Understanding the Relationship between Depression and Chronic Diseases Such as Diabetes and Hypertension: A Grounded Theory Study

There is a bi-directional relationship between depression and chronic illnesses such as diabetes and hypertension. This comorbidity is associated with higher mortality risk and diminishes the efficacy of interventions. The specific mechanisms of this mutual influence are still not fully understood, and most intervention protocols address these conditions separately. This study aims to improve our understanding of this relationship. We interviewed 18 patients and 24 health care professionals, focusing on understanding the different ways in which depression and chronic illness could influence each other. Our results show a common cyclical pattern and specific situations where the reported bi-directional relationship does not occur. We discuss the importance of opening a space for the patient’s grief process after the chronic illness diagnosis, managing the demands and stress of the patient’s treatment, and how to adjust the treatment to the different needs and possibilities of each person.

Investigating the severity of the grief experience among people whose family members died of COVID-19

Background & Objectives: COVID-19 has made the grief process more complicated and brought about loads of unexpressed grief. This study aimed at determining the severity of grief reactions due to the death of a first-degree relative (FDR) affected by COVID-19. Methods: This analytic cross-sectional study was conducted to determine the grief score of people over 18 years old with the experience of losing one of their FDRs (i.e. father, mother, and siblings) because of COVID-19. Convenience sampling was employed to gather the data. The instrument used in this study was the Grief Experience Questionnaire (GEQ-34) that was filled in through phone calls. The inclusion criteria included the tendency to participate in the study, age of over 18, and the experience of FDR’s death. On the other hand, the exclusion criteria were severe discomfort and restlessness while talking on the phone. To analyze the data, descriptive statistics and multiple linear regression were employed to diagnose the factors affecting grief, using SPSS version 22 with a significance level of 0.05. Results: The findings indicated that the mean score of GEQ was 67.22±19.24, ranging from 34 to 126. In this study, 54.5% of the bereaved had an experience of low-level grief, 40.2% moderately experienced the grief, and 5.3% were highly affected. There was a positive relationship between the gender of the mourners, widows, or widowers with the grief score, while a negative relationship was observed between being an employed mourner as well as the age of the dead person with the grief score. Conclusion: COVID-19 pandemic has brought about quite a lot of changes in the social and economic situation; mourning condition has become a complicated challenge. To facilitate the grief process and prevent psychological problems, it is recommended that some changes take place in this process. For example, online memorials, and online meetings of mourning can replace the traditional ones. Television, mass media, and clergymen can play a great role in making these changes in funeral rituals.

QOLP-26. ANALYSIS OF REDDIT USERS' PERSPECTIVES OF BRAIN TUMORS

BACKGROUND Reddit, ranking 6th in worldwide Internet site traffic, is a commonly used forum among patients and caregivers affected by brain tumors to discuss diagnoses, treatment, and self-care management. The use of the online forum may suggest patients and caregivers have unmet needs and are seeking further support outside of the clinical setting. We aimed to examine trends from Reddit discussion treads on brain tumors to identify areas of need in patient care. METHODS We used a qualitative, descriptive design to understand patient and caregivers unmet and met needs. We analyzed the top 100 posts and accompanying 271 comments from the ‘braincancer’ subreddit to identify common themes. RESULTS The qualitative content analysis revealed three major topic areas: (1) moving through the grief process; (2) processing diagnostic pathway; and (3) expressing gratitude toward other Reddit users. Most of the authors of the posts were patients with brain tumors (n = 32; 38.5%) who used Reddit as a reflective journaling tool to move through the grief process for themselves or loved ones. About 47% of theses posts discussed the diagnostic process of glioblastoma multiforme (GBM) brain tumors, where users requested an inclusive/welcoming environment in the clinic by their healthcare professionals (HPs). Users also solicited and gave support for other members in the online community. CONCLUSIONS This study highlights the need of implementing social media as a part of HPs’ repertoire for patient outreach/needs. Furthermore, social media outlets like Reddit can help HPs understand the level of support they can give to their patients. Plans of action for physicians seeking to meet the needs of brain tumor patients include monitoring the concerns of patients, becoming verified on the platform/openly identifying themselves online, or conducting ‘Ask Me Anything’ discussions to educate patients.

