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Firouzkouhi M, Abdollahimohammad A, Alimohammadi N, Naderifar M, Akbarizadeh M. Lived Experiences of Critically Ill COVID-19 Patients About Death and Dying: A Descriptive Phenomenology. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:333-346. [PMID: 35098799 PMCID: PMC8801334 DOI: 10.1177/00302228211073269] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Thinking about death is one of the most common problems of critically ill patients with COVID-19 in ICUs. Therefore, this study aims to explore the experiences of critically ill patients with COVID-19 about death and dying. This is a descriptive phenomenology approach. Participants in this study had 12 participants who were purposefully selected. The data collection method was semi-structured through interviews. Data were analyzed based on Colaizzi's approach. Data analysis generated two main themes, including personal, and non-personal; challenge thinking about death, and eight sub-themes. Thinking about the death of critically ill COVID-19 patients is a significant challenge that affects the patient's health and prolongs the treatment process. Therefore, it should be careful in the patient's treatment and care program.
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Affiliation(s)
- Mohammadreza Firouzkouhi
- Department of Medical Surgical, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Abdolghani Abdollahimohammad
- Department of Medical Surgical, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Nasrollah Alimohammadi
- Department of Nursing Intensive Care, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahin Naderifar
- Department of Nursing, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Majidreza Akbarizadeh
- Department of Pediatrics, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran
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Sperling D. "They choke to death in front of your very eyes": nurses' lived experiences and perspectives on end-of-life care during COVID-19. BMC Palliat Care 2024; 23:35. [PMID: 38331781 PMCID: PMC10854065 DOI: 10.1186/s12904-024-01352-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic led to an intensified fear and threat of dying, combined with dying and grieving in isolation, in turn significantly impacting nursing in end-of-life situations. The study aims (1) to understand the lived experiences of nurses who provided care to end-of-life patients during COVID-19; and (2) to explore whether providing care under such circumstances altered the perspectives of these nurses regarding end-of-life care. METHODS Applying the phenomenological-interpretive qualitative approach, 34 in-depth semi-structured interviews were conducted between March 2020-May 2021 with nurses from eight hospitals in Israel who were recruited through purposive and snowball sampling. Thematic analysis was applied to identify major themes from the interviews. RESULTS Five main themes emerged from the analysis, including: (1) a different death; (2) difficulties in caring for the body after death; (3) the need for family at end-of-life; (4) weaker enforcement of advance care directives; and (5) prolonging the dying process. DISCUSSION During the pandemic, nurses encountered numerous cases of death and dying, while facing ethical and professional issues regarding end-of-life care. They were required to administer more aggressive care than usual and even necessary, leading to their increased moral distress. The nurses' ethical concerns were also triggered by the requirement to wrap the corpse in black garbage-like bags to prevent contagion, which they felt was abusing the dead. The findings also demonstrate how family presence at end-of-life is important for the nursing staff as well as the patient. Finally, end-of-life situations during the pandemic in Israel were managed in an individual and personal manner, rather than as a collective mission, as seen in other countries. CONCLUSIONS The study offers insights into the nurses' attitudes towards death, dying, and end-of-life care. An emphasis should be placed on the key elements that emerged in this study, to assist nurses in overcoming these difficulties during and after medical crises, to enhance end-of-life care and professionalism and decrease burnout.
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MacNeil A, Findlay B, Bimman R, Hocking T, Barclay T, Ho J. Exploring the Use of Virtual Funerals during the COVID-19 Pandemic: A Scoping Review. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:425-448. [PMID: 34550814 PMCID: PMC10647914 DOI: 10.1177/00302228211045288] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic and physical distancing limitations have had a profound impact on funeral practices and associated grieving processes. The purpose of the present scoping review is to summarize the existing literature on the emerging use of virtual funerals. Five medical databases, five social science databases, and five grey literature databases were searched, identifying 1,351 titles and abstracts, of which 62 met inclusion criteria. Four themes, each with various subthemes emerged: (a) Impact of virtual funerals on coping with death; (b) Impact of the COVID-19 pandemic on the funeral industry; (c) Benefits and disadvantages of virtual funerals; and (d) Future implications for health and social work practitioners. Virtual funerals are an evolving resource for individuals, families, and communities to mourn in response to the interruptions to traditional grieving practices due to the COVID-19 pandemic.
