The transformative meanings of viewing or not viewing the body after sudden death

This study investigates the experience of viewing or not viewing the body for 64 relatives bereaved after a sudden and unexpected death1. Thematic analyses of in-depth interviews reveal the importance of viewing and the challenges in providing choice. Some participants experienced difficulties including regret and intrusive images. These are discussed alongside the transformative meanings of seeing or not seeing the body for bereaved relatives

Help-seeking experiences of bereaved adolescents: A qualitative study

Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provided a critical appraisal of positive and negative experiences, and noted barriers and facilitators for help-seeking. As adolescents bereaved through suicide may receive less social support, professional help is a much needed auxiliary. Parental encouragement is important in accessing adequate professional help

"Don't bother about me". The grief and mental health of bereaved adolescents

Death of a relative or friend is a potentially disruptive event in the lives of adolescents. To provide targeted help, it is crucial to understand their grief and mental health experiences. Thematic analysis of 39 semi-structured telephone interviews yielded two themes: Grieving apart together, and Personal growth. High self-reliance and selective sharing were common. Feelings of guilt and 'why' questions seemed more pronounced among the suicide bereaved. There was strong evidence of personal growth, increased maturity and capacity to deal with personal mental health/suicidality. Despite its devastating effects, experiencing a death can be a catalyst for positive mental health.status: publishe

Help-seeking experiences of bereaved adolescents: A qualitative study

Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provided a critical appraisal of positive and negative experiences, and noted barriers and facilitators for help-seeking. As adolescents bereaved through suicide may receive less social support, professional help is a much-needed auxiliary. Parental encouragement is important in accessing adequate professional help.status: publishe

Transition to a new reality: the experience of viewing or not viewing the body of a relative in the context of grief after a sudden and unexpected death

Social work practice generally advocates the importance for the bereaved of viewing their relative’s body after death. However, previous studies examining viewing have shown mixed results, suggesting evidence of both benefit and harm. Hitherto, bereaved relatives’ qualitative experience of viewing, alongside symptom measures, and in a coronial practice context has not been studied. A convenience sample of 64 bereaved male and female relatives was recruited between 2004 and 2007 through the Office of the NSW Coroner, some six months after their relative’s sudden, unexpected death. Participants’ grief experience was qualitatively explored and also measured by the Inventory of Complicated Grief – Revised (ICG-R), the Impact of Event Scale – Revised (IES-R), and the Hogan Grief Reaction Checklist (HGRC). Qualitative themes were elucidated from a semi-structured interview about the viewing and non-viewing experience, and variables such as regret were compared.Most participants viewed the body and found meaning in doing so, including relational connection, reality about the death, and relinquishment of the physical body. However, decisions about viewing for some were constrained by the management of the death or influenced by advice from others. Those who had regret for viewing or not viewing indicated that their initial viewing preference was not supported and some had been given inadequate information about viewing options.Regret was associated with higher scores on the questionnaires, particularly for those who regretted viewing. Difficulties associated with viewing included high distress and experiencing intrusive images. While half of those who did not view were satisfied with this choice, the remainder had intense regret, attributing a sense of unreality about the death to not viewing, and some had intrusive imagined images.The study concludes that personnel should ascertain and support the bereaved person’s preference to view or not within a context of coronial requirements, family culture, information about the appearance of the body and the capacity of the bereaved at the time of the death. Findings are contextualised in current understandings of grief adjustment after a sudden loss, and implications for practice are discussed. Limitations of the study include the cross-sectional design. Further longitudinal research with a representative sample is recommended

Signs of post-traumatic stress disorder in caregivers following an expected death: A qualitative study

Background: Complications of grief are an important area of investigation with potential to improve the well-being of palliative care caregivers. There has been little study of the prevalence or significance of post-traumatic stress disorder for those bereaved after an expected death. Aim: To identify evidence suggestive of post-traumatic stress disorder symptoms in a population of bereaved caregivers of patients who have died of ovarian cancer. Design: Caregivers’ recollections of their end-of-life experiences were coded and analysed, using qualitative data obtained from interviews 6 months after the patient’s death. Setting/participants: Australian Ovarian Cancer Study–Quality of Life Study is a population-based epidemiological study using mixed methods to explore caregivers’ experiences following the expected death of a woman with ovarian cancer. Thirty-two caregivers from the Australian Ovarian Cancer Study–Quality of Life Study participated in semi-structured telephone interviews 6 months post-bereavement. Results: When describing the patient’s death at their 6-month interview, all interviewees used language consistent with some degree of shock and traumatisation. For the majority, there was also evidence suggesting resilience and resolution. However, a number of interviewees describe intrusive memories associated with physical sights and sounds that they witnessed at the deathbed. Conclusions: This exploratory study demonstrates the phenomenon of the ‘shocked caregiver’. If trauma symptoms are present in bereaved carers in palliative care, it has implications for palliative care provision. Given that trauma symptoms may be distinct from prolonged grief disorder, this may also have implications for provision of bereavement counselling. Further research into this phenomenon is required

A preliminary study to develop an intervention to facilitate communication between couples in advanced cancer

Objective: Psychosocial interventions directed to couples where one has advanced cancer can reduce distress, enhance communication, and provide an opportunity for relational growth. The present study aimed to develop an intervention to facilitate communication about living with advanced cancer using the Patient Dignity Inventory (PDI) as the focus of a clinical interview with couples toward the end of life. Method: Couples were recruited from oncology and palliative care services at a Sydney hospital. After the PDI was developed and manualized as an intervention for couples, the PDI-Couple Interview (PDI-CI) was delivered by a clinical psychologist and comprised the following: (1) the patient completed the PDI. ; (2) the patient's identified partner completed the PDI about how they thought the patient was feeling. ; (3) the clinician reviewed the results with the couple, summarizing areas of concurrence and discordance and facilitating discussion. Results: Some 34 couples were referred, of which 12 consented, 9 of whom completed the clinical interview. Reported benefits included enabling couples to express their concerns together, identifying differences in understanding, and giving "permission to speak" with each other. The focus of the interview around the PDI provided a structure that was particularly acceptable for men. Most couples confirmed that they were "on the same page", and where differences were identified, it provided a forum for discussion and a mutual understanding of the challenges in managing advanced cancer within a supportive context. Significance of Results: Participant couples' experiences of the PDI-CI provide valuable insight into the benefits of this intervention. This preliminary study indicates that the intervention is a relatively simple means of enhancing closer communication and connection between couples where one has advanced cancer and may be an important adjunct in helping prepare couples for the challenges inherent toward the end of life. Further investigation of feasibility with a larger sample is recommended