scholarly journals “It was brutal. It still is”: A qualitative analysis of the challenges of bereavement during the COVID-19 pandemic reported in two national surveys

Author(s):  
Anna Torrens-Burton ◽  
Silvia Goss ◽  
Eileen Sutton ◽  
Kali Barawi ◽  
Mirella Longo ◽  
...  

ABSTRACTThe COVID-19 pandemic has been a devastating, mass bereavement event characterised by sudden unexpected deaths and high levels of disruption to end-of-life, grieving and coping processes, as well as social life more broadly. We analysed qualitative free-text data from two independent UK-wide online surveys to describe in depth the experiences of 881 people bereaved during the Covid-19 pandemic using. We analysed the data in two phases, conducting an inductive thematic analysis and then applying Stroebe and Schut’s Dual Process Model (DPM) (1999; 2010) as an analytic lens to further contextualise and interpret the data. The DPM identifies loss-oriented and restoration-oriented coping processes between which grieving people naturally oscillate. Loss-oriented coping involves coming to terms with the death and lost relationship, while restoration-oriented coping involves adapting to new ways of life. We identified six main themes: troubled deaths (guilt, anger and unanswered questions); mourning, memorialisation and death administration; mass bereavement, the media and the ongoing threat of the pandemic; grieving and coping (alone and with others); work and employment; and support from the health and social care system. Examples of loss-oriented stressors included being unable to visit or say goodbye, the sudden and traumatic nature of many deaths, and restricted funeral and memorialisation practices. Associated reactions were feelings of guilt and anger, and problems accepting the death and starting to grieve. Examples of restoration-oriented stressors and reactions were stressful death-related administration and severely curtailed social networks, support systems and social/recreational activities, which impacted people’s ability to cope. Study results demonstrate the exceptionally difficult sets of experiences associated with pandemic bereavement, and the utility of the DPM for conceptualizing these additional challenges and their impacts on grieving. Our analysis builds and expands on previous use of the DPM (Stroebe and Schut, 2021) in explicating the impact of the pandemic on bereavement. We make recommendations for statutory, private and third sector organisations for improving the experiences of people bereaved during and following this and future pandemics.

2021 ◽  
Vol 33 (S1) ◽  
pp. 13-13
Author(s):  
Alison Wheatley ◽  
Marie Poole ◽  
Louise Robinson

Background:The COVID-19 pandemic precipitated widespread change across health and social care in England and Wales. A series of lockdowns and UK Government guidance designed to reduce the spread of COVID-19 which emphasised social distancing and increased use of personal protective equipment led to changes such as increased use of remote consultation technologies and the closure of services deemed non-essential. This included many services for people with dementia and their families, such as day centres and dementia cafes.Objective:To explore the changes made to services during the pandemic and the impact of these changes on the delivery of good post-diagnostic dementia support.Method:Professionals who had previously been recruited to the ongoing PriDem qualitative study were approached for follow up interview. Eighteen interviews with a total of 21 professionals working in health, social care and the third sector were conducted using telephone or video conferencing.Interviews were audio recorded, transcribed and checked prior to thematic analysis.Results:Key themes emerging from preliminary analysis of the data include: uncertainty about the future and the need to adapt quickly to shifting guidance; changing job roles and ways of working; the emotional and physical impact of the pandemic on staff working with people with dementia and their families; and the impact of changes made (e.g. increased PPE, remote working) on the ability to deliver post-diagnostic support. However, there were also some unintended positive outcomes of the changes. These included the ability to include family members living at a distance in remote consultations, allowing for more robust history-taking, as well as the uptake of technology to facilitate cross-sector and multidisciplinary working between professionals.Conclusion:Delivering post-diagnostic dementia support during COVID-19 was challenging and forced dementia services to make adaptations. Participants expected that some of these changes would be incorporated into post-pandemic work, for example increased use of technology for multidisciplinary team meetings or blended approaches to patient-facing services involving both virtual and face to face work as appropriate. However, most participants agreed that it was not appropriate nor desirable to provide fully remote post-diagnostic support on a full time basis.


Dementia ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 1427-1445 ◽  
Author(s):  
Barbara K Sharp

Health and social care research on stress in dementia has predominantly considered the stress experienced by family and professional carers. Focus on the person with dementia has frequently laid emphasis on the impact of stress-related behaviour on others and how such behaviour might be ‘managed’. This paper describes a qualitative study which gives voice to people with dementia on the subject of stress and responds to the need for a better understanding of stress as it is experienced by people with dementia themselves. An interpretative phenomenological analysis was conducted on data collected from a purposive sample of people diagnosed with varying types of dementia from across Scotland. Discussions across five focus groups consisting of 21 participants with dementia in total generated data which was audio and video recorded, and analysed thematically. Five key themes emerged, described in the participants’ own words, which were: (1) ‘Something’s torn, your life’s torn’; (2) ‘Families can bring stress’; (3) ‘It’s the stress of living with dementia’; (4) ‘A whole new set of rules’; and (5) ‘It’s our lives and we’ll get it under control ourselves’. These themes reflect experiences of loss, challenges to one’s sense of self, relationship dynamics, living with the symptoms of dementia, learning to do things differently and establishing coping mechanisms that provide control. Study participants illustrated individual potential for adapting and coping with some of the most stressful aspects of living with dementia, challenging assumptions of inevitable fixed decline and progressive vulnerability to stress. Participants describe a process of recovery in their perceptions of self-worth, purpose and value in life following diagnosis.


