Death From COVID-19, Muslim Death Rituals and Disenfranchised Grief - A Patient-Centered Care Perspective

Invalidating the Leadership of Muslim Spiritual Leaders in Death From COVID-And Shaping the Grief Journey - A Narrative Inquiry

This narrative study voices the perspectives of a hidden population, spiritual leaders of the Muslim minority in Israel whose leadership in attending to deaths throughout COVID-19 was invalidated. Findings elucidate their dilemmas as being responsible for protecting the community from infection on one hand, and for guiding religious death rituals and preventing disenfranchised grief of families and the community on the other hand. Denying religious minorities their right to conduct traditions in a safe manner and leaving spiritual leaders outside of decision making on shaping COVID-19 guidelines creates distrust and deepens aggravation of enfranchised grief. As the global society is becoming religiously fragmented, distrust of religious minorities in health authorities due to denial of burial of death rituals, funerals, and burials, may have societal consequences and must be considered. Recommendations of this study may assist authorities in creating guidelines that accord with the laws, traditions, and values of religions minorities, empowering their spiritual leaders.

Cultural or Spiritual End-of-Life Practice Preference Assessment and Documentation: Identifying Current Practice in Pediatric Hospice

Communities use rituals at end of life to foster a peaceful death, ensure passage to the afterlife, and grieve their lost loved ones. Studies report fear of misunderstanding or impeding rituals as a barrier to accepting hospice care. However, there has been little research on cultural and spiritual rituals in the setting of hospice care or how patient preference should be assessed, documented, and supported by hospice staff. This project sought to identify the current practice for assessment of cultural or spiritual end-of-life practice preferences, and the documentation of those preferences, within pediatric hospice programs in a Midwestern state. In surveys of 2 pediatric hospice programs, employee respondents reported routine assessment (97.3%) and routine documentation (70.3%) of cultural or spiritual end-of-life practice preferences. Most respondents reported documentation was written by various disciplines and in various locations in the medical record. Additionally, a retrospective chart review was performed including decedents of 1 pediatric hospice program over a 5-year period. Documentation affirming familial spiritual beliefs was identified in 75.9% of charts, of which, only 12.2% had documentation regarding end-of-life-specific spiritual needs. Standardized documentation practices may help foster equitable hospice care for all patients by ensuring care providers are aware of the patient and/or family's end-of-life spiritual needs.

Measurement of Risk Factors Associated With bereavement Severity and Deterioration by COVID-19: A Spanish Validation Study of the Pandemic Grief Risk Factors

The present study translated and evaluated the psychometric evidence of the Pandemic Grief Risk Factors (PGRF) in a sample of 363 people from the general population of Peru who suffered the death of a loved one by COVID-19 (63-4% women and 36.6% men, where 78.5% were between 18 and 29 years old). The findings indicated that the PGRF is a unidimensional and reliable measure. The PGRF items can differentiate between individuals with different levels of risk factors and thus cover a wide range of the latent construct. Also, a greater sense of distress for each of the risk factors for pandemic grief is necessary to answer the higher response categories. Risk factors significantly and positively predict COVID-19-associated dysfunctional grief. The results indicated that the PGRF in Spanish is a measure with adequate psychometric properties to measure risk factors for pandemic grief.

Bereavement in the Time of COVID-19: Learning from Experiences of those Bereaved as a Result of Deaths in an Acute Hospital Setting in 2020

The COVID-19 pandemic has resulted in many people experiencing bereavement in challenging circumstances. In April 2020 at a large London Trust, a "Bereavement Welfare Hub" was established to offer support and advice by telephone to relatives and carers of all adults who died as inpatients. Data from BWH call records regarding 809 adults who died at the Trust in March, April and May 2020 were collated. A random selection of 149 call records were examined using thematic analysis. Six themes which influenced the bereavement experiences and grief status of call recipients were identified. These included family and community support, care up to the point of death, communication, care after death and death rituals and customs. Several factors positively and negatively influenced the experiences of people bereaved during the first wave of COVID-19. From these findings, recommendations have been made which have the potential to improve the bereavement experience, particularly during the pandemic era.

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)

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.

Etiquette in the Context of Death and Dying: Communication and Conversation

Death, bereavement, and grief are experiences suffused with conflict and disenfranchisement. Intricately connected is 'etiquette' - the sense of 'should' 'must' 'right' 'wrong' 'appropriate' and 'inappropriate' individuals feel in death and bereavement situations. This paper is the first of two answering the question, 'where does etiquette arise in death and bereavement situations and what does this 'look like?'' The theme The etiquette of communication and conversation is described, highlighting the importance of early communication for resolving conflict, what is considered 'appropriate' communication and support, and the social values underpinning these. Data highlighted how the CBT concept of 'shoulding and musting' manifests in death and bereavement situations, gave insight into etiquette's role in disenfranchising grief through shaping conversations, and offered suggestions for bereavement support. Though the term 'etiquette' may be misleading out of context, the concept resonated with the bereaved community and provided language to discuss the nuances of their experiences.

Investigation into Grief Experiences of the Bereaved During the Covid-19 Pandemic

The objective of the current study was to investigate the grief experiences of people affected by COVID-19. The study adopted a qualitative design of descriptive phenomenology. Fifteen adults who had lost a family member during the COVID-19 pandemic were selected as the sample through the purposive sampling method until theoretical saturation was achieved. Data was collected using semi-structured interviews and the Colaizzi analysis method. Six main themes (i.e., unexpressed grief, psychosomatic reactions, negative emotions, family problems, and social and occupational problems) were extracted. Data analysis showed that complex disenfranchised grief is the pervasive consequence of the COVID-19 experience. According to the findings, participants experienced disenfranchised grief during the loss of their loved ones due to the COVID-19 disease, which was a complex, painful experience accompanied by negative emotions and family, work, and social tensions. This grief is accompanied by more severe and prolonged symptoms, making it difficult for the bereaved to return to normal life. In unexpressed grieving, there are intense feelings of grief, pain, separation, despair, emptiness, low self-esteem, bitterness, or longing for the presence of the deceased. This grief originated from the conditions of quarantine and physical distance on the one hand, which required the control of the outbreak of the COVID-19 disease, and on the other hand, the cultural-religious context of the Iranian people.

Death, Funeral Rituals, and Stigma: Perspectives from Mortuary Workers and Bereaved Families

Deaths caused by COVID-19 have affected bereaved family members in several ways, including the inability to perform funeral rites and rituals. Understanding the dynamics and experiences of death and funerals of bereaved families and mortuary workers can lead to improvements in funeral services and the provision of social support for the affected families and mortuary workers. This study aimed to capture the experiences of mourning family members in Indonesia who lost a loved one due to COVID-19 and of mortuary workers who performed funerals according to COVID-19 protocols. Ten family members and 12 mortuary workers living in West Timor, Indonesia, were interviewed using a semistructured interview approach. Findings of the study show that mortuary workers were able to strictly implement the new funeral protocols. However, the rushed nature of these funerals led to resistance from families and prevented bereaved families from performing the usual cultural and religious funeral rituals. This, combined with stigma from their neighbors, led these families to have poor psychological wellbeing.