Understanding grief and bereavement

Hamilton, Ian J

doi:10.3399/bjgp16x687325

Cited by 25 publications

(13 citation statements)

References 13 publications

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“…Family members who decided not to initiate lifeextending treatments appeared to have already experienced some anticipatory grief [43] and seemed to be prepared for the possibility that the patient might not survive. During the decision-making process, they had drawn on their previous experiences with those of the patient (for example, of the patient's multiple hospital admissions, and declining health and quality of life), and knowledge of the patient's treatment preferences.…”

Section: Summary Of Key Resultsmentioning

confidence: 99%

The considerations, experiences and support needs of family members making treatment decisions for patients admitted with major stroke: a qualitative study

Visvanathan

Mead

Dennis

et al. 2020

BMC Med Inform Decis Mak

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Background: Treatment decision-making by family members on behalf of patients with major stroke can be challenging because of the shock of the diagnosis and lack of knowledge of the patient's treatment preferences. We aimed to understand how, and why, family members made certain treatment decisions, and explored their information and support needs. Method: Semi-structured interviews with family members (n = 24) of patients with major stroke, within 2 weeks of hospital admission. Data were analysed thematically. Results: Families' approach to treatment decision-making lay on a spectrum according to the patient's state of health pre-stroke (i.e. patient's prior experience of illness and functional status) and any views expressed about treatment preferences in the event of life-threatening illness. Support and information needs varied according to where they were on this spectrum. At one extreme, family members described deciding not to initiate lifeextending treatments from the outset because of the patients' deteriorating health and preferences expressed prestroke. Information from doctors about poor prognosis was merely used to confirm this decision. In the middle of the spectrum were family members of patients who had been moderately independent pre-stroke. They described the initial shock of the diagnosis and how they had initially wanted all treatments to continue. However, once they overcame their shock, and had gathered relevant information, including information about poor prognosis from doctors, they decided that life-extending treatments were no longer appropriate. Many reported this process to be upsetting and expressed a need for psychological support. At the other end of the spectrum were family members of previously independent patients whose preferences pre-stroke had not been known. Family members described feeling extremely distressed at such an unexpected situation and wanting all treatments to continue. They described needing psychological support and hope that the patient would survive.

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Section: Summary Of Key Resultsmentioning

confidence: 99%

The considerations, experiences and support needs of family members making treatment decisions for patients admitted with major stroke: a qualitative study

Visvanathan

Mead

Dennis

et al. 2020

BMC Med Inform Decis Mak

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“…(40) Our results also corroborate results from studies involving family members of patients admitted to intensive care which have reported that, in addition to information regarding prognosis from doctors, the majority of family members estimated the patient's prognosis depending on their perceptions of the patient's strength of character, unique story of illness and survival and previous experiences and choices of treatments. (41,42) Family members who decided not to initiate life-extending treatments appeared to have already experienced some anticipatory grief (43) and seemed to be prepared for the possibility that the patient might not survive. During the decision-making process, they had drawn on their previous experiences with those of the patient (for example, of the patient's multiple hospital admissions, and declining health and quality of life), and knowledge of the patient's treatment preferences.…”

Section: Summary Of Key Resultsmentioning

confidence: 99%

The considerations, experiences and support needs of family members making treatment decisions for patients admitted with major stroke: a qualitative study.

Visvanathan

Mead

Dennis

et al. 2020

Preprint

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Background Treatment decision-making by family members on behalf of patients with major stroke can be challenging because of the shock of the diagnosis and lack of knowledge of the patient’s treatment preferences. We aimed to understand how, and why, family members made certain treatment decisions, and explored their information and support needs. Method Semi-structured interviews with family members (n=24) of patients with major stroke, within two weeks of hospital admission. Data were analysed thematically. Results Families’ approach to treatment decision-making lay on a spectrum according to the patient’s state of health pre-stroke (i.e. patient’s prior experience of illness and functional status) and any views expressed about treatment preferences in the event of life-threatening illness. Support and information needs varied according to where they were on this spectrum. At one extreme, family members described deciding not to initiate life-extending treatments from the outset because of the patients’ deteriorating health and preferences expressed pre-stroke. Information from doctors about poor prognosis was merely used to confirm this decision. In the middle of the spectrum were family members of patients who had been moderately independent pre-stroke. They described the initial shock of the diagnosis and how they had initially wanted all treatments to continue. However, once they overcame their shock, and had gathered relevant information, including information about poor prognosis from doctors, they decided that life-extending treatments were no longer appropriate. Many reported this process to be upsetting and expressed a need for psychological support. At the other end of the spectrum were family members of previously independent patients whose preferences pre-stroke had not been known. Family members described feeling extremely distressed at such an unexpected situation and wanting all treatments to continue. They described needing psychological support and hope that the patient would survive. Conclusion The knowledge that family members’ treatment decision-making approaches lay on a spectrum depending on the patient’s state of health and stated preferences pre-stroke may allow doctors to better prepare for discussions regarding the patient’s prognosis. This may enable doctors to provide information and support that is tailored towards family members’ needs.

