The field of bereavement research is currently lacking empirical studies examining grief in adolescent and young adult populations. Furthermore, the roles of religion (Hays, & Hendrix, 2008), meaning-making (Park, 2005) and post-bereavement personal growth (Davis, 2008), all of which are critical to understanding the loss experiences of people in these age groups (Balk, & Corr, 1996), have yet to be enumerated in a reliable way in the literature. Stroebe (2004) has emphasized the need to improve methods and measurement tools by including more thorough measures of religious coping and bereavement experience. The current study aimed to clarify the process of meaning-making following the loss of a loved one by testing a mediational model in which the use of positive religious coping methods influence the maintenance or development of adaptive core beliefs, which in turn produce favorable outcomes. Data were collected in a survey format from 222 college students, and analyzed using structural equation modeling to test the data against Baron and Kenny’s (1986) criteria for mediation. The data do not support a mediational model of meaning-making for the current sample, but an acceptable model of the effects of world assumptions on outcome variables was developed. The data suggest that while all core beliefs are important to the process of personal growth following a loss, beliefs regarding self-worth are the strongest predictors of positive outcomes and stronger beliefs in the randomness of events are problematic.

This research explored the social and psychological needs of caregivers of advanced cancer patients, and their subsequent bereavement adjustment. The study focuses exclusively on informal caregivers who provide assistance to patients receiving hospice care for end-stage cancer. Those individuals living furthest from the dying care recipient, the long distance caregivers, were of particular interest. This study used a prospective design to explore how a caregiver's geographic proximity impacted their social support and bereavement adjustment. A 2 x 3 repeated measures design was used to gather data from caregivers before a patient's death (using a pre-death questionnaire) as well as after the death (by post-death questionnaire). This design allowed for an examination of differences between three groups of caregivers over time: long distance caregivers (who live an hour or more from the care recipient), proximate caregivers (who live less than an hour away) and co-residing caregivers. One hundred and six (N = 106) caregivers were recruited to participate from Covenant Hospice, a large Gulf Coast-based palliative care organization. Validated instruments were used to measure levels of social support and bereavement adjustment. A repeated measures MANCOVA procedure explored the impact of geographic proximity on measures of social support and adjustment. Results did not support the proposed multivariate model. However, quality of dying (as measured by the QOD-Hospice) was identified as an influential between-groups covariate within the model. Further exploration of the QOD-Hospice revealed a negative correlation with levels of emotional grief, and positive correlations with length of stay in hospice, and pre-loss and post-loss levels of social support. Overall results seem to suggest that timely referrals to hospice, improvements in care for the dying, and increased attention to quality of dying, may have a beneficial impact for survivors during bereavement. Furthermore, findings from this study suggest that the quality of a person's final days may play an important role in how the surviving caregivers adjust to the loss. Not only can high quality end-of-life care benefit dying patients, but it may also facilitate bereavement adjustment for those who participated in their care network. However, findings were limited and further investigation of these relationships is warranted.

A research report submitted to the Faculties of Health Sciences and Humanities, Schools of Public Health and Social Sciences, University of Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Arts in the field of Demography and Population Studies, October 2017 / Background: Various international and national commitments and interventions that focus on improving maternal, newborn and child health have been established in South Africa. Irrespective of these efforts, adverse pregnancy outcomes (stillbirths and miscarriages) remain invisible within policies and programmes intended to reduce this public health burden thus leading to its high rate in South Africa. This mismatch of burden to action is due to several factors that keep stillbirths and miscarriages hidden, notably underreporting which leads to a lack of data and a lack of consensus on priority interventions and, social taboos that reduce the visibility of stillbirths and the associated family morning. While studies have identified a number of individual demographic and socioeconomic factors associated with stillbirths and miscarriages, the role of household socioeconomic factors remain unexplored. Poor socioeconomic conditions within a household have broadly been linked with poor health and negative birth outcome among pregnant women. This study therefore sought to identify demographic and household socioeconomic associated with stillbirths and miscarriages in South Africa. Methods: This study utilized secondary data from the 2010 – 2014 South African General Household Survey (SAGHS). The study sample comprises of women of reproductive age 15 49 years who were resident in the households selected to participate in