Developmental Understanding of Death and Grief Among Children During COVID-19 Pandemic: Application of Bronfenbrenner's Bioecological Model

COVID-19 Pandemic has influenced death-related attitudes and understanding during the childhood development leading to a life-long impact. Factors like pandemic-related movement restrictions, school closures, and parents' stay-at-home have exposed children to the phenomenon of grief and death. In that case, children anticipate adverse outcomes and fear while they struggle with unanswered questions. Children may not have coping skills needed to manage their grief in constructive ways to identify, normalize, and express their responses to the loss in their lives. Naming and validating these responses as distinctive aspects of grief process and providing safe space to express their feelings are essential components of a child's coping with loss and grief. This is crucial to consider, as different children react to and are influenced by their environments differently. This article aims to explore the developmental understanding of the process of death and grief by applying the conceptual framework of Bronfenbrenner's theory. Understanding mutual interaction between a child and various ecological systems determines how children perceive death and process grief can facilitate effective communication that has significant implications.

Factors affecting the grieving process after perinatal loss

Background Factors associated with the grief process in response to perinatal loss have been investigated. However, few studies focused on the intrapersonal factors, such as developmental and personality traits. Hence, this study aimed to investigate medical and psychosocial risk factors, including inter- and intrapersonal factors for the development of complicated grief following perinatal loss, while considering emotional support. Methods A total of 50 patients who were treated for grief due to perinatal loss at the National Center for Child Health and Development were divided into two groups according to the treatment period (< 6 months: n = 28; ≥ 6 months: n = 22). We compared medical and psychosocial variables between the two groups using the χ2 test and t test. All data were further analyzed using a logistic regression model to adjust for confounding effects. Results Patients who had traits of developmental/personality disorders (adjusted odds ratio [OR]: 7.21, 95% confidence interval (CI): 1.21–42.9, P = .030), and those treated with psychoactive drugs (adjusted OR: 5.77, 95% CI 1.09–30.5, P = .039) required a longer treatment period (≥ 6 months). Conclusions Patients with personality/developmental traits and those with active psychiatric symptoms required a more extended treatment period in response to loss, suggesting the accumulation of negative factors in these patients; thus, more intensive and specialized care is necessary for these patients. Precise analysis of the coping style, attachment style, communication skills, and life history including relationship with the original family of the patients may have implications on the approach toward patients with complicated grief after perinatal loss. Studies with larger sample size are required to increase the reliability of the present findings, and future research should address the effects of the differential attachment and coping styles of patients with developmental/personality traits on the grief process.

The Many Faces of Grief: A Systematic Literature Review of Grief During the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) pandemic has halted life all around the world. The disease, along with quarantine, social distancing, unemployment, and displacement, has led to myriad losses. There is a rising concern for the epidemic of grief that can result from these multiple losses. The present study aimed to investigate how grief is understood and discussed in the extant literature during the COVID pandemic. A systematic literature review was conducted using PsycArticles, Web of Science, and Scopus databases. The qualitative synthesis of 33 articles indicates that grief can be manifested at various levels such as grief for self, relational grief, collective grief, and ecological grief. Another theme emphasizes some of the factors that could intensify the grief process leading to prolonged grief disorder. A third theme relates to the focus of grief processes as experienced by individuals in different developmental periods from childhood to senescence. The study contributes theoretically by expanding our perception and understanding of varied forms of grief.

Prevalence and Phenomenology of Sensory Experiences of a Deceased Spouse: A Survey of Bereaved Older Adults

Sensory and quasi-sensory experiences of the deceased (SED), also called bereavement hallucinations, are common in bereavement, but research detailing these experiences is limited. Methods: An in-depth survey of SED was developed based on existing research, and 310 older adults from the general Danish population participated in the study 6–10 months after their spouse died. Results: SED were reported by 42% of the participants with wide-ranging phenomenological features across sensory-modalities. In particular, seeing and hearing the deceased spouse was experienced as very similar to the couple’s everyday contacts before death. SED were endorsed as positive by a majority of experiencers, and the experiences were often shared with family and friends. Discussion: SED are conceptualized as social and relational phenomena, which may comfort the surviving spouse in late-life bereavement, but also provide tangible help to some experiencers. In clinical practice, SED may be considered a potential resource for the therapeutic grief process.