Students’ Confidence and Interest in Palliative and Bereavement Care: A European Study

As part of a European Erasmus Plus project entitled Death Education for Palliative Psychology, this study assessed the ways in which Master’s Degree students in psychology and the creative arts therapies self-rated their confidence and interest in death education and palliative and bereavement care. In five countries (Austria, Israel, Italy, Poland, Romania), 344 students completed an online questionnaire, and 37 students were interviewed to better understand their views, interest, and confidence. The results revealed some significant differences between countries, and showed that older respondents with previous experience as formal caregivers for end-of-life clients showed greater interest in obtaining practical clinical competence in these fields. A mediation analysis indicated that students’ previous care experiences and past loss experiences were related to students’ current interest in death education and palliative and bereavement care through the mediation of their sense of confidence in this field. The qualitative findings identified five shared themes: life and death, learning about death, the psychological burden, personal experience and robust training, and four key training needs. Overall, students’ interest in studying and working with terminal illness and death are rooted in internal resources, a preliminary sense of confidence, but also external requirements

Committing to arts-based palliative and bereavement care: Evaluation of students’ experiences in an online course

Surveys show that only 14% of those in need of palliative care actually receive it. The creative arts therapies can respond to this growing need. The current mixed-methods pilot study was part of a larger European Erasmus+ project entitled Death Education for Palliative Psychology that was conducted from 2019 to 2022 in five countries. This report examined the experiences of 20 creative arts therapies master's degree students in Israel enrolled in an online course on arts-based palliative and bereavement care. The students who completed the course reported a significantly greater commitment to engaging in a career in palliative and bereavement care than students in the control group. The students considered the course important for their training. The curriculum helped them to communicate end-of-life in both personal and professional situations. The arts provided a bridge for processing death-related issues. The students also reported the challenges they encountered during the course and their thoughts for future directions. Overall, these findings point to a field requiring more investigation that is essential to the training of creative arts therapies students and future therapists

Hardships in Italian Prisons During the COVID-19 Emergency: The Experience of Healthcare Personnel

Background: The recent COVID-19 pandemic has highlighted the deficiencies that characterize the functioning of the Italian national health system. Prisons have always mirrored the most radical expressions of these weaknesses. During the early stages of the pandemic, prison facilities across Italy underwent a series of changes dictated by the need to ensure the safety of the prisoners and staff. The adoption of these rules contributed to a total or partial redefinition of many central facets of life in prison, such as intake procedures for new arrivals and the ways prisoners were allowed to communicate with their families. Objectives: The aim of this qualitative study was to analyze the testimony of penitentiary healthcare workers in prisons throughout Italy to determine the impact of COVID-19 on their professional and personal lives. Participants: Thirty-eight participants were contacted and 20 decided to participate in the interview. The sample was made up of 10 women and 10 men. All the participants were members of the healthcare staff of a penitentiary facility (psychologists, psychiatrists, physicians, and nurses). All were recruited through an Italian association whose mission is the development, promotion, and implementation of social solidarity projects including prisoners' social and health care. This study was facilitated through representatives serving in nine different regions of Italy. The participants were divided according to their professional roles in prisons. Method: In-depth interviews were conducted by telephone or online using telecommunication platforms (e.g., Zoom, WhatsApp, and Skype). The transcribed texts underwent thematic analysis using the Atlas.ti software to identify patterns of meaning across the dataset. Results: Four main themes emerged from the analysis: Interpersonal difficulties, management and operational difficulties, the personal distress and bereavement of healthcare workers, and the distress of inmates. The importance of relationship management skills when interacting with prisoners emerged as a key topic in many interviews, and the participants highlighted the need for adequate training. The increase in prisoners' anxiety made communication more difficult. Conclusions: The findings suggest that healthcare workers in jails need emergency-oriented training. Participants described their feeling of loneliness and quasi-abandonment when carrying out their duties during the pandemic. In particular, they underscored the need for psychological guidance to better manage altered reactions with prisoners and colleagues as a result of heightened death anxiety and isolation