the SAGHS. A sample of 248,057 women were included in the study; these are women who reported to have been pregnant in the last 12 months preceding the survey from 2010-2014. The population of interest in this study are South African women whose pregnancy has ended in a stillbirth and or a miscarriage. The outcome variable was pregnancy outcomes (stillbirths, miscarriages and others) while predictor variables include household wealth status, maternal age, source of drinking water, type of toilet facility, sex of household head, province of residence, household electricity, population group and HIV status. Data analysis was done in three stages. First, univariate analysis was done to provide descriptive results of the study population. The second staged involved a bivariate analysis producing odds ratios to examine the association between each predictor variable with each pregnancy outcome. The third stage included an unadjusted (bivariate) and adjusted (multivariate) multinomial logistic regression producing relative risk ratios (RRRs) to examine the demographic and household socioeconomic determinants of stillbirths and miscarriages. Results: The levels of stillbirths were 0.17% and 0.37% in 2013 compared to 0.11% and 0.12% respectively. The stillbirth rate (SBR) from 2010-2014 was 25.7 per 1000 births while miscarriage rate was 24.5 per 1000 pregnancies. Results from the multinomial logistic regression showed that maternal age, race, sex of household head, province of residence, source of drinking water, type of toilet facility, geographic type, household wealth index, hypertension and HIV positive status are significant determinants of stillbirths and miscarriages among women in South Africa. Advanced maternal age (34-39 and 40-44 years), rural residence, being Black, use of other type of toilet facilities, poor wealth quintile, Northern Cape province, being 000HIV positive and drinking piped water are associated with an increased risk of stillbirths and miscarriages. Conclusion: This study found that demographic and household socioeconomic factors are associated with pregnancy outcomes (stillbirths and miscarriages) among women aged 15-49 years in South Africa. This study has demonstrated the fact that household socioeconomic factors are important in understanding the determinants of stillbirths and miscarriages. Thus, the outcomes of pregnancy are not separable from the socioeconomic conditions of the pregnant women within a household as maternal poverty can translate to poor foetal health. Interventions on maternal, newborn and child health should also be more targeted at these pregnancy outcomes as stand-alone health indicators to address the dearth of data and to ensure proper monitoring. Furthermore, women in remote areas who do not have access to electricity, toilet facilities and other important assets in their household should be prioritized by programs on poverty alleviation. Lastly, it is crucial that quality obstetric care services should be made available, accessible and affordable for women in remote areas. This may improve the outcomes of pregnancy through early detection of pregnancy complications. / XL2018

Thesis advisor: June Horowitz / Parents who simultaneously grieve the loss of one twin and nurture the surviving twin experience a paradox of grief and joy. The acute grief of losing a twin coincides with a critical time in the development of the parental role and relationship with the surviving twin. Very few researchers have addressed the unique parenting situation in which one twin infant dies. The aim of this qualitative descriptive study was to describe the experience of parents who lose one twin in utero, at birth, or in the neonatal period. The study question was "What is the parenting experience of mothers and fathers who simultaneously face the grief of the loss of one twin while nurturing the surviving twin during infancy?" Nine parents, recruited via a support group, were interviewed. Systematic content analysis, emphasizing in-vivo coding (participant's own words), was conducted until data saturation was reached. A comprehensive description of the experience of raising a surviving twin was constructed. Four descriptive themes were identified: (1) Living with ambiguity: the irony of raising a lone twin, belonging and not belonging, and at least there is one; (2) Communicating the family journey: telling or not telling, deciding who needs to know, and how many children; (3) Parenting with wonder and worry: doubt and hyper-vigilance, unanswered questions, and the living twin as a unique person; and (4) Life is different now: loss of innocence, honoring both twins, making and keeping relationships, work-life challenges, and accepting that it doesn't go away. Issues raised by parents included the ambiguity and irony of losing one twin, no one understands, multiple losses, and living with this loss. The description of this experience gives insight to the dynamics and burden of this loss. Data from this study can inform pediatric nurses about the issues, concerns, and needs of parents who sustain this kind of loss. Therapeutic interventions based by the tenets of family-centered nursing care can be developed by understanding the long-term effects of grief on parenting. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Finally, some recommendations for the development of bereavement counselling in relation to social policy, service delivery, education and training, workers' personal development, as well as future research were presented. / In--depth interviews were conducted with 12 social workers working in palliative care. This figure was nearly half of the total number of palliative care social workers in Taiwan, so the research findings may reflect the general situation of bereavement counselling in Taiwan. Their stories revealed the endeavours of these social workers in the past years and showed the development of the services from nothing to multifarious. / The narratives of the workers reflected the required individual characteristics of a bereavement counsellor, such as stability in emotion, resilience, creativity, psychic energy. Due to the nature of their work they often encountered death and sufferings, as well as feeling of helplessness. In facing different obstacles and challenges, some of them might retreat themselves at times, especially for those who were still entangled in their personal bereavement. Their emotional state would affect the establishment of effective helping relationship and subsequently the effectiveness of their service. / The research revealed that most of the social workers did not apply any specific theories, or techniques in working with the bereaved. Their narratives reflected that they worked with the bereaved by establishing a meaningful working relationship. They respected and accepted their clients' needs; their empathic support helped the bereaved face the pain of losing their loved ones. Their encouragement and assurance helped them develop and change. Their skills and methods matched well with those of humanism and existentialism. They also tended to adopt postmodernism approach of storytelling in helping the bereaved. Through narration, the workers helped the bereaved re-construct the meaning of their relationship with the deceased in their life. / The study revealed that the social workers considered most of the bereaved had the ability of self-healing, but for some, due to personal or environmental factors they might be entangled in their grief and might need assistance. Their work reflected the emphases of bereavement counselling in Taiwan. Besides counselling service, they also provided assistance in medical related matters, emotional support, enhancement of family members' communication, social adjustment and religious support. Due to the socio-cultural backgrounds of Taiwan, their tasks also included special arrangements at death and discussion of funeral services and rituals. The social workers also stressed the importance of the traditional value of harmony among Heaven, Earth and Man. They paid special attention to the emotional harmony of the bereaved, harmony between the bereaved and their relatives, and harmony among the social environment, the spiritual and the bereaved. / This study is a narrative analysis of the palliative care social workers' experiences in bereavement counselling in Taiwan. It explored the characteristics of bereavement counselling, the social workers' interpretation of their experiences and the cultural and contextual factors that affected the palliative care social workers and bereavement counselling. / 李閏華. / Adviser: Mong Chow Amy Lam. / Source: Dissertation Abstracts International, Volume: 73-03, Section: A, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (p. 277-305) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Li Runhua.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2016-08-24T12:25:58Z No. of bitstreams: 1 Cibele Martins de OLiveira Marras.pdf: 2219286 bytes, checksum: 238fc1d9eb40d1f46695d0f5889dc89f (MD5) / Made available in DSpace on 2016-08-24T12:25:58Z (GMT). No. of bitstreams: 1 Cibele Martins de OLiveira Marras.pdf: 2219286 bytes, checksum: 238fc1d9eb40d1f46695d0f5889dc89f (MD5) Previous issue date: 2016-04-01 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Grief is a human experience after the loss of a significant person. It enters the workplace, although companies and workers try to avoid it. This study aimed to comprehend the experience of grief in workers in the workplace through the evaluation of expected symptoms and reactions after the loss of a loved one. The method used was of a midst research with quantitative and qualitative analyses. The data basis was collected by internet by an on-line questionnaire. Thirty-four bereaved people of the metropolitan region of São Paulo that were working in the period of the death of their loved ones attended the research. The symptoms and reactions were divided in categories and classified by their effects in the performance of the worker. The physical and psychosomatic, emotional, relationship, cognitive and work related areas had more frequency of negative effects. Spiritual and resilient areas had more positive effects. A grouping of the sample was done by clusters, and divided them in 3 groups. Group 1 do not have effects of the symptoms, group 2 had the negative effects, and group 3 do not have the symptoms and had more positive effects of spiritual and resilient areas. Gender had influence in the answers; women reported more negative effects than men. In the qualitative analyses, work was positive and had a coping factor when the company is flexible and when provides social support to the bereaved worker. It has negative effect when the worker is threatened by his low performance and when do not recognize the loss and the bereaved. About the experience of the grief, the bereaved refers difficulty of being present, illness after the loss, lack of emotional control and the secondary losses. But they too refer review of life choices and the help of specialized support of doctors and psychologists / O luto é uma experiência humana desencadeada após a perda de uma pessoa significativa. Ele