Orientador: Milena Temer Jamas / Resumo: Os profissionais de saúde utilizam algumas táticas com intuito de se resguardar psiquicamente do sofrimento vivenciado por seus pacientes. Entre uma das maneiras de proteção está a concepção de que setor da maternidade seja um lugar onde surgem novas vidas e não onde elas acabam. Entretanto a maternidade pode ser marcada por acontecimentos negativos, acompanhados por perdas ao invés de ganhos, tornando a morte um assunto polêmico e desafiador nesse meio. Diante disso, o objetivo desta pesquisa foi melhorar a qualidade do atendimento da equipe de enfermagem diante das pacientes/familiares que sofreram uma perda perinatal a partir de um material instrutivo destinado aos cuidados de enfermagem em situação de óbito perinatal. Trata-se de um estudo do tipo metodológico, para construção de uma tecnologia educativa, o qual adotou as etapas de: submissão do projeto ao comitê de ética, levantamento de vivências e demandas da população alvo por meio de um estudo qualitativo, levantamento bibliográfico e elaboração do material educativo. A elaboração da cartilha seguiram as seguintes etapas: A sistematização do conteúdo; A seleção e elaboração das ilustrações; A composição da cartilha e os critérios editoriais utilizados. Foram entrevistados individualmente nove enfermeiros e dez técnicos de enfermagem que atuam na maternidade do Hospital das Clínicas de Botucatu (HC), maternidade referência regional para atendimentos de gestante alto risco. As entrevistas foram gravadas a partir da per... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Health professionals use some tactics to protect themselves psychically from the suffering experienced by their patients. One of the ways of protection is the conception that the maternity sector is a place where new lives emerge and not where they end. However, motherhood can be marked by negative events, accompanied by losses rather than gains, making death a controversial and challenging issue in this environment. Therefore, the objective of this research was to improve the quality of care provided by nursing staff to patients / family members who suffered a perinatal loss from an instructional material intended for nursing care in perinatal death situation. This is a methodological study, for the construction of an educational technology, which adopted the steps of: submission of the project to the ethics committee, survey of experiences and demands of the target population through a qualitative study, bibliographic survey and elaboration of educational material. The elaboration of the booklet followed the following steps: The systematization of the content; The selection and elaboration of the illustrations; The composition of the booklet and the editorial criteria used. Nine nurses and ten nursing technicians who work at the maternity ward of the Botucatu Hospital (HC), a regional reference maternity ward for high-risk pregnant women, were interviewed individually. The interviews were recorded from the guiding question: "What are the biggest difficulties faced by health... (Complete abstract click electronic access below) / Mestre

abstract: Using data from a randomized, experimental trial of a brief family-based preventive intervention for parentally-bereaved families, this study evaluated whether participation in the Family Bereavement Program (FBP) when the offspring were in childhood/adolescence (ages 8 to 16) improved competencies when the offspring were emerging/young adults (ages 23 to 32). Participants were 244 emerging/young adults; data used were from assessments at pretest, posttest, 6 years post-intervention, and 15 years post-intervention. In addition to testing the direct effects of the program, developmental cascade effects models were used to test the relations between program-induced improvements in positive parenting and decreased negative life events at posttest and subsequent effects on domains of competence and behavior problems in adolescence/emerging adulthood (ages 14 to 22) and four developmental competencies of emerging/young adulthood: academic, peer, romantic, and work competence. Results supported a cascading effects model of program effects on competence outcomes. In the full sample, there were significant mediation effects of the intervention to decreased negative life events at posttest to increased grade-point average (GPA) at the 6-year follow-up to higher academic and work competence at the 15-year follow-up. For females only, two additional significant mediational pathways of the FBP occurred. The FBP led to an increase in peer competence 6 years post-intervention, which was associated with an increase in work competence 15 years post-intervention. Also, the FBP led to a decrease in externalizing problems in adolescence/emerging adulthood, but externalizing problems were positively associated with work competence. For males, additional mediation effects of the FBP on work competence occurred. The FBP decreased negative life events. However, higher negative life events were associated with lower externalizing problems in adolescence/emerging adulthood, and externalizing problems were positively associated with work competence. For males only, a significant three-pathway mediation effect of the intervention occurred on increased positive parenting at posttest to increased romantic attachment at the 6-year follow-up to higher romantic competence at the 15-year follow-up. Peer competence showed continuity over development. Mediational analyses highlighted the role of program-induced improvements in parenting, reductions in exposure to negative life events, and earlier developmental competencies on competence outcomes in emerging/young adulthood. Implications for promoting resilience in parentally-bereaved, at-risk youth are discussed. / Dissertation/Thesis / Doctoral Dissertation Psychology 2020

Losing a loved one can lead to bereavement grief. It is often accompanied by anxiety, profound sadness, sleep disturbance and lingering depression. Prolonged grief can affect the ability to function properly, through overall reduction in cognitive function. Being able to find effective interventions early on in the grieving process for the bereaved is essential in preventing disorders associated with prolonged sorrow. Mindfulness research has shown that it can improve well-being and a variety of conditions such as stress, anxiety, worry, depression and disturbed sleep. But the research into mindfulness as a potential grief intervention is relatively new and lacking. The aim of this study is to see if the research and literature on the subject can tell us about mindfulness interventions and their benefit to those experiencing bereavement: in particular, the loss of a family member. Four studies were included, making this a more explorative research. In all studies, grief-related psychological conditions as well as grief-levels decreased after the mindfulness intervention, such as depression symptoms, trauma symptoms, anxiety, and any difficulties in emotion regulation.Those with elevated depression or traumatic bereavement seem to experience a larger change in all eviated symptoms after the mindfulness intervention. The findings indicated that mindfulness-based cognitive therapy helped with the ability to emotionally regulate as well as decreasing spontaneous mind-wandering during resting-state. It also seemed to enhance cognitive control and working memory.

