Death studies
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Few studies have fully explored the problem of communication barriers in pediatric palliative care, particularly the detrimental effects of poor interaction between staff and families on children's health and well-being. A literature review was undertaken to expand the current body of knowledge about staff to patient communications. ⋯ A narrative synthesis identified 5 overarching themes as barriers to communication. Improvements in staff education and individualized palliative care plans for children and their families may help to overcome communication barriers.
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Service-learning can be a meaningful and effective tool for integrating death education into counselor preparation. The authors describe the design, implementation, reflection process, and evaluation of a service-learning based support program for grieving families and offer suggestions for death educators interested in service-learning as pedagogy. Their evaluation indicated that students who took a graduate-level group counseling course with a service-learning component exhibited lower distress in death-related clinical situations than students who took the course without the service component. Service-learning is closely aligned with death education aims and can be used to enhance counselor preparation program curricular alignment with relevant accreditation standards.
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This study critically examines the concepts of dignity and liminality at the end-of life, in an effort to better understand the processes of healing within suffering among Chinese terminal cancer patients receiving palliative care services in Hong Kong. Meaning-oriented interviews were conducted with 18 Chinese terminal patients, aged 44 to 98, to elicit the narratives and stories of their illness experience. ⋯ Two major themes and eight subprocesses of healing adopted by patients to achieve and maintain dignity were identified: (a) personal autonomy, which encompasses the need to (i) regain control over living environments, (ii) maintain self-sufficiency despite institutional care, (ii) make informed care decisions to reduce sense of burden, and (iv) engage in future planning to create a lasting legacy; and (b) family connectedness, which encompasses the need to (i) maintain close ties with family members to express appreciation, (ii) achieve reconciliation, (iii) fulfill family obligations, and (iv) establish a continuing bond that transcends generations. Implications of these themes for advanced care planning and life review interventions were discussed with the goal of enhancing patient autonomy and family connectedness, and thereby providing structure and meaning for Chinese terminal patients and their families at the end of life.
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To identify what protocol and coping strategies oncologists turn to cope with patient loss, the authors interviewed 20 oncologists at 3 hospitals. Using the grounded theory method, findings revealed that their protocol may include meeting with families, participating in bereavement rituals, making a phone call, or sending a condolence card. Coping strategies included social support, activity-oriented coping, turning to faith, compartmentalization, and withdrawing from patients and families. The authors conclude by offering implications from this research on how to address oncologists' grief over patient loss in institutional settings in order to improve bereavement care for families and enhance oncologists' quality of life.
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This study investigated type of continuing bonds (CB) expression and its comforting versus distressing nature in relation to psychosocial adjustment among bereaved mothers. Twenty-eight mothers whose child had died within the previous five years participated in a CB interview in which they rated the extent they used each of 11 different types of CB expression during the past month and the degree to which they experienced each of the CB expressions as comforting and distressing. ⋯ Furthermore, mothers who reported CB as more comforting than distressing had lower symptom ratings. The implications of the findings for the attachment theory perspective on unresolved loss are discussed.