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Affiliation(s)
- Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Blythe Findlay
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Rennie Bimman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Taylor Hocking
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Tali Barclay
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Jacqueline Ho
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
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Moya-Salazar J, Cañari B, Zuñiga N, Jaime-Quispe A, Contreras-Pulache H. The End of Life Accompanied by COVID-19: A Qualitative Study on Changes in Behavior and Stigmatization of the Grieving Families in Peru (Part II). OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231212655. [PMID: 37934453 DOI: 10.1177/00302228231212655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
The rapid spread of SARS-CoV-2 has led to changes in every aspect of life and death. In Peru, where the longest quarantine has occurred with suboptimal results, the rituals have been turned around, impacting the relatives in multiple aspects. Here, we used a qualitative approach to analyze unresolved grief, hygiene changes, and stigma through semi-structured, online (Google Meet) interviews with 15 participants aged 20-72, who had lost family members to COVID-19. The recorded and transcribed interviews were analyzed using reflexive thematic analysis. Most participants had unresolved grief due to the blocking of funeral rituals, which could predispose them to prolonged mourning. After the loss of relatives, hygiene measures will be improved to avoid infections and new deaths in every family, while most participants felt no stigma in their milieu, since their relatives accompanied them during the funeral, supporting them from afar. It is important that interventions are implemented to prevent the progression of grief by providing mental health opportunities for the bereaved.
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Affiliation(s)
- Jeel Moya-Salazar
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- School of Biomedical Engineering, Faculty of Engineering, Universidad Tecnológica Del Perú, Lima, Peru
| | - Betsy Cañari
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
| | - Nahomi Zuñiga
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
| | - Alexis Jaime-Quispe
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
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Jarnkvist K. Articulations of 'Funeral' in Swedish Newspapers During the Covid-19 Pandemic. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231174601. [PMID: 37165654 DOI: 10.1177/00302228231174601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This article explores how 'funeral' was articulated in Swedish newspapers during the Covid-19 pandemic and how such articulations relate to power and ideology. Articles from the six most prominent Swedish newspapers, published over 2 years, have been analyzed using critical discourse analysis and intersectionality. The study reveals three funeral discourses dominating during different periods of the pandemic: 'Funeral as a risk,' 'Funeral as an essential ritual,' and 'Funeral as a profession.' Altogether, the three discourses expose an ideal of 'the responsible mourner.' This rational woman follows the funeral restrictions and arranges a church funeral shortly after the death of a relative. The 'good funeral' is portrayed as a church funeral with physically present mourners, performed according to the deceased's will and in honor of the dead. The 'bad funeral,' described as the opposite of the 'good funeral,' dominates the understanding of the pandemic funeral situation.
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Affiliation(s)
- Karin Jarnkvist
- Department of Humanities and Social Sciences, Mid Sweden University, Sundsvall, Sweden
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Buckley A, Dodd A, Guerin S. Grief and bereavement in the time of COVID-19: a thematic analysis exploring psychotherapists’ observations of clients’ experiences. COUNSELLING PSYCHOLOGY QUARTERLY 2023. [DOI: 10.1080/09515070.2023.2186834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- Amy Buckley
- School of Psychology, University College Dublin, Belfield, Ireland
| | - Anne Dodd
- School of Psychology, University College Dublin, Belfield, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Belfield, Ireland
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Scott MA, Olszowy KM, Dancause KN, Roome A, Chan C, Taylor HK, Marañon-Laguna A, Montoya E, Garcia A, Mares C, Tosiro B, Tarivonda L. Challenges and opportunities in rapid disaster research: lessons from the field in New Mexico and Vanuatu. FRONTIERS IN SOCIOLOGY 2023; 8:983972. [PMID: 37152207 PMCID: PMC10157172 DOI: 10.3389/fsoc.2023.983972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 03/28/2023] [Indexed: 05/09/2023]
Abstract
Rapid research is essential to assess impacts in communities affected by disasters, particularly those communities made "hard-to-reach" due to their active marginalization across history and in contemporary practices. In this article, we describe two rapid research projects developed to assess needs for and experiences of communities hard-hit by disasters. The first is a project on the COVID-19 pandemic in southern New Mexico (USA) that was developed to provide information to local agencies that are deploying programs to rebuild and revitalize marginalized communities. The second is a project on population displacement due to a volcanic eruption in Vanuatu, a lower-middle income country in the South Pacific, with mental and physical health outcomes data shared with the Vanuatu Ministry of Health. We describe the similar and unique challenges that arose doing rapid research in these two different contexts, the potential broader impacts of the research, and a synthesis of lessons learned. We discuss the challenges of rapidly changing rules and regulations, lack of baseline data, lack of survey instruments validated for specific populations and in local languages, limited availability of community partners, finding funding for rapid deployment of projects, rapidly training and working with research assistants, health and safety concerns of researchers and participants, and communicating with local and international partners. We also specifically discuss how we addressed our own personal challenges while also conducting time-intensive rapid research. In both studies, researchers shared results with governmental and non-governmental partners who may use the data to inform the design of their own relief programs. While different in context, type of disaster, and research strategy, our discussion of these projects provides insights into common lessons learned for working with communities at elevated risk for the worst outcomes during disasters, such as the need for flexibility, compromise, and good working relationships with community partners.
