Humans ; COVID-19 ; Pandemics ; Grief ; SARS-CoV-2

INTRODUCTION: The COVID-19 pandemic has brought about multiple losses to various groups, namely patients, families and healthcare professionals. Grief, which is the reaction to these losses, could cause strain on these individuals' physical and mental health if not identified and managed early. This scoping review analysed loss, grief and how they were managed among these groups during the pandemic. METHOD: This scoping review utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute framework for scoping reviews. Only qualitative studies relating to loss and grief and their management were included. Of 166 studies screened, 69 were included in the study. Qualitative analysis and data coding of each record were conducted through qualitative data analysis software. RESULTS: Losses included the death of family members, patients, colleagues and others. They also included the loss of usual routines, lifestyles and physical health. The grief experienced was multidimensional, affecting mainly the emotional, physical, social and existential realms. Anger, guilt and fear resulted from unsatisfactory farewells, issues with funerals, social isolation, financial strain and stigmatisation. Management strategies could be categorised into 5 themes: communication, finance, counselling, education and spiritual care. CONCLUSION Loss and grief identification and management among patients, family members and healthcare professionals are critically important during this COVID-19 pandemic. Current operating guidelines have proven insufficient in managing loss and grief. Innovative strategies are essential to tackle the many dimensions of loss and grief. Nevertheless, further research is necessary to better understand the effectiveness of implemented policies.
Humans ; COVID-19 ; Grief ; Health Personnel ; Pandemics ; Qualitative Research

OBJECTIVES: To investigate the attitudes and skills of grief counseling in the front-line medical workers from coronavirus disease 2019 (COVID-19) designated hospitals in Wuhan for the bereaved family members and to provide the basis for proper hospital management strategies. METHODS: The convenience sampling method was applied to select 422 medical workers who kept touch with the bereaved family members in five COVID-19 designated hospitals in Wuhan from January to February 2020. Questionnaire regarding grief counseling attitudes and questionnaire regarding grief counseling skills were used to evaluate the attitudes and skills of grief counseling in medical workers. The scores of grief counseling attitudes and skills in group of different characteristics were further compared. Pearson correlation was used to analyze the attitudes and skills of grief counseling in medical workers. RESULTS: The scores of grief counseling attitudes in medical workers were 15-46 (33.00±9.31). Length of service, professional title, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' attitudes of grief counseling (all <0.05). The scores of grief counseling skills in medical workers were 9-30 (19.30±4.42). Length of service, professional title, religion, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' skills of grief counseling (all <0.05). There was a significant positive correlation between the attitudes and skills of grief counseling in the medical workers (=0.608, <0.01). CONCLUSIONS The attitudes and skills of grief counseling in the medical workers from COVID-19 designated hospitals in Wuhan still need to be improved. Grief counseling group and a long-term, comprehensive training system are recommended.
Attitude of Health Personnel ; Betacoronavirus ; China ; Coronavirus Infections ; psychology ; Counseling ; Grief ; Health Personnel ; psychology ; Hospitals ; Humans ; Pandemics ; Pneumonia, Viral ; psychology

PURPOSE: The aim of this study was to identify factors influencing on the mental health in bereaved adults. METHODS: A descriptive and correlational study was conducted in 160 adults who had experienced bereavement. The collected data was analyzed using descriptive statistics, Pearson's correlation, and hierarchical multiple linear regression analyses with SPSS 26.0. RESULTS: The participants' mental health showed a positive correlation with complicated grief (r=.31, p<.001) and a negative correlation with grief and meaning reconstruction (r=−.30, p<.001). Sex, sleeping time, intimacy with the deceased, grief reaction, and grief and meaning reconstruction were significant factors influencing on the mental health. The total explanatory power of these variables was 31.8%. CONCLUSION: It is necessary to explore the persistent and impairing grief after experiencing bereavement. Our study findings will be fundamental evidence to develop nursing interventions to improve adult mental health dealing with bereavement and grief.
Adult ; Bereavement ; Grief ; Humans ; Linear Models ; Mental Health ; Nursing

