleeping time, intimacy with the deceased, grief reaction, and grief and meaning reconstruction were significant factors influencing on the mental health. The total explanatory power of these variables was 31.8%. Conclusion: It is necessary to explore the persistent and impairing grief after experiencing bereavement. Our study findings will be fundamental evidence to develop nursing interventions to improve adult mental health dealing with bereavement and grief.

• Journal of Hospice and Palliative Care
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• 제24권2호
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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.

• 한국노년학
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• 제40권3호
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• pp.477-483
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• 2020

본 논문은 사별 후 알콜 관련 문제를 겪고 있는 남성 노인을 대상으로 하는 단기프로그램의 알콜 문제와 심리적 문제 경감의 효과성을 검증한 파일럿 연구이다. 연구 참가자는 최근에 배우자를 사별한 남성 노인이고 이들에 대해서는 연구에 관한 정보를 전하고 동의를 구하였다. 총 참가자는 26명으로 무작위로 두 그룹으로 나누었다. 13명은 알콜문제모니터링 프로그램에 나머지 13명은 비교 그룹에 속하였다. 프로그램 집단에 속한 연구 참가자들은 알콜 관련 문제와 복잡성비애를 포함한 심리문제가 비교 집단에 비해 통계적으로 유의한 수준으로 경감되는 결과를 보였다.

• 대한불안의학회지
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• 제14권1호
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• pp.44-52
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• 2018

Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

• 복식
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• 제58권3호
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• pp.49-62
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• 2008

The purpose of this study was to analyze the signification system between color and clothes systematically in black and white clothes. For this purpose, after examining the images of black and white clothes, we selected 55 clothes that represented as black and white and analyzed their meanings and the sources using semiotic framework, based on the work of Saussure and Barthes. The results as follows: First, the meaning in black and white clothes was generated from original color image. White clothes of religious person like Virgin Mary, Angel expressed pure and sacred color image. And black clothes like funeral dress expressed grief and death. Next, the meaning of black and white clothes was regenerated into modern color image by new environment. After industrial revolution, black was considered as a traditional men's fashion color. With diverse leisure activities, white sports wear appeared as active and clean image. Finally the source of the meaning of the clothes was the designer or the wearer. A little black dress by Chanel who was interested in simplicity and function represents an ideal of simple and sexy object. The situation is complicated by the fact that these three kinds of explanation may be found singly or mixed together.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권4호
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• pp.177-184
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• 2020

Objectives: This study aims to examine the effect of adolescent suicide survivors' experience on suicide death risk, and the effect of referral to mental health services (hereafter referral) in this regard. Methods: This study used the data of 878 suicide-deceased and suicide-attempted adolescents aged 8-19 years, managed by the Suicide and School Mental Health Institute from 2016 to 2018. Results: Regression analysis for main effects showed that although suicide experience had no direct effect on suicide death, non-referral status was associated with a greater risk of death by suicide. While the "non-suicide survivor with non-referral" and "suicide survivor with non-referral" groups showed 1.87 [adjusted odds ratio=1.87, 95% confidence interval (CI)=1.21-2.89] and 4.59 (adjusted odds ratio=4.59, 95% CI=2.02-10.42) times higher odds of suicide death, respectively, the "suicide survivor with referral" group showed no difference compared to the "non-suicide survivor with referral" group. Conclusion: From these findings, there is a need to strengthen referral to mental health services and apply complicated grief treatment to improve the mental health of adolescent suicide survivors.