Experiences of grief and mourning practices of Greek bereaved adults during the pandemic: A qualitative approach

This pilot study aims to explore the experiences of grief and mourning practices of bereaved adults during the pandemic. Eleven adults who have lost a loved one since March 2020 participated in a semi-structured interview exploring the experiences of grief and mourning. Data were analyzed through Thematic Analysis. Participants experienced contrasting psycho-emotional reactions to loss, and they highlighted the restriction of being physically present to the dying loved one as the hardest aspect of losing someone during COVID-19. Moreover, they identified challenging factors during the funeral practices: the small number of mourners during ceremonies, abstinence from hugging and touching each other as a form of consolation, and wearing masks, which further made the ceremony impersonal. Finally, the alteration of the paying respects process has contributed to the mourners' experienced stress and sorrow. Findings are discussed per the current literature and recommendations based on cultural diversities are proposed.

Measurement and assessment of grief in a large international sample

BACKGROUND

In 2022, the International Classification of Diseases (ICD-11) and an update of the Diagnostic Statistical Manual of Mental Disorders (DSM 5 TR) were released for implementation worldwide and now include the new Prolonged Grief Disorder (PGD). The newest definition of PGD is based on robust clinical research from the Global North yet until now has not been tested for global applicability.

METHODS

The current study assesses the new PGD ICD-11 criteria in a large international sample of 1393 bereaved adults. The majority of the sample was included from the USΑ. Additionally, we conduct a sub-sample analysis to evaluate the psychometric properties, probable caseness of PGD, and differences in network structure across three regions of residency (USA, Greece-Cyprus, Turkey-Iran).

RESULTS

The psychometric validity and reliability of the 33-item International Prolonged Grief Disorder Scale (IPGDS) were confirmed across the whole sample and for each regional group. Using the strict diagnostic algorithm, the probable caseness for PGD for the whole sample was 3.6 %. Probable caseness was highest for the Greece-Cyprus group (6.9 %) followed by Turkey-Iran (3.2 %) and the USA (2.8 %). Finally, the network structure of the IPGDS standard items and cultural supplement items (total of 33 items) confirmed the strong connection between central items of PGD, and revealed unique network connections within the regional groups.

LIMITATIONS

Future research is encouraged to include larger sample sizes and a more systematic assessment of culture.

CONCLUSION

Overall, our findings confirm the global applicability of the new ICD-11 PGD disorder definition as evaluated through the newly developed IPGDS. This scale includes culturally sensitive grief symptoms that may improve clinical precision and decision-making.

"Almost the copy of my child that's dead": Shakespeare and the loss of Hamnet

This article emphasizes the importance of studies which look at changes and similarities in mourning over time. It argues that relevant evidence can come from creative fiction as well as from other sources, provided that this is analyzed rigorously in terms of structures and patterns. As an illustration of this approach, it examines the evidence in recurring features of Shakespeare's plays that his writing was deeply and lastingly affected by the death of his only son Hamnet, a twin, at the age of 11, and identifies five motifs which support this interpretation: the resurrected child or sibling; androgynous and twin-like figures; a growing emphasis on father-daughter relationships; paternal guilt; family division and reunion. The article suggests that this approach could be applied to other instances where a body of creative writing shows traces of overt or buried grief.

Illness-related hopelessness in advanced cancer: influence of anxiety, depression, and preparatory grief

The growing interest in the psychological distress in patients with cancer has been the major reason for the conduction of this study. The aims were to assess the relationship of hopelessness, anxiety, distress, and preparatory grief, as well as their predictive power to hopelessness. Ninety-four patients with advanced cancer completed the study at a palliative care unit in Athens, Greece. Beck Hopelessness Scale, the Greek version of the Hospital Anxiety and Depression (HAD) scale, and the Preparatory Grief in Advanced Cancer Patients scale were administered. Information concerning patients' treatment was acquired from the medical records, whereas physicians recorded their clinical condition. Hopelessness correlated significantly with preparatory grief (r = .630, P < .0005), anxiety (r = .539, P < .0005), depression (r = .642, P < .0005), HAD-Total (r = .686, P < .0005), and age (r = -.212, P = .040). Multiple regression analyses showed that preparatory grief (P < .0005), depression (P < .0005), and age (P = .003) were predictors of hopelessness, explaining 58.8% of total variance. In this patient sample, depression, preparatory grief, and patients' age were predictors of hopelessness.

RETRACTED: Attitudes of midwives towards perinatal bereavement in Hong Kong

OBJECTIVE

to explore attitudes towards perinatal bereavement care among midwives working in Hong Kong through examination of relationships between attitudes towards bereavement support, need for bereavement education and appropriate hospital policy.

DESIGN

a descriptive correlational survey.

SETTING

the obstetric and gynaecology units at two hospitals.

INSTRUMENT

a structured self-report questionnaire on attitudes towards perinatal bereavement support; required support and education needs for midwives on bereavement care.

PARTICIPANTS

154 out of 202 midwives (76.2% response rate) working at the two units.

FINDINGS

two-step cluster analysis yielded two clusters. Cluster 1 consisted of 91 (59.1%) midwives and cluster 2 consisted of 63 (40.9%) midwives. Cluster 2 midwives were younger, had less obstetric and gynaecology experience, junior ranking and less post-qualification education than cluster 1 midwives. Cluster 1 midwives had additional personal grieving experiences and experience of caring for grieving parents. Attitudes towards bereavement care were positively correlated with educational needs (r(s)=0.55, p< 0.001) and hospital policy support (r(s)=0.50, p< 0.001).

CONCLUSIONS

Hong Kong midwives require increased bereavement care knowledge and experience, improved communication skills, and greater hospital and team member support. Findings may be used to improve support of midwives, to ensure sensitive bereavement care in perinatal settings and to reflect training needs in the midwifery education curricula. Study findings highlight the universality of grief for a lost baby, irrespective of cultural differences in approaching emotional topics. This study may help midwives internationally to gain a broader perspective in this area.