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Affiliation(s)
- Mary Alice Scott
- Department of Anthropology, New Mexico State University, Las Cruces, NM, United States
| | - Kathryn M. Olszowy
- Department of Anthropology, New Mexico State University, Las Cruces, NM, United States
- Department of Anthropology, Binghamton University, Binghamton, NY, United States
- Department of Criminology, Anthropology, and Sociology, Cleveland State University, Cleveland, OH, United States
- *Correspondence: Kathryn M. Olszowy
| | - Kelsey N. Dancause
- Département des sciences de l'activité physique, Université du Québec à Montréal, Montreal, QC, Canada
| | - Amanda Roome
- Department of Anthropology, Binghamton University, Binghamton, NY, United States
- Bassett Research Institute, Basset Healthcare Network, New York, NY, United States
| | - Chim Chan
- Department of Parasitology and Virology, Osaka Metropolitan University, Osaka, Japan
| | - Hailey K. Taylor
- Department of Anthropology, New Mexico State University, Las Cruces, NM, United States
| | - Andrea Marañon-Laguna
- Department of Anthropology, New Mexico State University, Las Cruces, NM, United States
| | - Emilee Montoya
- Department of Anthropology, New Mexico State University, Las Cruces, NM, United States
| | - Alysa Garcia
- Department of Anthropology, New Mexico State University, Las Cruces, NM, United States
| | - Claudia Mares
- Department of Health and Human Services, Las Cruces, NM, United States
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Norman G, Mason T, Dumville JC, Bower P, Wilson P, Cullum N. Approaches to enabling rapid evaluation of innovations in health and social care: a scoping review of evidence from high-income countries. BMJ Open 2022; 12:e064345. [PMID: 36600433 PMCID: PMC10580278 DOI: 10.1136/bmjopen-2022-064345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic increased the demand for rapid evaluation of innovation in health and social care. Assessment of rapid methodologies is lacking although challenges in ensuring rigour and effective use of resources are known. We mapped reports of rapid evaluations of health and social care innovations, categorised different approaches to rapid evaluation, explored comparative benefits of rapid evaluation, and identified knowledge gaps. DESIGN Scoping review. DATA SOURCES MEDLINE, EMBASE and Health Management Information Consortium (HMIC) databases were searched through 13 September 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included publications reporting primary research or methods for rapid evaluation of interventions or services in health and social care in high-income countries. DATA EXTRACTION AND SYNTHESIS Two reviewers developed and piloted a data extraction form. One reviewer extracted data, a second reviewer checked 10% of the studies; disagreements and uncertainty were resolved through consensus. We used narrative synthesis to map different approaches to conducting rapid evaluation. RESULTS We identified 16 759 records and included 162 which met inclusion criteria.We identified four main approaches for rapid evaluation: (1) Using methodology designed specifically for rapid evaluation; (2) Increasing rapidity by doing less or using less time-intensive methodology; (3) Using alternative technologies and/or data to increase speed of existing evaluation method; (4) Adapting part of non-rapid evaluation.The COVID-19 pandemic resulted in an increase in publications and some limited changes in identified methods. We found little research comparing rapid and non-rapid evaluation. CONCLUSIONS We found a lack of clarity about what 'rapid evaluation' means but identified some useful preliminary categories. There is a need for clarity and consistency about what constitutes rapid evaluation; consistent terminology in reporting evaluations as rapid; development of specific methodologies for making evaluation more rapid; and assessment of advantages and disadvantages of rapid methodology in terms of rigour, cost and impact.