adentra o ambiente de trabalho, apesar de empresas e trabalhadores buscarem afastar emoções deste local. A presente pesquisa teve como objetivo compreender a vivência do luto em profissionais neste ambiente através da avaliação de sintomas e reações esperadas após uma perda de um ente querido. O método utilizado foi pesquisa mista, com análise quantitativa e qualitativa. A coleta de dados foi divulgada por bola de neve e feita por questionário on-line. Participaram 34 enlutados residentes na região metropolitana de São Paulo e que trabalhavam no momento da perda. Os dados dos sintomas e reações foram divididos em categorias e classificados segundo seus efeitos no desempenho do profissional. As áreas física e psicossomática, emocional, relacional, cognitiva e relacionada ao trabalho apresentaram maior frequência de efeitos negativos. As áreas espiritualidade e resiliência tiveram mais efeitos positivos. Foi realizado agrupamento por clusters da amostra, que resultou em 3 grupos, com as seguintes características: grupo 1 não apresentavam efeitos dos sintomas, grupo 2 referiam efeitos negativos sobre o desempenho laboral e o grupo 3 não apresentavam os sintomas pesquisados. A questão do gênero mostrou ter influência nas respostas, sendo que as mulheres referem mais sintomas negativos do que os homens. Na análise qualitativa o trabalho foi avaliado como tendo efeitos positivos no processo de luto e sendo um recurso de enfrentamento quando a empresa é flexível e quando há suporte social. É negativo quando o enlutado sente-se ameaçado por seu baixo rendimento e pelo não reconhecimento do luto. O enlutado, ao se referir a experiência do luto no trabalho, relata dificuldade de estar presente, o adoecimento físico advindo da perda, descontrole emocional e perdas secundárias. Demonstra que esse processo também favorece revisão de escolhas pessoais e que a presença de suporte especializado auxilia o processo

SammanfattningVid en förlust av en nära anhörig kan ett barns livsvärld förändras, vilket kan innebära ett lidande för barnet. Beroende på barnets ålder, utvecklingsstadium och tidigare erfarenheter reagerar alla barn olika. Sjuksköterskan kan möta barn i sorg inom vården och därför behöver denne veta hur barnet reagerar på förlusten av en nära anhörig.Syftet med studien är att belysa hur barn upplever förlusten av en nära anhörig. Vi gjorde en litteraturstudie mellan årtalen 1999-2011, där vi använde oss av åtta artiklar i vårt resultat. Där framkom fyra ämnen: barnets sätt att hantera sorgen, omständigheter kring dödsfallet, förståelsen av döden utifrån ålder och utveckling och genusperspektiv. Barnen behöver rak och ärlig information anpassat till dess ålder och utvecklingsnivå. Vidare framkom att sjuksköterskan behöver mer kunskap inom området.

Conversations about Mortality is a series that uses installation, sculpture, painting, and audio to explore our relationship to mortality. The premise of the work relies on the quote, “The truth is rather than the images, though beautiful in themselves, come to life in the act of vanishing…” The research begins with a recorded conversation with four individuals who have all lost someone they love. The audio explores the memories each speaker has of the deceased. A portrait of the speaker is painted on watersoluble paper with a quote from the conversation laser etched into the back of the painting. The painting is then placed in a water vessel made of plexiglass, and then installed on found raw wood and steel for support. Viewers are encouraged to sit on a provided chair to listen to each speaker. / Includes bibliography. / Thesis (M.F.A.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

INTRODUÇÃO: O luto é a reação psíquica gerada pelo rompimento de um vínculo afetivo; pode ser elaborado de forma satisfatória, mas em certas situações pode gerar sintomas de ansiedade e depressão, e em alguns casos o luto complicado. No presente estudo avaliou-se a prevalência, frente ao acompanhamento psicológico, de sintomas de ansiedade e depressão em familiares enlutados, que perderam seus entes queridos em um hospital oncológico de alta complexidade; percebeu-se o impacto que o coping religioso/espiritual, traduzido no português como enfrentamento religioso/espiritual, tem no processo de elaboração do luto. CASUÍSTICA E MÉTODO: Foram avaliados 15 familiares, após convite a participar dessa pesquisa mediante avaliação do Serviço de Psicologia Hospitalar do ICESP (Instituto do Câncer do Estado de São Paulo); os sujeitos deveriam ser maiores de 18 anos, e que estiveram presente no processo de internação e falecimento do paciente. A esta população foi oferecida 12 sessões de psicoterapia, sendo que na primeira foram aplicados a entrevista semi-estruturada, os Inventários de Beck de ansiedade e depressão, e a Escala de coping religioso/espiritual; ao fim do processo, os Inventários de Beck de ansiedade e depressão foram novamente aplicados. RESULTADO: No trabalho realizado, notou-se, através da aplicação dos Inventários de Beck de ansiedade e depressão, e da entrevista semiestruturada a presença de sintomas de ansiedade e depressão em sujeitos enlutados, sendo que anterior aos atendimentos os escores do Inventário de Beck de ansiedade e depressão, eram, respectivamente 13 e 18; ao fim dos atendimentos, o valor decresceu para 8 em cada um dos Inventários. Além disso, pode-se perceber um alto uso do coping religioso/espiritual pelos sujeitos, com mediana de 3,6 comprovando que a religiosidade/espiritualidade tem grande influência no processo de elaboração do luto. DISCUSSÃO: Os escores dos Inventários de Beck de ansiedade