The thesis concerns on the phenomenon of death and it's tabooisation in the modern Czech society. Attitude, whether the death is taboo or not, divides not only the society but also the scientists of sociological field. In the first part it sets up basic arguments of both opposing groups by analyzing relevant scientific and general fiction literature. The other part of the thesis concerns on author's own research, with an aim to find out, what attitude to death and burial rituals is adopted by informants belonging to younger-middle aged generation living in the Czech Republic, primarily in Prague. The research uses qualitative methods, method of concerned and unconcerned observation on funeral ceremonies and semi-structured interviews with a group of informants. It focuses on recognition, whether the informants speak about death, go to cemeteries and practice rituals in relation to departed. Based on synthesis of gathered knowledge, the work sets up a new attitude to death-taboo as two different phenomena differing by relation to departed person.

This review article addresses end-of-life care issues characterizing human immunodeficiency virus progression by delineating associated stages of medical and nursing care. The initial progression from primary medical and nursing care aimed at functional cure to palliative care is discussed. This transition is considered in accord with the major symptoms experienced, including fatigue, pain, insomnia; decreased libido, hypogonadism, memory, and concentration; depression; and distorted body image. From the stage of palliative care, progression is delineated onward through the stages of hospice care, death and dying, and the subsequent bereavement process.

Bereavement beliefs and practices in the modern, American culture have been well documented. However, virtually no research has been conducted on traditional and contemporary death, dying, grief, and bereavement beliefs and practices among native tribes, such as the Lakota. The present study was conducted with the Lakota, and fulfilled two goals. iii First, the contemporary and traditional death, dying, grief, and bereavement beliefs and practices of the Lakota were documented and summarized. Such documentation may help bereaved Lakota tribal members who are experiencing problems with death and bereavement, and may help preserve traditional knowledge, beliefs, and practices. Second, the consensus of opinion among Lakota tribal elders about death, dying , grief, and bereavement practices and beliefs was qualitatively evaluated and compared with that of mental health and substance abuse workers who serve the Lakota. Two main theoretical conclusions to this study were reported. First, the Lakota elders' preferred interventions for bereavement for their people included family, social, community, tribal , and ceremonial activities. These findings likely resulted from the functional aspects of these types of culturally appropriate practices not only to help the bereaved Lakota individual, but also to help "fill the hole in the circle" left by the death of a tribal member. A cultural mechanism for continued tribal unity and wholeness is provided by these tribal bereavement practices. Second, the ancient historical Lakota ceremonies used to ameliorate grief within the tribe appear to have been fragmented over time, but these rituals still exist and their derivatives are used in various contemporary forms. Two main clinical findings were reported. First, a careful clinical assessment of the bereaved Lakota client's level of acculturation is required as a prerequisite to treatment planning. Second, intervention with grieving Lakota clients should include informed attention to both "western" bereavement treatment methods and traditional Lakota family, community, and social bereavement practices. The relative value of various Lakota family, social, community, and tribal bereavement practices and a rank ordering of various Lakota ceremonies were provided. These ceremonies and Lakota tribal practices were compared to modern "western" bereavement treatment methods.

Young widowhood is a unique experience that has received little in-depth attention in research and clinical settings. Their experiences may differ from other types of losses, particularly from losses that are typically expected to happen later in life. The present study treated the lived experiences of young men and women who have experiences the loss of a spouse. Eleven men and women between the ages of 18 and 49 were interviewed about their experiences post-loss using phenomenological methods. After coding for similarities and differences between the experiences, five themes emerged in all eleven interviews: (1) relationship, (2) first reactions, (3) resources, (4) concerns, and (5) age and gender. The results explored these themes in depth and provided insight into the grief process of young widows and widowers. Implications included the need for more accessible resources for young widowed individuals, such as therapeutic services, finances, and childcare. Implications are also provided for clinicians, individuals, couples, and families.

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Grief is a universal reaction to loss. Losses are often associated to the death of a loved one, however, they may also originate from the end of an intimate partner relationship. Whereas studies have focused on grief after a divorce or on symptomology students endure after a death, this article attends to the understudied college student experience of grief following a breakup. Within emerging adulthood, the loss of a close romantic relationship may be challenging to navigate alongside the daily stressors of college. Stigmatization by means of social cues convey sentiments, such as the need to get over an ex-partner, which in turn can lead to disenfranchised grief where individuals do not feel heard, accepted, or valid in their experience of grief. It was hypothesized that as endorsed closeness of the past relationship increases so does grief intensity, and that as feelings of stigmatization increase also increases grief intensity. Multiple regression models supported the main effects, although the interaction effect between levels of closeness and perceived stigmatization was not supported. Implications and future directions are discussed.