• Wei-Shu Lai, Wen-Wen Li, and Wei-Hsin Chiu.
• Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan. Electronic address: weisue@mail.ncku.edu.tw.
• Eur J Oncol Nurs. 2021 Jun 1; 52: 101967.

PurposeTo explore the experience of grief in bereaved Taiwanese family members whose loved ones died from cancer.MethodA qualitative study was used in this interview-based investigation. A purposive sampling technique and maximum variability were used to obtain a comprehensive overview. A total of 16 Taiwanese adults whose beloved family member had died of cancer were recruited from a palliative care unit of a medical center in southern Taiwan. Interviews were transcribed verbatim and analyzed using thematic analysis. The data analysis and interpretation were critically evaluated and discussed until final agreement was achieved. Recruitment was terminated when the data were found to be saturated.ResultsFour "TEAR" themes reflecting the experience of grief in bereaved Taiwanese family were extracted from the transcript analyses: taboo topics, emotion hiding, asynchronous grief, and relational tension. The participants endured the mutual influence of the family atmosphere, which was akin to silently walking the grief journey and inconsistent with TEAR model of task-oriented mourning. Silent grieving dominated their lives, which is different from Western culture with a more explicit expression of grief.ConclusionsSilent grief provides a new avenue for exploring grief among bereaved families, potentially impacting their ability to fully grieve through the expressed feelings proposed by William Worden's TEAR model of task-oriented mourning. Thus, this silent grieving should be acknowledged. The findings provide support for developing family-centered, culturally tailored bereavement care. Healthcare professionals play an important role in detecting changes in family dynamics that may interfere with support from family members.Copyright © 2021 Elsevier Ltd. All rights reserved.

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