How Well Are We Caring for Caregivers? Prevalence of Grief-Related Symptoms and Need for Bereavement Support Among Long-Term Care Staff

Abstract To define the prevalence and correlates of grief-related symptoms among long-term care staff who care for patients near the end of life, a cross-sectional survey was conducted at six Program of All-inclusive Care for the Elderly (PACE) organizations that provide long-term care in the home and in institutions. All clinical and non-clinical program staff were surveyed to examine the prevalence of 20 grief-related symptoms and assess current sources of bereavement support, as well as willingness to use additional sources of support. Suveys were completed by 203/236 staff (86%), who described a wide variety of symptoms they attributed to the death of one of their patients in the past month. Most staff (147/203; 72%) reported at least one symptom. Staff with more symptoms had experienced more patient deaths in the past month (Spearman rho 5 0.20, P 5 0.007), had worked for a longer time at a PACE organization (Spearman rho 5 0.16, P 5 0.031), and reported a closer and longer relationship with the last patient who died (Spearman rho 5 0.32, P ! 0.001; rho 5 0.24, P 5 0.001). Although staff identified several informal sources of bereavement support (mean 2.3 sources, range 0--6), almost all (n 5 194; 96%) said they would use additional support services if they were offered. These community-based long-term care staff experience a variety of symptoms attributable to the deaths of their patients, and would welcome additional sources of bereavement support. J Pain Symptom Manage 2005;30:227--233.

How do developing country constraints affect renewable energy entrepreneurs?

Renewable energy entrepreneurs in developing countries are selling and facilitating the uptake of a new technology and new ideas in an already difficult environment. We explore entrepreneurs' perceptions of the constraints they face while operating their businesses. We used two stages of analysis — primary data from individual entrepreneurs and country level secondary data. The primary data included in-depth interviews with entrepreneurs, as well as their self-ranking of constraints via a questionnaire. Findings emphasised the importance of government/regulatory and local market constraints. To contextualise these findings, we compared the individual-level findings to country-level conditions to assess whether they have any bearing on the entrepreneurs' perceptions of constraints. Country conditions may influence the entrepreneurs' perceptions of the demand for their products and/or services, and their opportunity and ability to supply these to customers. These may be influencing whether and how the entrepreneurs perceive and respond to opportunities to carry on with their renewable energy businesses