Editorial: The State of the Art in Creative Arts Therapies

Creative Arts Therapies is an umbrella term for healthcare professions that use the creative and expressive process of art making to improve and enhance the psychological and social well-being of individuals of all ages and health conditions. Creative arts therapies use the relationship between the client and therapist and among clients in group or dyadic therapy in the context of the creative-expressive process as a dynamic and vital force for growth and change. The creative-expressive process engages physiological sensations, emotions, and cognition; facilitates verbal and non-verbal symbolization, narration, and expression of conscious or unconscious conflicts and meaning-making through internal and external dialogue and communication between oneself and others. The major objective of this Research Topic was to introduce, collect, discuss, and disseminate new clinical practices, scientific evidence, methodologies, theoretical concepts, and notions about Creative Arts Therapies. By publishing this open-access articles under this Research Topic we hope not only to distribute updated knowledge among the many clinicians in this field, but also to inform and convey the importance and significant therapeutic impact of this field, to scientists and clinicians from other psychological disciplines. Creative arts therapists work in a variety of settings such as hospitals, educational institutions, community mental health facilities, prisons, hospices, and private practices, and include a variety of Professional specializations. Contributors to this Research Topic included experts in dance-movement therapy (DMT), drama-therapy and psychodrama, film therapy, music therapy, and art therapy. The topics of their studies vary from theoretical concepts and underlying mechanisms through methodology and up to evidence-based clinical studies and their review or meta-analysis. In the following paragraphs we summarized the 36 different contributions to this Research Topic, based on their artistic modality

Death Education for Palliative Psychology: The Impact of a Death Education Course for Italian University Students

The present study investigated the effects of a hybrid online course on a group of Italian Master’s degree students involved in a European Erasmus+ project. The course was composed of nine modules about death education, palliative psychology and the use of creative arts therapies—such as psychodrama, intermodal psychodrama and photovoice—in the end-of-life-field. The project involved 64 students in the experimental group (who attended the course) and 56 students as the control group. Both groups completed an online questionnaire before and after the delivery of the course and 10 students from the experimental group participated in a focus group at the end of the course. The quantitative analysis revealed that the experimental group students showed lesser levels of perception of death as annihilation, fear of the death and death avoidance, while they increased their levels of death acceptance, creative self-efficacy and attitude toward the care of the dying. Qualitative analysis identified three main themes: the positive impact of the course on death education and end-of-life care; the role of art therapies on death and end-of-life care; and the unhelpful facets of the course. Overall, this intervention changed the perception and the feelings of the students regarding the themes of death and palliative psychology and increased their creative self-efficacy and their interest in working in an end-of-life field

A challenge for palliative psychology: Freedom of choice at the end of life among the attitudes of physicians and nurses

: This article considers a particular aspect of palliative psychology that is inherent to the needs in the area of attitudes concerning Advance Healthcare Directives (AHDs) among Italian physicians and nurses after the promulgation of Law No. 219/2017 on AHDs and informed consent in 2018. The study utilized a mixed-method approach. The group of participants was composed of 102 healthcare professionals (63 females and 39 males). The quantitative part utilized the following scales: Attitudes toward Euthanasia, the Religious Orientation Scale, the Balanced Inventory of Desirable Responding, and the Testoni Death Representation Scale. The results were mostly in line with the current literature, especially concerning a positive correlation between religiosity and the participants\u2019 rejection of the idea of euthanasia. However, the qualitative results showed both positive and negative attitudes towards AHDs, with four main thematic areas: \u201cPositive aspects of the new law and of AHDs\u201d, \u201cNegative aspects of the new law and of AHDs\u201d, \u201cChanges that occurred in the professional context and critical incidents\u201d, and \u201cAttitudes towards euthanasia requests.\u201d It emerged that there is not any polarization between Catholics or religious people and secularists: Their positions are substantially similar with respect to all aspects, including with regard to euthanasia. The general result is that the law is not sufficiently understood, and so a quarter of the participants associate AHDs with euthanasia. Discussions on the opportunity for palliative psychologists to help health professionals to better manage these issues through death education courses are presented

