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 purpose of this study was to investigate the relationship between end of life care competencies and terminal care stress of nurses in long term care hospitals. METHODS: For this study, 140 nurses were sampled among those that have over 6-month end of life care experience and were working at long term care hospitals located in A city and C city of Chungcheongnam-do. Using a questionnaire, data were collected from January 2018 through March 2018. Data were analyzed using the SPSS, Windows version 21.0, according to the purpose of the study and analyzed by descriptive statistics, t-test, one way ANOVA, Schéffe's test, and Pearson's correlation coefficient. RESULTS: The mean score on terminal care stress of nurses was above the normal level. The scores on end of life care competencies significantly varied by age, total career at hospitals, death/hospice and palliative care education, and bereavement experience. The mean score of end of life care competencies was negatively correlated with the mean score of lack of knowledge and skills among the sub-items of the terminal care stress category (r=−0.260, P=0.002). CONCLUSION: To decrease the terminal care stress of long term care hospital nurses, it is suggested to carry out end of life care education tailored to nurses' characteristics.
Bereavement ; Chungcheongnam-do ; Clinical Competence ; Education ; Long-Term Care ; Palliative Care ; Terminal Care

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

PURPOSE: This study aimed to (1) explore current levels of quality of life, depression, resilience and social support and (2) investigate factors associated with quality of life among parents who lost children in the Sewol ferry disaster. METHODS: Data for this descriptive and correlation study was collected from December 2016 to June 2017. Structured questionnaires were completed by 114 parents. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation, and multivariate linear regression. RESULTS: Lower levels of quality of life were reported by parents with no current occupation, who considered emotional support by others as not helpful, not disclosing self as family of a victim, experiencing change in social activities related to the disaster, and not participating in bereavement activities with other families (all p values <.05). Factors associated with quality of life were depression (β=−.53) and resilience (β=.26) and explained 48.0% variance (F=50.37, p<.001), while social support was not a significant factor. CONCLUSION: Our study findings provide fundamental information on the mental health status of families of the Sewol ferry disaster victims. Nursing interventions to improve quality of life of parents who lost their children in the disaster should emphasize both managing depression and improving resilience.
Bereavement ; Child ; Depression ; Disaster Victims ; Disasters ; Humans ; Linear Models ; Mental Health ; Nursing ; Occupations ; Parents ; Quality of Life ; Resilience, Psychological ; Statistics as Topic

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

OBJECTIVE: We monitored a group of students from Danwon High School who survived the Sewol ferry disaster for 27 months to examine the course of their psychological symptoms. METHODS: We performed a chart review at the Danwon High School Mental Health Center at the following time points (T): 9 months (T1), 12 months (T2), and 15 months (T3) after the disaster. Additionally, we performed a follow-up review at 27 months (T4). Subjects completed the ‘State’ section of the State-Trait Anxiety Inventory for Children, the Center for Epidemiological Studies-Depression assessment, the Child Report of Post-traumatic Symptoms, and the Inventory of Complicated Grief. Data from the 32 subjects who completed all four assessments were used in the statistical analyses. RESULTS: Scores of psychological variables tended to increase until T2 and then slowly decreased until T4. The severity of anxiety and complicated grief symptoms changed significantly over time, but the severity of depression and posttraumatic stress symptoms did not. CONCLUSION: We found that the symptoms of anxiety and complicated grief reported by Sewol ferry survivors from Danwon High School were exacerbated at the first anniversary of the disaster, but these symptoms subsided after the students graduated from high school.
Anniversaries and Special Events ; Anxiety ; Child ; Depression ; Disasters* ; Follow-Up Studies* ; Grief ; Humans ; Mental Health ; Prospective Studies* ; Retrospective Studies* ; Survivors*

OBJECTIVE: The Sewol ferry disaster caused shock and grief in South Korea. The aim of this study was to identify the factors associated with symptoms of complicated grief (CG) among the surviving students 20 months after that disaster. METHODS: This study was conducted using a cross-sectional design and a sample of 57 students who survived the Sewol ferry disaster. Data were collected using the following instruments: Inventory of Complicated Grief (ICG), the Lifetime Incidence of Traumatic Events-Child, the Child Report of Post-Traumatic Symptoms (CROPS), KIDSCREEN-27, Family Adaptability and Cohesion Evaluation Scales-III, the Peri-traumatic Dissociation–Post-traumatic Negative Beliefs–Post-traumatic Social Support scale, and the Strengths and Difficulties Questionnaire. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with symptoms of CG. RESULTS: The mean score on the ICG was 15.57 (standard deviation: 12.72). Being born in 1999, a higher score on the CROPS and a lower score in autonomy and relationship with parents on the KIDSCREEN-27 were related to higher levels of CG. CONCLUSION: Twenty months after the Sewol ferry disaster, 24.5% of surviving students were suffering from CG. This study uncovered a vulnerable population of bereaved children at high risk for CG.
Child ; Disasters* ; Grief* ; Humans ; Incidence ; Korea* ; Linear Models ; Parents ; Shock ; Vulnerable Populations