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Section: Aspectos Psicológicos Do Lutounclassified

“…No âmbito psicológico, o falecimento de um ente querido traz consigo um profundo impacto na saúde mental das pessoas, o que desencadeia e desafia o indivíduo a um momento de adaptações e transformações internas (HAMILTON, 2016;NORTON e GINO, 2014). O luto cria a necessidade da finalização dos laços afetivos, das transformações às novas demandas da vida e do estabelecimento de novos relacionamentos a fim de que o indivíduo tenha um maior crescimento da capacidade de resiliência (HAMILTON, 2016). O luto simples é definido como um processo fisiológico e multidimensional que envolve a adaptação de vários aspectos e áreas do ser humano, tais como: afetivos, cognitivos, comportamentais e espirituais e que surgem após uma determinada perda (SELMAN et al, 2020;WALLACE et al, 2020;ZHAI e DU, 2020).…”

Section: Aspectos Psicológicos Do Lutounclassified

Perdas, Mortes e Luto Durante a Pandemia de Covid-19: Uma Revisão da Literatura / Losses, Deaths and Grief During the Covid-19 Pandemic: A Literature Review

Fontes¹,

Assis²,

Santos³

et al. 2020

IDonline

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A pandemia de COVID-19, com o elevado quadro de mortalidade, trouxe consigo uma nova realidade quanto aos processos de luto e morte, pois a implantação de medidas de segurança pública fez com que os tradicionais rituais de mortes sofressem alterações importantes. Este trabalho de pesquisa teve como objetivo realizar uma revisão de literatura sobre os possíveis impactos psicossociais e culturais nas famílias dos pacientes, das pessoas enlutadas e profissionais da saúde. Foi realizado um levantamento bibliográfico nas bases de dados PubMed (NCBI), Science Direct, Scopus e Google Scholar, com estudos nos idiomas inglês, espanhol, francês e português. O luto é um processo fisiológico que envolve e abrange vários aspectos da dimensão humana e a morte associada a ele traz a necessidade da realização de eventos simbólicos para criar uma representação pessoal. Os eventos e rituais fúnebres são momentos importantes na superação do luto para familiares, uma vez que constatam a passagem do ente querido e marcam o final de um ciclo. No contexto da pandemia, três fatores principais podem ser considerados responsáveis por efeitos negativos. Primeiramente, a falta de execução dos tradicionais rituais de morte gera nas famílias sentimentos de estresse, ansiedade e possíveis complicações no luto, pois podem afetar aspectos psicológicos, culturais e sociológicos. Em segundo lugar, os prejuízos do isolamento social na saúde mental dos indivíduos, torna mais provável a ocorrência do chamado luto prolongado ou complicado. Por fim, o medo e a ansiedade decorrentes da imprevisibilidade da doença, pode ocasionar o luto antecipado. Para amenizar essa problemática, sugere-se que os profissionais da saúde disponibilizem informações precisas para a família a respeito do estado de saúde do doente. Além disso, o estabelecimento da “visita virtual”, da terapia cognitivo comportamental e a criação de memoriais virtuais são outras opções viáveis que podem ajudar a reduzir a sensação de perda e suas consequências. No que diz respeito aos profissionais de saúde, que estão tendo que lidar com o crescente número de mortes e também com dilemas morais, devido à escassez de equipamentos, é dever do empregador disponibilizar apoio psicossocial para esses trabalhadores.

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Understanding grief and bereavement

Cited by 25 publications

References 13 publications

The considerations, experiences and support needs of family members making treatment decisions for patients admitted with major stroke: a qualitative study

The considerations, experiences and support needs of family members making treatment decisions for patients admitted with major stroke: a qualitative study

The considerations, experiences and support needs of family members making treatment decisions for patients admitted with major stroke: a qualitative study.

Perdas, Mortes e Luto Durante a Pandemia de Covid-19: Uma Revisão da Literatura / Losses, Deaths and Grief During the Covid-19 Pandemic: A Literature Review

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