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Affiliation(s)
- Gill Norman
- Division of Nursing, Midwifery & Social Work; School of Health Sciences; Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Research and Innovation Division, Manchester University Foundation NHS Trust, Manchester, UK
| | - Thomas Mason
- Centre for Primary Care and Health Services Research; School of Health Sciences; Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Jo C Dumville
- Division of Nursing, Midwifery & Social Work; School of Health Sciences; Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Research and Innovation Division, Manchester University Foundation NHS Trust, Manchester, UK
| | - Peter Bower
- Manchester Academic Health Science Centre, Research and Innovation Division, Manchester University Foundation NHS Trust, Manchester, UK
- Centre for Primary Care and Health Services Research; School of Health Sciences; Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Paul Wilson
- Manchester Academic Health Science Centre, Research and Innovation Division, Manchester University Foundation NHS Trust, Manchester, UK
- Centre for Primary Care and Health Services Research; School of Health Sciences; Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Nicky Cullum
- Division of Nursing, Midwifery & Social Work; School of Health Sciences; Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Research and Innovation Division, Manchester University Foundation NHS Trust, Manchester, UK
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Mejía Grueso A, Ramírez Pazos J, Roldán Bernal MC, López Sanmiguel A, Velásquez DA. Buen morir en la persona mayor:. UNIVERSITAS MÉDICA 2022. [DOI: 10.11144/javeriana.umed63-4.bmpm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
El buen morir es un fenómeno que se construye desde múltiples perspectivas de los actores involucrados en la atención del adulto mayor. El objetivo de este trabajo es realizar una revisión temática con análisis cualitativo del contenido 50 artículos relacionados con el buen morir en el adulto mayor publicados en los últimos 10 años. Se encontró que el buen morir carece de una definición universal y está configurada por elementos que varían según el actor involucrado, variables sociodemográficas y aspectos culturales. Visibilizar los elementos más relevantes de lo que configura el buen morir permite ampliar su comprensión, con el objetivo de mejorar la atención en el fin de vida del adulto mayor.
Palabras clave: Anciano, muerte, morir, cuidados paliativos, final de vida
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Tao X, Yu CC, Low JA. Exploring loss and grief during the COVID-19 pandemic: A scoping review of qualitative studies. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022. [DOI: 10.47102/annals-acadmedsg.2021460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Introduction: The COVID-19 pandemic has brought about multiple losses to various groups, namely patients, families and healthcare professionals. Grief, which is the reaction to these losses, could cause strain on these individuals’ physical and mental health if not identified and managed early. This scoping review analysed loss, grief and how they were managed among these groups during the pandemic.
Method: This scoping review utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute framework for scoping reviews. Only qualitative studies relating to loss and grief and their management were included. Of 166 studies screened, 69 were included in the study. Qualitative analysis and data coding of each record were conducted through qualitative data analysis software.
Results: Losses included the death of family members, patients, colleagues and others. They also included the loss of usual routines, lifestyles and physical health. The grief experienced was multidimensional, affecting mainly the emotional, physical, social and existential realms. Anger, guilt and fear resulted from unsatisfactory farewells, issues with funerals, social isolation, financial strain and stigmatisation. Management strategies could be categorised into 5 themes: communication, finance, counselling, education and spiritual care.
Conclusion: Loss and grief identification and management among patients, family members and healthcare professionals are critically important during this COVID-19 pandemic. Current operating guidelines have proven insufficient in managing loss and grief. Innovative strategies are essential to tackle the many dimensions of loss and grief. Nevertheless, further research is necessary to better understand the effectiveness of implemented policies.
Keywords: Bereavement, death, mourning, outbreak, palliative care
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Affiliation(s)
- Xinyu Tao
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Chou Chuen Yu
- Geriatric Education and Research Institute, Yishun Community Hospital, Singapore
| | - James Alvin Low
- Geriatric Education and Research Institute, Yishun Community Hospital, Singapore
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Asgari Z, Naghavi A, Abedi MR. Death and Dying in a Digitalized World. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221130617. [PMID: 36170208 DOI: 10.1177/00302228221130617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The impact of digitalization on the topic of death and dying seems to be accelerated in recent years. This study aimed to explore the online ways people used to overcome grief and used the COVID-19 restrictions as an example. Thirty-two bereaved participants were interviewed and the data were analyzed using the constructive grounded theory method. Three main themes were extracted from the data: 1) an online way to remember; 2) digitalization of social support, and 3) continuing the bonds. Findings highlighted the important and inevitable role of the digital world in the grief process when there is a restriction in holding usual ceremonies.