2001 ◽  
Vol 43 (2) ◽  
pp. 129-144 ◽  
Author(s):  
Virginia E. Richardson ◽  
Shantha Balaswamy

A Dual Process Model of Bereavement, which considers the impact of loss- and restoration-oriented variables on widowers' levels of well-being, is tested on 200 widowed men during the second year of bereavement. Those who were widowed less than 500 days exhibited significantly more negative affect, less positive affect, and lower well-being that those widowed more than 500 days. Multiple regression analyses revealed that both loss and restoration variables were important throughout bereavement. Loss variables influenced negative affect and were especially critical during the early stages. Restoration variables significantly affected positive affect and had greater impact on the later bereaved. The results support a dual process model of bereavement, but also suggest that certain events, such as circumstances of death, are more important during early bereavement while reinvestment activities, such as dating, become relevant later. Some circumstances, such as a wife's suffering, have prolonged effects.


Diagnosis ◽  
2014 ◽  
Vol 1 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Pat Croskerry

AbstractPeople diagnose themselves or receive advice about their illnesses from a variety of sources ranging from their family or friends, alternate medicine, or through conventional medicine. In all cases, the diagnosing mechanism is the human brain which normally operates under the influence of a variety of biases. Most, but not all biases, reside in intuitive decision making, and no individual or group is immune from them. Two biases in particular, bias blind spot and myside bias, have presented obstacles to accepting the impact of bias on medical decision making. Nevertheless, there is now a widespread appreciation of the important role of bias in the majority of medical disciplines. The dual process model of decision making now seems well accepted, although a polarization of opinions has arisen with some arguing the merits of intuitive approaches over analytical ones and vice versa. We should instead accept that it is not one mode or the other that enables well-calibrated thinking but the discriminating use of both. A pivotal role for analytical thinking lies in its ability to allow decision makers the means to detach from the intuitive mode to mitigate bias; it is the gatekeeper for the final diagnostic decision. Exploring and cultivating such debiasing initiatives should be seen as the next major research area in clinical decision making. Awareness of bias and strategies for debiasing are important aspects of the critical thinker’s armamentarium. Promoting critical thinking in undergraduate, postgraduate and continuing medical education will lead to better calibrated diagnosticians.


2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S611-S612
Author(s):  
P Thapwong ◽  
C Norton ◽  
H Terry ◽  
W Czuber-Dochan

Abstract Background Inflammatory Bowel Disease (IBD) not only impacts the quality of life of the patient, but also affects their family members. Studies to date have provided an understanding of impact of IBD and IBD implications for people with IBD. However, little is known about the impact of IBD on their family members. Therefore, the current study aimed to explore the lived experience of people with IBD and their family members regarding the impacts of IBD on family members and their coping methods. Methods Twelve participants, including six people with IBD with their six partners, were purposively selected, no other family members (parents / children, sibling) came forward to participate in the study. The in-depth, semi-structured online interviews were conducted via Skype, Zoom, or Microsoft Teams between February-June 2020. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis by Braun and Clarke. Results Four main themes emerged during the analysis under the central theme “our relationship with IBD, for better or worse”. IBD affected the partners in terms of their own relationship, relationship with others, everyday life, and emotional and mental well-being. The theme “our relationship” showed the impact of IBD on the relationship between a couple, including the intimate relationship, family planning, role change as partner and carer, and the importance of honest communication. IBD also affected wider relationships with family, children, and social life, but teamwork could mediate negative impact in relationships. Emotional well-being was impacted by living in constant fear and guilt. Humour and knowledge of IBD reduced negative impacts. IBD impacts on everyday life (diet, finances, and travel) for both patients and partners. Planning for uncertain situations was helpful to reduce restrictions. Conclusion The study provides an understanding of IBD impact on partners and the coping strategies from patients and partners’ perspectives. There are wide-ranging implications for health and social care professionals caring for people with IBD and their families. Social support has been recognised as a vital buffering mechanism in facilitating an individual’s adjustment to IBD. Healthcare professionals and researchers may integrate a bio-psycho-social approach into their work with IBD family members. There is a need to develop interventions to help family members of IBD patients to better cope with the illness and to have a more fulfilling life.


