The Virulence of Grief in the Pandemic: Bereavement Overload During COVID

The COVID-19 pandemic brought about bereavement overload as a risk factor for complicated grief. Bereavement overload (BO) describes individuals’ reactions to losses transpiring in a quick succession, without the time and opportunity for coping [9]. It can occur during catastrophic events and impact everyone experiencing the loss. With the high death toll from COVID-19, many people have lost multiple loved ones followed by an abbreviated grieving process due to the nature of the pandemic. This can have psychosocial impact on survivors for years. One of the evolving roles of Palliative Care within and after the pandemic should be to recognize those suffering from BO. Obtaining loss histories may identify those at risk of pathologic grief to provide preventive bereavement care. We present three cases encountered in our health system during the COVID-19 pandemic amongst a family member, a patient, and a healthcare provider. In each case the Palliative Care Team worked closely with these individuals to identify COVID-associated BO and helped them reconcile their unresolved grief to be able to move forward. These cases reflect only a fraction of those who experienced loss during the pandemic, but they illustrate how grief can be complicated by the pandemic for everyone involved. Palliative Care will have a crucial role moving forward, in treating the pandemic of complicated grief within the pandemic to adapt to the needs of all survivors, as we realize the effects of COVID will last long after its virulence has waned.

A brief psychodynamic intervention for couples with unresolved grief: a case study report

Two case reports of couples with unresolved grief who received a short-term psychoanalytically oriented intervention for couples are presented. The sixteenweek intervention is based on the unresolved grief triad (UGT) which links empirically based predictors of prolonged or complicated grief, including a history of unmourned losses and couple dynamics that prevent mourning, to couple manifestations of unresolved loss. In the first and second phases of therapy, experienced analytic couple therapists identified these factors and linked them into a unique UGT for the couple which is made explicit and worked with in the middle phase of treatment in relation to the day-to-day experiences that they bring to the sessions. In the final (third) phase of the intervention the loss of the therapy and therapist constitutes links that have been identified and processed with the couple during the intervention. The two case studies presented shared important similarities that offer insights into how couples become mired in unresolved grief. Their successful treatment using a short-term psychoanalytically based couple therapy suggests that the underpinning model on which it is based may be cost-effective in treating unresolved grief in couples.

Psychometric Properties of Grief Traits and State Scale for Nurses to Measure Levels of Grief

Frequent exposure to patient deaths prompts nurses to experience grief. Unresolved grief leads to harmful consequences of nurses’ mental health and quality of nursing care. A cross-sectional study using an online survey was conducted to determine the psychometric properties of the Grief traits and State Scale for Nurses. Exploratory factor analysis revealed two factors measuring the level of nurses’ grief traits (Cronbach’s alpha: 0.84) and two factors in grief state (Cronbach’s alpha: 0.86). Nurses’ feelings of unable to provide good care were associated with a higher risk of grief (odds ratio (OR): 4.30, 95% confidence interval (CI): 1.45–12.75), uncomfortable feeling toward deaths (OR: 11.29, 95%CI: 1.48–85.91), and emotional exhaustion (OR: 7.12, 95%CI: 1.63–30.99). Results indicated that the scale was reliable in determining the levels of their grief. Nurse managers can use the scale to identify their nurses’ levels of grief, creating opportunities to influence the resolution of the grief experiences.

‘A constant reminder of what we had to forfeit’

This article examines the intergenerational effects of hydropower expansion on Sámi living conditions. In-depth conversations were conducted with five research participants from three different generations living in a hydropower impacted area on the Swedish side of Sápmi. The aim is to analyse how natural resource extraction has affected living conditions for the Indigenous Sámi people, using an intergenerational approach. The questions cover how to deal with the consequences and how coping strategies have affected the living conditions for the research participants and the participants’ families: older and younger generations. Historical unresolved grief connected to large-scale resource extraction is an important component for understanding experiences of colonialism in a Nordic Indigenous context. Furthermore, an intergenerational approach is essential for studying long-term impacts on Indigenous communities. From the conversations, four main themes are crystallized: bereavement, fear and worries, agreements with the energy company, and reconciliation and strategies for the future.

Mourning During Corona: A Phenomenological Study of Grief Experience Among Close Relatives During COVID-19 Pandemics

Considering the need for observing health protocols, the experience of the loss and the grieving process has changed in nature during this disease. Therefore, this study aims to gain a deep understanding of the experience of mourning during COVID-19 pandemic by exploring the experiences of survivors of the death of their loved. During COVID-19 pandemic, the inability to hold the usual ceremonies for mourning and receive the social support needed in this period, the relatives of the deceased encounter various conditions that disrupt the grieving process and may lead to the spread of unresolved grief in future.

Unresolved grief in parents of children with CF: A pilot randomised controlled trial on the use and delivery sequence of disease-related education and psychotherapeutic support

Diagnosis of chronic disease in a child can result in unresolved grief (UG) in parents. This study aimed to evaluate the efficacy of psychological insight-oriented therapy (IOT) as a treatment for UG compared to disease related education in parents of children with cystic fibrosis (CF). Sequence of delivery, first IOT then disease related education (or vice versa ) was also examined, to let all participants experience both interventions. Parents were screened for UG. Parents with UG were randomised to either five one-hour sessions of IOT or five one-hour sessions of education. Measures were assessed pre-intervention, after the first intervention period (primary efficacy assessment), and after the second intervention period (swapping intervention). Forty-seven parents were screened of which 46.8% (22/47) had UG. Median duration of UG was 5 years (range: 6 months to 14 years). Anxiety (50% vs. 20%, p =0.03) and stress (59% vs. 28%, p =0.03) were significantly more prevalent in parents with UG. There was no difference between arms in the odds of UG resolving either following the first intervention period (OR 0.88; 95%CI 0.5, 1.5) or the second intervention period (OR 0.91; 95%CI 0.5, 1.6). While not statistically significant, adjusted mean values of all nine mental health measures were lower in the IOT (first) arm compared to the ED (first) arm, following the first intervention period. Conclusions: UG is a significant burden for families affected by CF. Provision of disease related education and psychological support, regardless of sequence, can result in resolution of grief.

