• 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.

• Korean Journal of Social Welfare
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• v.65 no.4
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• pp.165-193
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• 2013

This study purposes to explore the growing process through spousal bereavement in later life, and to develop the theory. A qualitative research was conducted, and the participants were 17 seniors. The analysis according to Strauss and Corbin's grounded theory(1998), resulted in 143 concepts, 43 subcategories, and 19 categories. Range analysis according to paradigm showed that the causal conditions were 'marital relationships', 'independent/dependent tendencies', and 'emotional readiness for the death of a spouse', and the phenomena were 'depression', 'hopelessness', 'daily stress', 'psychological intimidation', 'regret', and 'sense of being freed'. The contextual conditions that affect these phenomena were 'desire for intimate personal relationships' and 'desire to maintain independence'; the action/interaction strategies to manage the phenomena were 'facing reality' and 'efforts for construction of the new life'; and the mediating conditions that promote or suppress these action/interaction strategies were 'social support' and 'spirituality'. The results were 'reconstruction of the meaning in life', 'increase in self-esteem', 'reinforcement of social network' and 'embrace and acceptance'. Furthermore, when personal growth after bereavement of a spouse was analyzed focusing on changes over time, the growth process consisted of three steps: 'sadness and despair', 'embracing and moving forward', and 'personal growth'. The pattern analyses were performed to typify recurring relations by category, and 5 types were derived. The results of our study show that personal growth after spousal loss is an integrative process in life after crisis, and can be conceptualized as the process of overcoming the despair that immediately follows the death of a spouse, seeking a new life by actively taking control, and discovering a strengthened self.

• Korean Journal of Social Welfare
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• v.67 no.2
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• pp.61-84
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• 2015

The purpose of this study was to develop the Post-bereavement Growth Inventory(PBGI) for the elderly and to evaluate its validity. The items for developing PBGI were compiled from a literature search, content validity review, and a preliminary survey. A main survey of 308 widowed persons(aged 60+) was conducted. The results were as follows. First, an exploratory factor analysis revealed six factors of the PBGI. The results of the confirmatory factor analysis supported a five-factor structure for the final 24 scale items of scale. Second, in terms of concurrent validity, the PGBI compared favorably with the "Personal Growth" scale from The Hogan Grief Reaction Checklist (HGRC: Hogan and Schimdt, 2001). Third, the results of contrast group validity tests demonstrated that the group scoring in the upper 30% on the scales of Psychological Well-being (PWB, Ryff and Keyes, 1995) and the Grief Reaction Inventory (GRI: Remondet and Hansson, 1987) showed a significantly higher degree of post-bereavement growth (PBG) than the group scoring in the lower 30%. Fourth, Cronbach's ${\alpha}$ values for the five factors were between .649-.856 and .907 overall, indicating high internal consistency. Finally, education had the most significant influence on PBG. All results indicated the high validity of the PBGI. The findings from this study could provide the rationale for practical interventions from a growth-oriented perspective for widowed persons, as well as an objective assessment tool for practitioners in clinical areas.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.143-151
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• 2005

Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

• Journal of Korean Academy of Nursing
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• v.37 no.7
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• pp.1119-1130
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• 2007

Purpose: This study was done to develop the concept of grief focusing on the process of spousal bereavement in Korea. Methods: The Hybrid model was used for analysis according to the 3 phases. An extensive literature review was done for the Theoretical phase. In-depth interviews were conducted with 15 participants whose spouses died within the past 3 years in the Field phase. In the Final analytic phase, the results in the Theoretical and the Field phases were compared, analyzed, and integrated according to the process of grief. Results: The antecedent of the concept of spousal grief was spousal death. The dimensions of grief were classified to inner dimensions related to oneself, relational dimensions related to family and others, and existential dimensions related to the meaning of being. The attributes of grief were physical suffering, decline of cognitive ability, heartbreaking sorrow, expectations and conflicts of a new life, social stigma, dependence on or resentment towards God, etc. The empirical referent of grief was physical, psychological, social, and spiritual health status. The grieving progressed through 3 phases-shock-emancipation, suffering, and integration. Conclusion: Nurses should recognize the importance of their unique position as supporters for grievers, and try to assess individual characteristics and to provide tailored nursing interventions.

• Psychiatry investigation
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• v.15 no.12
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• pp.1168-1173
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• 2018

Objective After the Sewol ferry disaster, bereavement with suicidal ideation was a critical mental health problem that was accompanied by various neuropsychological symptoms. This study examined the frontal alpha asymmetry (FAA), heart rate variability (HRV), and several psychological symptoms in bereaved family members (BFM) after the Sewol ferry disaster. Methods Eighty-three BFM after the Sewol ferry disaster were recruited. We assessed FAA, HRV, and psychological symptoms, including depression, post-traumatic stress, post-traumatic growth factor, anxiety, grief, and positive resources, between BFM with the presence and absence of current suicidal ideation. Results Compared to BFM without suicidal ideation, BFM with suicidal ideation showed a higher FAA with right dominance. Significant differences in psychological symptoms were observed between the groups. In BFM with suicidal ideation, the low: high frequency (LF:HF) ratio correlated with social resources and support. Conclusion The FAA and LF:HF ratio may be biomarkers that represent the pathological conditions of BFM with suicidal ideation. If researched further, they may shed light on the interaction between bereavement with suicidal ideation and social resources for therapeutic intervention.