BACKGROUND: The objective of this study was to determine whether severity and severity change of coexisting psychiatric symptoms might affect change of complicated grief (CG) regarding the Sewol ferry disaster. METHODS: Data from a cross-sectional survey were obtained 18 months (Time 1) and 30 months (Time 2) after the disaster. We ascertained sociodemographic variables and variables obtained from self-reporting questionnaires (i.e., CG, depression, anxiety, post-traumatic stress disorder [PTSD], insomnia, embitterment, and suicidal risk) among 56 bereaved family members. RESULTS: Severity of other psychiatric symptoms at Time 1 had no effect on change of CG at Time 2. However, changes in severity of PTSD over a year affected change of CG. CONCLUSION: It is important to evaluate changes in severity of PTSD and its treatment during management of CG, especially when it involves bereaved families experiencing a traumatic accident.
Anxiety ; Bereavement ; Cross-Sectional Studies ; Depression ; Disasters ; Follow-Up Studies ; Grief ; Humans ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic

OBJECTIVE: After the Sewol ferry disaster, bereavement with suicidal ideation was a critical mental health problem that was accompanied by various neuropsychological symptoms. This study examined the frontal alpha asymmetry (FAA), heart rate variability (HRV), and several psychological symptoms in bereaved family members (BFM) after the Sewol ferry disaster. METHODS: Eighty-three BFM after the Sewol ferry disaster were recruited. We assessed FAA, HRV, and psychological symptoms, including depression, post-traumatic stress, post-traumatic growth factor, anxiety, grief, and positive resources, between BFM with the presence and absence of current suicidal ideation. RESULTS: Compared to BFM without suicidal ideation, BFM with suicidal ideation showed a higher FAA with right dominance. Significant differences in psychological symptoms were observed between the groups. In BFM with suicidal ideation, the low: high frequency (LF:HF) ratio correlated with social resources and support. CONCLUSION: The FAA and LF:HF ratio may be biomarkers that represent the pathological conditions of BFM with suicidal ideation. If researched further, they may shed light on the interaction between bereavement with suicidal ideation and social resources for therapeutic intervention.
Anxiety ; Bereavement ; Biomarkers ; Depression ; Disasters* ; Grief ; Heart Rate* ; Heart* ; Humans ; Mental Health ; Suicidal Ideation*

PURPOSE: The purpose of this study was to investigate variables and construct paths that affect complicated grief. METHODS: Participants in this cross-sectional, descriptive study were 164 bereaved spouses of cancer patients at least 12 months before the death. Data were collected from October 2016 to February 2017 using self-report structured questionnaires and were analyzed using IBM SPSS 21.0 and AMOS 20.0. RESULTS: The variables affecting complicated grief of bereaved spouses of cancer patients were the quality of end-of-life care (γ=.15, p < .001), preparedness for death (β=−.06, p=.005), and coping with bereavement (β=−.24, p < .001), whereas the quality of death and dying did not show any effects. Preparedness for death had multiple mediating effects in the relationship between the quality of end-of-life care and complicated grief (z=−2.20, p=.028), and in the relationship between the quality of end-of-life care and coping with bereavement (z=2.11, p=.035). Coping with bereavement had a mediating effect on the relationship between preparedness for death and complicated grief (z=−2.39, p=.017). CONCLUSION: This study revealed that preparedness for death and coping with bereavement play a prominent role in complicated grief. Therefore, it is important to help in preparing for death and enhancing coping with bereavement of spouses providing end-of-life care to cancer patients. In addition, investigating cultural differences in the relationship between the quality of end-of-life care and complicated grief is recommended.
Bereavement ; Grief ; Humans ; Negotiating ; Palliative Care ; Spouses ; Terminal Care