The right to mourn: Post-traumatic stress and the forensic pathologist

Post-traumatic stress disorder (PTSD) is a condition characterised by recurrent intrusive distressing memories of a traumatic event(s) with recurrent dreams and flashbacks. Given the nature of standard forensic pathology practice which involves on-going assessments of violent crimes and their sequelae with autopsy dissections of victims and in detail study of injuries, it is surprising that more has not been written on this in the literature. Perhaps PTSD should be studied further in a forensic context with a recognition that years of intimate exposure to violence may lead to accumulated, ongoing and unresolved grief in practitioners.

Acute and long-term grief reactions and experiences in parentally cancer-bereaved teenagers

Background Previous research shows that many cancer-bereaved youths report unresolved grief several years after the death of a parent. Grief work hypothesis suggests that, in order to heal, the bereaved needs to process the pain of grief in some way. This study explored acute grief experiences and reactions in the first 6 months post-loss among cancer-bereaved teenagers. We further explored long-term grief resolution and potential predictors of having had “an okay way to grieve” in the first months post-loss. Methods We used a population-based nationwide, study-specific survey to investigate acute and long-term grief experiences in 622 (73% response rate) bereaved young adults (age > 18) who, 6–9 years earlier, at ages 13–16 years, had lost a parent to cancer. Associations were assessed using bivariable and multivariable logistic regression. Results Fifty-seven per cent of the participants reported that they did not have a way to grieve that felt okay during the first 6 months after the death of their parent. This was associated with increased risk for long-term unresolved grief (odds ratio (OR): 4.32, 95% confidence interval (CI): 2.99–6.28). An association with long-term unresolved grief was also found for those who reported to have been numbing and postponing (42%, OR: 1.73, 95% CI: 1.22–2.47), overwhelmed by grief (24%, OR: 2.02, 95% CI: 1.35–3.04) and discouraged from grieving (15%, OR: 2.68, 95% CI: 1.62–4.56) or to have concealed their grief to protect the other parent (24%, OR: 1.83, 95% CI: 1.23–2.73). Predictors of having had an okay way to grieve included being male, having had good family cohesion, and having talked about what was important with the dying parent. Conclusion More than half of the cancer-bereaved teenagers did not find a way to grieve that felt okay during the first 6 months after the death of their parent and the acute grief experiences and reaction were associated with their grief resolution long-term, i.e. 6–9 years post-loss. Facilitating a last conversation with their dying parent, good family cohesion, and providing teenagers with knowledge about common grief experiences may help to prevent long-term unresolved grief.

Identifying of Damages and Psychological Dysfunctions of the Students with Academic Failure: A Phenomenological Study

Introduction: Academic failure is one of the most common problems among university students, which accompanied by a range of interpersonal and psychological disorders and impairs a person's function in all aspects of the life. The purpose of the current study was to evaluate the quality of damages and psychological dysfunctions of the students with academic failure. Method: This study was administered by qualitative method and the descriptive phenomenological. The study population of this study consisted of all masters' degree students with academic failure in Allameh Tabatabayi University in the years of 2016-2018. In addition, the sampling method was purposeful sampling during which 16 students were selected to participate in the study and then they were interviewed. All interviews were recorded and then transcribed line by line and eventually were analyzed by using the Diekelmann et al. descriptive analysis method., Low self-esteem, communication fractures and discomforts) and 26 sub-themes in the field of injuries and psychological dysfunctions of students were conditioned. Results: Sixteen semi-structured interviews were conducted and the analysis of the data from the interviews led to identification and classifying of 6 main themes (psychological distress and discomfort, unpleasant perceptual emotions, cognitive-mental impairments, unresolved grief, low self-esteem, failures and relational Inconveniences) and 26 sun themes in the field of the psychological dysfunctions of students became. Conclusion: Based on the results of the present article, functional programs should be designed and implemented with the aim of correcting and improving the common psychological problems and dysfunctions among students on academic probation, thus their efficiency in handling their academic duties and responsibilities will increase.

Existential Dread and the Trouble with Transcendence

This chapter examines how post-horror films engage with metaphysical and existential issues, with stories about protagonists’ attempts to gain some sort of transcendence thus serving as a way of imagining post-horror’s own mixed success at (for better or worse) transcending the genre itself. Films like A Ghost Story and I Am the Pretty Thing That Lives in the House transform the ghost from a vengeful, fear-inducing trope into a much more existentially wandering figure of unresolved grief and the impermanence of human memory. Meanwhile, A Dark Song uses occultism to echo A Ghost Story’s concern with individual grief’s relationship to cosmic realms of (non)existence, much as mother! and I Am the Pretty Thing ask whether artistic creation itself can play any role in personal or spiritual redemption.