• Korean Journal of Hospice Care
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• v.5 no.1
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• pp.42-49
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• 2005

To determine which are the culturally specific factors of Korean bereavement, this chapter focuses on the view of death and the traditional mourning process which reflect Korean values and norms. The formation of the Korean view and understanding of death has been strongly influenced by three of its major traditional religions: Shamanism, Buddhism, and Confucianism (Park:1994: Hao:1999) and Christianity more recently. Each religion has a different view of death and the appropriate expression of mourning. Korea accommodates funeral customs and rules strictly as a cultural system and has retained these traditions over a long period; hence, some of the traditional funeral rituals still remain in modern Korean life, although some of the rites have been simplified. We have looked at the various ways in which grief and mourning is displayed and shared in a collective manner over a long period of time. This fits in well within the other Eastern cultures that are collectively organized, and contrary to the Eurocentric models do not hastily seek to detach the living from the dead and recognize that grief is a long process, and different individuals may take different amounts of time to recover from the grief. The view of death and bereavement in Korea has sprung from the roots of three Korean religions, together with the recent addition of Christianity, although they mainly result from the three earlier religions. The beliefs of these religions are still closely linked together in the rituals of Korean bereavement on both conscious and unconscious levels. The influence of these religions is evident in practice through the bereaved family's mourning reactions, funeral rites and customs and its views about death. Korea used to have a period of mourning for three years, following traditional mourning rites; then the chief mourner and the bereaved families could return to their normal life. In spite of this long mourning process for the bereaved family, once the funeral ceremony is finished, people expect the bereaved family not to express their grief in public; even the bereaved family does not like to talk about death. The process for bereaved people is related to mourning processes in terms of detachment from the deceased in order to start a new life. Relatives and the community recommend the performance of the kut ceremony for relieving the grief of the bereaved. When one family member dies in an unlucky way, the bereaved family may have some fear or other psychological reactions of grief such as pain, depression, insomnia and nightmares, hallucinations or other physical reactions. Unlucky deaths give the bereaved a very painful time and these types of reactions are often more serious than reactions to natural death. But through the kut ceremony, the bereaved family can start to make a new relationship with the deceased. The taboo of this type of death and death generally remains a crucial aspect of the isolation that bereaved people might face and the collective nature of mourning(even where it is still present) is unable to address this aspect of the privatization of grief.

• Korean Journal of School Psychology
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• v.18 no.1
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• pp.121-151
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• 2021

This study aimed to identify the factors that helped and hindered secondary school teachers who experienced student suicide using the concept-mapping approach. Seven South Korean middle and high school teachers were interviewed from which 113 core statements were elicited. The participants sorted these core statements into categories by meaning. Multidimensional scaling and hierarchical cluster analysis were conducted to identify the underlying structure of the teachers' experiences. Four hindering factor clusters emerged: (1) regret over failing to prevent the suicide, (2) an apathetic atmosphere in the school, (3) a sense of helplessness related to suicide survivors, and (4) approach-avoidance conflicts related to suicide survivors. Six helpful factor clusters emerged: (1) cooperation and care offered between suicide survivors, (2) focusing on the present, busy life, (3) spiritual activity, (4) social support, (5) overcoming grief through altruistic behaviors, and (6) sympathy for the deceased. Two dimensions were found for both the hindering and helpful factors. The hindering factor dimensions were external system-internal experiences and related to suicide survivors-related to suicide decedents. The helpful factor dimensions were distancing from the loss-approaching the loss and professional activities-personal activities. The present study empirically explored and described the underlying structure of teachers' bereavement experiences after student suicides.

• Journal of Technologic Dentistry
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• v.25 no.1
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• pp.119-142
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• 2003

In the present work the knowledge of dental health as well as dental prosthesis has been studied on the basis of analysis of current dental prosthetic treatments for dental diseases prophylaxis and the final decision for dental prosthetic appliance. The results have been analyzed by the current dental health care and the subjective acknowledgement from 700 people of urban as well as rural inhabitance in our country. The results from the present work have been summarized as following: Depending dental status has been shown worse to be in the cases of divorce and bereavement, age and less educated or jobless. It is also interesting to note that the dental status has shown to be even worse than health status. It has been shown that the dental prosthetic treatments have been mainly caused by the oral disease (62.2%) and depend on the age and the educational level. According to the actual status of dental prosthetic treatments, the fixed partial denture was the most case (78.9%) that increased as divorced, bereavement and as less educated, less income, retired and jobless as well as from urban to rural. As a clinic for the dental prosthetic treatments, dental clinics have been most frequent visited as indicated by 59.6%, then the un-licensed dentist (6.5%), then the hospitals (3.7%), then the public health centers (2.2%). Most of those who are older in age, less educated and jobless have been treated by the un-licensed dentists. In point of view on the cost for dental prosthetic treatments, 93.1% have claimed to be too expensive, in as the divorced and the bereaved, the older age, the less educated and the jobless. About satisfaction of dental prosthetic treatments, 51.4% was satisfied, 39.4% was normal and 9.2% was dissatisfied. Most of people experienced increasing levels of satisfaction as their income increase. Most in the age range of 40-60 have wanted to be insured for the dental prosthetic treatments. It is also interesting to note that the older age and the less educated wanted to apply this kind of insurance.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.2
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• pp.172-181
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• 2006

Purpose: This study was done to identify observation and performance of nursing role activities by student nurses graduating from 3 year junior colleges or 4 year universities. Method: A descriptive design was used and the participants were 295 student nurses who were graduating. Data were collected using a structured questionnaire. Results: The average score for observation of nursing role activity was $2.16{\pm}0.29$, and for performance $1.61{\pm}0.29$. Among the college students, the mean item score for observation was highest for medication administrator and lowest for provider of spiritual & bereavement care, while for the university students the highest was for provider of care during surgery and lowest for provider of spiritual & bereavement care. The college students had higher scores for observation, and the university students for performance. Conclusion: It is concluded that standardized practice learning programs need to be designed in schools and in clinical practice areas, in order to further develop adaptability to nursing roles.