BACKGROUND: The purpose of this study was to examine post-traumatic stress, depression, anxiety, and complicated grief in Korean high school students who experienced a peer suicide. METHODS: A total of 956 students were included in the statistical analysis. One week after a peer suicide, a school-based crisis intervention program was conducted. The cohort was followed-up at one week and five months after a peer suicide. The program consists of screening tests, educational sessions, and further interview with psychiatric specialists for the selected group. Screening tests were conducted for all students to measure the Child Report of Post-traumatic Symptoms (CROPS), the post-traumatic stress symptoms (The University of California at Los Angeles post-traumatic stress disorder [PTSD] reaction index; UCLA-PTSD-RI), the anxiety symptoms (The Korean-Beck Anxiety Inventory; K-BAI), the depressive symptoms (The Korean-Beck Depression Inventory-II; K-BDI-II), and the complicated grief reaction (The Inventory of Complicated Grief; ICG). For statistical analysis, the SPSS Statistics 21.0 program was used. RESULTS: At baseline and five months follow-ups, 8.6% and 2.9% of the students showed post-traumatic stress symptoms. At five months follow-up, there was a statistically significant decline in the post-traumatic stress symptoms, anxiety, depression, and complicated grief among the ‘trauma group.’ A higher proportion of the female students showed post-traumatic stress symptoms after the incident of peer suicide than the male students. CONCLUSION: School-based crisis intervention helps improvement of trauma-related symptoms. It might be an effective way to prevent suicide spreading among students by alleviating trauma-related symptoms.
Anxiety ; California ; Child ; Cohort Studies ; Crisis Intervention* ; Depression ; Female ; Follow-Up Studies* ; Grief ; Humans ; Male ; Mass Screening ; Specialization ; Stress Disorders, Post-Traumatic ; Suicide*

OBJECTIVES: The purpose of this study is to examine the moderating effect of social supports on the relationship between grief level and suicidal ideation of the elderly living alone. METHODS: We analyzed data from a questionnaire administered to subjects aged 65 years or older living alone for a 2017 community mental health project in Gyeongnam S city. To investigate the moderating effects of variables, we conducted a hierarchial regression analysis and confirmed the change R2. RESULTS: When adjusted for education and economic level, grief level had not a direct impact on suicidal ideation. And it was found that interdependent social support was moderating variables in the relationship of grief level and suicidal ideation of the elderly living alone. CONCLUSIONS: There is a need for appropriate programs that reduce suicidal ideation and therefore suicidal action. Moreover, it is especially necessary to enhance interdependent social supports.
Aged* ; Education ; Grief* ; Humans ; Mental Health ; Suicidal Ideation*

PURPOSE: This study was conducted to identify the factors affecting on unmet healthcare needs of married immigrant women, especially who are working in South Korea. METHODS: It is designed as a cross-sectional descriptive study. We analyzed data from 8,142 working married immigrant women to the ‘National Survey of Multicultural Families 2015.’ Based on Andersen's health behavior model, logistic regression was conducted to determine the predictors of unmet healthcare need. RESULTS: The prevalence of unmet healthcare needs among the subjects was 11.6%. In multivariate analysis, significant predictors of unmet needs included existence of preschooler, country of origin, period of residence in predisposing factors, monthly household income, helpful social relationship, social discrimination, Korean proficiency, working hour per week in enabling factors, and self-rated health, experience of grief or desperation in need factors. CONCLUSION: The association between labor-related factors and unmet healthcare needs of marriage immigrant women currently working was found from nationally representative sample. Support policies for immigrant women working more than legally defined hours and having preschooler should be supplemented to reduce unmet healthcare needs. In addition, eradicating discrimination in workplace, enlarging social relationship, and developing culturally competent nursing services tailored to health problems caused by labor are needed.
Causality ; Delivery of Health Care ; Discrimination (Psychology) ; Emigrants and Immigrants ; Family Characteristics ; Female ; Grief ; Health Behavior ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Korea ; Logistic Models ; Marriage ; Multivariate Analysis ; Nursing Services ; Prevalence ; Social Discrimination ; Women, Working