Death studies
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This study examined the influence of surrogate gender on the accuracy of substituted judgments about the use of life-sustaining treatment in a sample of 249 older adults and their self-selected surrogate decision-makers. Overall, wives were more accurate than husbands at predicting their spouses' treatment wishes. Surrogates' perceptions of their own abilities did not differ by gender but, among patients, husbands had more confidence than wives in their spouses' accuracy as, and comfort being, a surrogate. The results are discussed within the context of broader gender differences in caregiving and highlight the need for more research regarding predictors of surrogate accuracy to assist patients in selecting surrogates who will help protect their end of life wishes.
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Studies examining medical teams indicate that exposure to the terminally ill often has detrimental effects on their physical and emotional well-being. However, recent theoretical developments suggest that this exposure might also have positive implications. The current study sought to examine 2 positive outcomes, meaning in life and personal growth, among physicians and nurses working with hospitalized children and exposed to different levels of patient mortality. ⋯ The findings indicate that a higher level of exposure to patient death, higher optimism, and professional self-esteem, and lower secondary traumatization predicted the sense of meaning in life, whereas occupation, as well as higher professional self-esteem and higher level of secondary traumatization, especially among lower professional self-esteem individuals, predicted a higher experience of personal growth. In addition, nurses reported higher levels of professional self-esteem, secondary traumatization, and personal growth than physicians. The theoretical and practical implications of the results are discussed.
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The author argues that the term recovery aptly describes the trajectory following the bereavement of most persons. While the term resilience has gained ascendancy in the thanatology literature and the term recovery has been dismissed as inappropriate to denote responses over time to being bereaved, the irony is that all dictionaries of the English language, other than specialized dictionaries in such fields as psychology, define resilience as ability to recover quickly from a misfortune. The author argues that recovery denotes the possibility of transforming change following a major life crisis, and wonders how such an outcome would be possible for those whose response to bereavement is marked by resiliency. ⋯ These changes are captured by what the author calls the reflexive meaning of the word recovery. In a final comment the author accepts that another word than recovery may unambiguously designate the transforming change that many persons experience following bereavement. But, of course, we need to find that word, and if recovery does not suffice, then how can resilience, a term that means quick recovery following misfortune?
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This article explores the concept of recovery in the wake of a loved one's death, using a cultural and developmental systems approach to understanding child, adult, and family bereavement outcomes as evolving, interdependent adaptive responses to changed circumstances of development within highly specific contexts in intergenerational time and cultural space. An integrative life span perspective on developmental psychopathology and resilience emphasizes the multi-dimensional nature of grief responses and their interweaving with ongoing and new interdependent adaptive strategies designed to accomplish specific, evolving tasks of shared life cycle development. ⋯ The article uses clinical examples of interventions after a loved one's death from a chronic illness to illustrate how interventions can help identify critical developmental systems and leverage points supporting positive development and giving priority to the bereaved's own goals for grief and growth. This intervention model emphasizes patient-centered perspectives, conducts an ethical inquiry about consequences of adaptive strategies for all family members, and constructs collaborations between care providers and families.