2011 ◽  
Vol 32 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Sarah B. Watson ◽  
Yong Wah Goh ◽  
Sukanlaya Sawang

The increasing incidence of occupational stress is recognized as a global phenomenon that is having a detrimental impact on both individuals and organizations. This study aims to identify whether men and women adopt different stress and coping processes when subjected to stress in a work context. A total of 258 workers of various professions (males = 106, females = 152) participated in the study. Results indicated that men and women differ in their stress and coping processes, forming two very distinct groups and adopting specific process models when encountering a stressful situation at work. Limitations and implications from this study are discussed.


2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Shakeel Ahmad ◽  
Muhammad Nazim ◽  
Rizwan Munir ◽  
Hafiz Muhammad Faiq Ilyas ◽  
Naeem Asghar ◽  
...  

Objectives: To assess the impact of myocardial infarction on quality of life in four year survivors and to determine factors associated with a poor quality of life. Design: Descriptive study. Settings: Faisalabad institute of cardiology Faisalabad. Duration of Study: 1st November 2017 to 30 April 2018. Sample Size: Sample size was 200 as calculated by WHO sample size calculator. Sampling Technique: Non probability consecutive sampling. Subjects: All patients diagnosed with acute myocardial infarction during 2013 and alive at a median of four years. Patients and Methods: 200 patients presenting in outdoor for routine follow up checkup who got MI approximately four years ago in year 2013 were included in the study. Results: 200 patients with an acute myocardial infarction in 2013 and alive and capable of responding to a questionnaire in 2018 were included in the study. Physical functioning was normal in 63%, fair in 25% and disturbed in 12% of patients. Social life functioning was normal in 66%, fair in 26% and disturbed in 8% of patients. No Angina episodes in 61.5%, 1 to 2 angina episodes per month in 25% and more than 3 episodes per month in 13.5% patients. 59% of patients were doing routine jobs, 21.5 % were doing off and on job and 19.5% were not doing any job after MI. Conclusions: this study provides valuable information for the practicing clinicians. Impaired quality of life was reported by patients, unfit for work, those with angina and dyspnea, patients with coexistent lung disease, those with anxiety and sleep disturbances and other co-morbid conditions. Improving quality of life after MI remains a challenge for practicing physicians.


2020 ◽  
Author(s):  
Rory Sheehan ◽  
Christian Dalton-Locke ◽  
Afia Ali ◽  
Vasiliki Totsika ◽  
Norha Vera San Juan ◽  
...  

Background Very little is known about the impact of previous epidemics on the care of people with intellectual and developmental disabilities, particularly in terms of mental health services. The COVID-19 pandemic has the potential to exacerbate existing health inequalities as well as expose gaps in service provision for this vulnerable population group. Methods We investigated the responses of 648 staff working in mental healthcare with people with intellectual disabilities and/or developmental disabilities. Participants contributed to a UK-wide online survey undertaken by the National Institute for Health Research Mental Health Policy Research Unit between 22nd April and 12th May 2020. Recruitment was via professional networks, social media and third sector organisations. Quantitative data describing staff experience over three domains (challenges at work, service user and carer problems, sources of help at work) were summarised and differences between groups explored using Chi square tests. Content analysis was used to organise qualitative data focusing on service changes in response to the pandemic. Results The majority of survey respondents worked in the NHS and in community mental health services. One third had managerial responsibility. Major concerns expressed by mental healthcare staff were: difficulties for service users due to lack of access to usual support networks and health and social care services during the pandemic; and difficulties maintaining adequate levels of support secondary to increased service user need. Staff reported having to quickly adopt new digital ways of working was challenging; nevertheless, free text responses identified remote working as the innovation that staff would most like to retain after the pandemic subsides. Conclusions Understanding the experiences of staff working across different settings in mental healthcare for people with intellectual and developmental disabilities during the COVID-19 pandemic is essential in guiding contingency planning and fostering service developments to ensure the health of this vulnerable group is protected in any future disease outbreaks.


2020 ◽  
pp. 001872672091232
Author(s):  
Nicolas Roulin ◽  
Namita Bhatnagar

Cigarette and electronic-cigarette users (i.e. vapers) are increasingly stigmatized in both society and the workplace. We examine effects of this stigmatization in the selection process by testing whether interviewers’ negative initial impressions of smokers and vapers extend throughout the interview. We used a dual-process framework of interviewer bias against stigmatized applicants, comprised of Type I-automatic and Type II-systematic processes, and conducted two experiments where US and Canadian participants enacted the role of an interviewer in video-based job interview simulations. Consistent with Type I processes, results show that cigarette smokers, and to lesser extent vapers, were initially rated as less qualified than non-smokers. These initial impressions were not subjected to justification/rationalization during the interview via harder questions asked. However, they served as anchors, also consistent with Type I processes, and impacted final assessments alongside Type II adjustments based on applicants’ response quality. Additionally, using attentional eye tracking data, we found that raters with worse attitudes toward smoking, but not vaping, glanced at stigma cues more frequently, which went on to influence first impressions. These findings provide valuable tests of key components of the dual-process model of interviewer bias, and raise concerns around the devaluation of smokers and vapers in hiring decisions.


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