Bereavement behind bars: Grief support groups with and without therapy dogs for incarcerated females

Grief is a universal experience; however not everyone experiences grief and loss in the same way. People who are incarcerated are often informed of losses via phone, are unable to attend funeral services or participate in supportive rituals, and can have difficulty expressing feelings in a place where showing emotion can be dangerous. Being unable to obtain support and process grief and loss may contribute to impaired functioning. In this study of bereavement support for women in prison, incarcerated women with recent or unresolved losses (n=32) were randomly assigned to grief support groups with therapy dogs (animal-assisted, AA) or without therapy dogs (non-AA). Pre- and post-test measures of bereavement symptoms and prolonged grief disorder (PGD) were obtained. This study shows that AA groups had more significant decreases in symptoms, lower rates of post-group diagnostic criteria for PGD and higher rates of perceived support/benefit from the groups.

Exploring how veterinary professionals perceive and use grief support resources to support companion animal caregivers in Ontario, Canada

Objective: The aim of this study was to qualitatively explore veterinary professionals’ use and perceptions of grief resources and services to support companion animal caregivers following companion animal euthanasia. Background: The loss of a companion animal can be a source of great sorrow and grief. Like human loss, many companion animal caregivers may seek out and benefit from grief resources, of which veterinary professionals are often important providers. Yet, little is known about how, when or for what reasons veterinary professionals provide these resources. Methods: A qualitative study consisting of group and individual interviews involving 38 veterinary professionals and staff from 10 veterinary hospitals in Ontario, Canada was conducted. Verbatim transcripts were evaluated using inductive thematic analysis to identify themes and subthemes. Results: Results indicated that typically resources were only provided if a caregiver requested information, or when veterinary professionals recognised that the caregiver may benefit from these resources. To assess a caregiver’s need, participants reported considering their age, the strength of the human-animal bond, their previous and ongoing life circumstances, and their emotional state. Several barriers limiting veterinary professionals’ use of grief resources were also described including perceptions that few adequate resources existed and a lack of knowledge of existing or new resources. Conclusion: Overall, findings suggest that there are substantial opportunities to improve and embed a provision of grief resources within the veterinary profession. There is a need to develop adequate resources to meet caregivers’ supportive needs and implement these resources within the greater veterinary profession.

A Narrative Evaluation of a Grief Support Camp for Families Affected by a Parent's Suicide

Background: Children of parents who suffer mental ill-health and die by suicide are vulnerable to developing psychological and social problems themselves; they also have a severely elevated risk of dying at a young age – particularly through suicide. This highlights the need to design supportive measures that can counteract such negative developments after a parent's suicide.Aim: This narrative evaluation of a grief support camp for families affected by a parent's suicide arranged by the non-profit organization Children's Rights in Society in Sweden investigates whether children [N = 11] and parents [N = 11] perceived their participation as meaningful and, if so, in what way, and the changes to which the program was said to have contributed.Methods: Family members were invited to reflect on their experiences in narratively structured interviews that took place 18 months after participation. Their narrated experiences were analyzed to examine how the program was integrated into their biographies and with what significance. Narratives of change were identified in particular in order to grasp the self-perceived effects of participation.Results: Both children and parents attributed major significance to their encounters with other suicide bereaved. This led to support exchange and normalization, which countered a perceived “suicide stigma” in everyday life. Help to narratively construct destigmatizing understandings of suicide was also said to have relieved self-blame and shame. Overall, the participants described changes in the form of a better-informed position in grief, increased manageability and enhanced family communication. The parents also reported improved ability to support their children and a more hopeful view of life ahead.Conclusion: The evaluation showcases how this psychoeducational intervention, at a relatively low cost compared to traditional approaches, has great potential to lessen the negative effects of a suicide in the family by assisting families with psychological processing and de-stigmatization. Parental resources are also strengthened, which can serve as continuing support for the children.

The Loss of a Service Dog Through Death or Retirement: Experiences and Impact on Partners

This study was designed to better understand how service dog partners experience the loss of their service dog. An anonymous survey was distributed to service dog partners who had lost a dog within the last five years. One-way ANOVAs were used to assess loss differences (retirement vs. death) on scores for Centrality of Events Scale, Warwick-Edinburgh Mental Well-Being Scale, Social Constraints Measure, and Self-Compassion Scale. Linear regression was conducted on the total bereavement score to determine the impact of the above assessment measures. We found higher grief scores for those whose service dog died compared to those whose dog retired. Perceptions of social constraints and feelings related to the centrality of the event were predictors of overall grief for those who lost a dog due to retirement; centrality of event feelings predicted grief level for those experiencing a death. Findings suggest a need for grief support for service dog partners.