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Affiliation(s)
- Zahra Asgari
- Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Azam Naghavi
- Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Mohammad Reza Abedi
- Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
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Manyaapelo T, Edwards A, Mpanza N, Nxumalo S, Nxumalo Z, Gumede N, Ngwenya N, Seeley J. COVID-19 and older people’s wellbeing in northern KwaZulu-Natal – the importance of relationships. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17841.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The COVID-19 pandemic and the non-pharmacological prevention methods have affected the wellbeing of older people. In this paper we focus on the wellbeing, and vulnerability, of older people in rural northern KwaZulu-Natal, South Africa during the first year of the pandemic. Methods: We conducted a series of up to four monthly in-depth interviews with 26 people aged 60 years and older. Interviews were conducted by telephone, because of restrictions on face-to-face contact, and digitally recorded. After transcription and translation, the data were coded thematically, with analysis guided by a wellbeing theoretical framework. Results: Having access to food, to healthcare and to somewhere they felt safe to stay, was essential for everyone, but for many managing expenses became more of a struggle as adult children who had lost their source of employment came home to stay. However, despite the shortages of money, the importance of relationships, whether they are familial or the close community of neighbours, was highlighted in the accounts from a number of participants. Older people not only got help with day-to-day life from others, but also found solace in the company of others. The sense of community, from family and neighbours, helped to ease some of the stress experienced as a result of the lockdowns. Conclusions: The COVID-19 pandemic and the restrictions imposed to limit the spread of the virus impacted the wellbeing of older adults in rural KwaZulu-Natal. Wellbeing for many older people has been nurtured by relationships with family and friends.
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Suwalowska H, Amara F, Roberts N, Kingori P. Ethical and sociocultural challenges in managing dead bodies during epidemics and natural disasters. BMJ Glob Health 2021; 6:bmjgh-2021-006345. [PMID: 34740913 PMCID: PMC8573672 DOI: 10.1136/bmjgh-2021-006345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/03/2021] [Indexed: 12/23/2022] Open
Abstract
Background Catastrophic natural disasters and epidemics claim thousands of lives and have severe and lasting consequences, accompanied by human suffering. The Ebola epidemic of 2014–2016 and the current COVID-19 pandemic have revealed some of the practical and ethical complexities relating to the management of dead bodies. While frontline staff are tasked with saving lives, managing the bodies of those who die remains an under-resourced and overlooked issue, with numerous ethical and practical problems globally. Methods This scoping review of literature examines the management of dead bodies during epidemics and natural disasters. 82 articles were reviewed, of which only a small number were empirical studies focusing on ethical or sociocultural issues that emerge in the management of dead bodies. Results We have identified a wide range of ethical and sociocultural challenges, such as ensuring dignity for the deceased while protecting the living, honouring the cultural and religious rituals surrounding death, alleviating the suffering that accompanies grieving for the survivors and mitigating inequalities of resource allocation. It was revealed that several ethical and sociocultural issues arise at all stages of body management: notification, retrieving, identification, storage and burial of dead bodies. Conclusion While practical issues with managing dead bodies have been discussed in the global health literature and the ethical and sociocultural facets of handling the dead have been recognised, they are nonetheless not given adequate attention. Further research is needed to ensure care for the dead in epidemics and that natural disasters are informed by ethical best practice.
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Affiliation(s)
- Halina Suwalowska
- Nuffield Department of Population Health, Wellcome Centre for Ethics and Humanities, Ethox Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - Fatu Amara
- Department of Chemistry, City University of New York, New York, New York, USA
| | - Nia Roberts
- Population Health and Primary Care Bodleian Health Care Libraries, University of Oxford, Oxford, Oxfordshire, UK
| | - Patricia Kingori
- Nuffield Department of Population Health, Wellcome Centre for Ethics and Humanities, Ethox Centre, University of Oxford, Oxford, Oxfordshire, UK
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