e depressão, ao fim dos atendimentos indicam a importância da psicoterapia no processo de elaboração do luto, sendo essa capaz de atenuar sintomas de ansiedade e depressão nos sujeitos; além disso, o alto uso do coping religioso/espiritual nos permite compreender que a religiosidade/espiritualidade são fatores importantes no processo de elaboração de luto, sendo para certos sujeitos o que facilita o processo de elaboração da perda, uma vez que oferece sentido à mesma e conforta o sujeito enlutado; para alguns sujeitos, a perda alterou sua estrutura de fé, o que gerou um distanciamento da religiosidade/espiritualidade. Neste trabalho foi possível compreender que quando isto ocorre, o sujeito está mais suscetível ao desenvolvimento de sintomas de ansiedade e depressão. CONCLUSÃO: No estudo realizado pode-se observar a presença de sintomas de ansiedade e/ou depressão em familiares enlutados, e que esses sintomas, em sua maioria, decrescem ao fim do acompanhamento psicológico; e que o coping religioso/espiritual tem grande influência no processo de elaboração do luto / INTRODUCTION: Grief is the psychic reaction generated by the breaking of an affective bond, sometimes it can be well elaborated, but in certain situations it can generate symptoms of anxiety and depression and in some cases the complicated grief. In the present study, the prevalence of anxiety and depression symptoms in bereaved patients, who lost their loved ones in a highly complex oncology hospital, was evaluated during psychological counseling; it was also accessed the impact that the religious / spiritual coping, has in the process of grief. METHODS: Fifteen family members were evaluated, after being invited to participate in this research, through an evaluation of the Hospital Psychology Service, the subjects should be 18 years old or older and be present in the process of hospitalization and death of the patient. To this population were offered 12 sessions of psychotherapy, in which the first were applied the semistructured interview, the Beck Inventories of anxiety and depression, and the Scale of religious / spiritual coping; at the end of the process, the Beck Anxiety and Depression Inventories were applied again. RESULTS: In the study carried out, the presence of symptoms of anxiety and depression in grieving subjects was noticed through the application of the Beck Inventories of anxiety and depression and the semi-structured interview. The anxiety and depression scores were, respectively, 13 and 18, in the beginning of the process, and at the end of the psychological support, the value decreased to 8 in both Inventories. In addition, one can notice a high use of religious / spiritual coping by the subjects, with a median of 3.6 that proves that religiosity / spirituality has a great influence on the process of mourning. DISCUSSION: The Beck Inventory of anxiety and depression scores at the end of the process indicates the importance of psychotherapy in the process of mourning, which is able to attenuate symptoms of anxiety and depression in the subjects; in addition, the high use of religious / spiritual coping allows us to understand that religiosity / spirituality are important factors in the process of mourning, and for some subjects it facilitates the process of elaborating the loss, since it offers meaning to the same and comforts the bereaved subject; for some subjects, the loss altered their structure of faith, which generated a distancing of the religiosity / spirituality. In this work it was possible to understand that when this occurs, the subject is more susceptible to the development of symptoms of anxiety and depression. CONCLUSION: In the present study the presence of anxiety and / or depressive symptoms in bereaved relatives can be observed, it was also possible to observe that these symptoms, for the most part, decrease at the end of the psychological follow-up; and that religious / spiritual coping has a great influence on the process of mourning

Children who experience a parent's death by suicide are a vulnerable population at risk for emotional and mental health issues as well as suicide attempts (Cerel, Fristad, Weller, & Weller, 1999; Kuramoto et al., 2010; Wilcox et al., 2010). Yet, in spite of the knowledge that effective postvention is in reality prevention (Cerel et al. 2008), relatively little is known about these children and adolescents, particularly regarding their experiences following the suicide. The current research study investigated which resources, assistance, and actions of those around the child were perceived as most helpful and unhelpful following the parental suicide. Through semi-structured qualitative interviews using the hermeneutic approach, the researcher interviewed 17 adults who, as children or adolescents, were bereaved by parent suicide. Helpful experiences and support included assistance processing the suicide and an openness in the face of stigma. Unhelpful experiences included judgment and blame, silence regarding the suicide and deceased parent, and a heightened awareness of the surviving parent's challenges. Individuals who were perceived as helpful generally had pre-existing relationships with the children and helped meet their practical and emotional needs. It is recommended that customized and varied support be offered, along with the message that it is important to talk about suicide and memorialize the deceased parent. Additional research is needed to further explore the complex experiences of children of parent suicide; this will aid in the development of evidence-based interventions to better support them.