Transcend the Death of Child with Cancer: Professional Health Experiences

Objective: To reveal the perception of grief support of professionals in pediatric oncology units, after the death of the patients. Method: Qualitative phenomenological study. 22 in-depth interviews were conducted with professionals from 5 pediatric oncology units of public hospitals in Santiago. Once the narratives were transcribed, the comprehensive analysis and subsequent triangulation of the data was performed, achieving saturation. Results: Professionals perceive themselves supported in their grief by being able to experience the losses in a protected environment and feeling supported by their surroundings. They recognized the existence of external and internal factors that facilitated the process of grief. However, this support is perceived as insufficient, as there is a lack of formal support from the institution, as well as a protected grief period, or support from mental health professionals to the teams. All death experiences allow professionals to transcend their pain based on lifelong learning and to give meaning to their work. Conclusion: Grief support felt by the professionals is generated from their own initiatives of re-encounter within the teams, which is insufficient. Therefore, training in coping with death is necessary from undergraduate level, which would allow greater cohesiveness in coping and greater self-care within the teams.

Availability and Quality of Grief and Bereavement Care in Pediatric Intensive Care Units Around the World, Opportunities for Improvement

Pediatric Intensive Care Units (PICUs) provide multidisciplinary care to critically ill children and their families. Grief is present throughout the trajectory of illness and can peak around the time of death or non-death losses. The objective of this study was to assess how PICUs around the world implement grief and bereavement care (GBC) as part of an integrated model of care. This is a multicenter cross-sectional, prospective survey study. Questionnaires with multiple-choice and open-ended questions focusing on unit infrastructure, personnel, policies, limited patient data, and practices related to GBC for families and health care professionals (HCPs) were completed by on-site researchers, who were HCPs on the direct care of patients. PICU fulfillment of GBC goals was evaluated using a custom scoring based on indicators developed by the Initiative for Pediatric Palliative Care (IPPC). We compared average total and individual items fulfillment scores according to the respective country's World Bank income. Patient characteristics and details of unit infrastructure were also evaluated as potential predictors of total GBC fulfillment scores. Statistical analysis included multilevel generalized linear models (GLM) with a Gaussian distribution adjusted by child age/gender and clustering by center, using high income countries (HICs) as the comparative reference. Additionally, we applied principals of content analysis to analyze and summarize open-ended answers to contextualize qualitative data. The study included 34 PICUs from 18 countries: high-income countries (HICs): 32.4%, upper middle-income countries (UMICs): 44.1%, low middle-income and low-income countries (LMI/LICs): 23.5%. All groups reported some compliance with GBC goals; no group reported perfect fulfillment. We found statistically significant differences in GBC fulfillment scores between HICs and UMICs (specifically, HCP grief support), and between HICs and LMICs (specifically, family grief support and HCP grief support). PICUs world-wide provide some GBC, independent of income, but barriers include lack of financial support, time, and training, overall unit culture, presence of a palliative care consultation service, and varying cultural perceptions of child death. Disparities in GBC for families and HCPs exist and were related to the native countries' income level. Identifying barriers to support families and HCPs, can lead to opportunities of improving GBC in PICUs world-wide.

A Multimethod Examination of Medical Students’ Experiences With Bereavement and Complicated Grief

Few studies have examined grief in medical students. This study used a multimeth approach to describe how bereavement and CG may impact medical students’ educational experience and their perspectives on grief support and training. One hundred three medical students completed an online survey with quantitative and qualitative methods. Seventy-three (71%) students reported experiencing bereavement, of which 12 (18%) screened positive for CG. Medical students who screened positive for CG reported significantly more emotional and behavioral challenges ( M = 3.58 [ SD = 2.64]) compared to medical students without CG ( M = 0.93 [ SD = 1.58], p < .001). Qualitative analyses revealed that bereaved and nonbereaved students wanted more grief education and bereavement support from medical institutions. Therefore, it is crucial for medical institutions, to acknowledge that grief and bereavement may impact students’ performance due to multifactorial causes.

What is good grief support? Exploring the actors and actions in social support after traumatic grief

Social support seems to enhance wellbeing and health in many populations. Conversely, poor social support and loneliness are a social determinant of poor health outcomes and can adversely affect physical, emotional, and mental well-being. Social support is especially important in traumatic grief. However, the ways in which grieving individuals interpret and define social support is not well understood, and little is known about what specific behaviours are perceived as helpful. Using qualitative description and content analysis, this study assessed bereaved individuals’ satisfaction of social support in traumatic grief, using four categories of social support as a framework. Findings suggest inadequate satisfaction from professional, familial, and community support. Pets emerged with the most satisfactory ratings. Further, findings suggest that emotional support is the most desired type of support following traumatic loss. Implications for supporting bereaved individuals within and beyond the context of the COVID-19 pandemic are discussed.