The COVID-19 Disappeared: From Traumatic to Ambiguous Loss and the Role of the Internet for the Bereaved in Italy

In Italy, in the very first phase of the COVID-19 pandemic there was a dramatic rise in mortality. However, families were forbidden because of lockdown regulations to be with their loved ones at their deathbeds or to hold funerals. This qualitative study examined bereavement experiences among family members, how they processed their grief, and how they used social networks in particular by uploading photographs during the working-through of bereavement. The sample was composed of 40 individuals aged 23-63 (80% women) from different Italian cities severely impacted by the virus, including a subgroup from the province of Bergamo, which was the city with the highest mortality rate during that time. All interviews were conducted by phone, Skype, or Zoom. Then, the transcriptions underwent a thematic analysis using Atlas.ti. The main themes that emerged were: abandonment anger and guilt, dehumanized disappeared, derealization and constant rumination, and social support and the importance of sharing photos on Facebook. Importantly, the use of social networks proved to be a valuable source of support and photographs were a powerful tool in facilitating the process of mourning by encouraging narration and sharing. Grief had a complex profile: on the one hand, it was traumatic and characterized by all the risk factors causing mourners to experience prolonged grief, but on the other, some features were similar to ambiguous loss (that occurs without closure and clear understanding) because of the impossibility to be with their relatives in their final moments. The possible relationships between ambiguous loss, the use of internet, and the risk of prolonged grief are discussed

Psychology Students' Perceptions of COVID-19 in a Death Education Course

The systematic removal of death from social life in the West has exposed people living in areas affected by COVID-19 to the risk of being unable to adequately manage the anxiety caused by mortality salience. Death education is a type of intervention that helps people manage their fear of death by offering them effective strategies to deal with loss and anxiety. To that end, a path of death education has been carried out with University students of psychology. The main purpose of the research is to understand how students who participated in the death education course perceive the lockdown experience in light of course teachings. The research was carried out at a University in northern Italy in an area severely affected by COVID-19, during the first year of the pandemic. The group of participants included 38 students, 30 women and 8 men, with an average age of 25.45 years (SD = 7). At the end of the course, the students could respond on an optional basis to the request to comment on the training experience according to what they experienced during the pandemic. A thematic analysis was subsequently carried out on the texts, which made it possible to identify the most relevant thematic areas for the students. The qualitative analyses permitted recognition of three main forms of discovery: the removal of death in contemporary culture; the importance of community, ritual and funeral, and spirituality; and the significance of death education for future health professionals. The texts have highlighted how the removal of these issues exposes people to the risk of being unable to handle extremely painful events such as those related to dying. The results show the positivity of death education pathways conducted at the University level to help students reflect on these issues and manage the related anguish

Creative Adaptability and Emotional Well-Being During the COVID-19 Pandemic: An International Study

The putative associations between creative adaptability and the experience of emotional well-being (i.e., a positivity ratio of more positive than negative emotions) was investigated during the COVID-19 pandemic outbreak with a sample of 1,432 adults from four countries: Israel (n = 310), United States (n = 312), Italy (n = 378), and China (n = 569). Country differences and a mediation model for creative adaptability predicting emotional well-being through creative self-efficacy, resilient coping, and emotion regulation (reappraisal and suppression) were examined. The findings point to slight differences in countries, which are potentially due not only to the culture but also to the phase of the pandemic. More consistently, creative adaptability was positively associated with creative self-efficacy, resilient coping, and reappraisal emotion regulation in all countries. Regarding mediation, in the Israeli, Italian, and Chinese samples, creative adaptability was positively related to resilient coping, which was positively related to emotional well-being. Similar relations were found for creative self-efficacy as a mediator in the United States and Chinese samples. In the Chinese sample, creative adaptability was positively associated with suppression, which was negatively associated with emotional well-being. These results are suggestive of the role of creative adaptability in dealing with the emotional burden associated with the COVID-19 crisis