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Exp Clin Transplant ; 18(Suppl 2): 31-42, 2020 07.
Article in English | MEDLINE | ID: covidwho-1405517


Tamil Nadu, Gujarat, Telangana, Maharashtra, Kerala, Chandigarh, Karnataka, National Capital Territory of Delhi, and Rajasthan are states and union territories having active deceased-donor organ transplant programs in India. Transplant data (2013-2018) have been collected by the National Organ and Tissue Transplant Organization from all states and union territories of India and submitted to the Global Observatory on Donation and Transplantation. From 2013 to 2018, 49155 transplants were reported in India, including 39000 living-donor organ recipients and 10 155 deceased-donor organ recipients. These transplants were for kidney (living donor = 32584, deceased donor = 5748), liver (living donor = 6416, deceased donor = 2967), heart (deceased donor = 895), lung (deceased donor = 459), pancreas (deceased donor = 78), and small bowel (deceased donor = 8). According to 2018 data, India was the second largest transplanting country in the world in terms of the absolute number of transplants. Here, we discuss the status, progress, challenges, and solutions for deceaseddonor organ transplantation. The plan to increase rates of organ donation in India include the following points: teamwork and focus by intensive care unit doctors; public education on organ donation using social media; professional education and family donation conversation programs for brain death declaration and donor management; organ procurement organizations; international collaboration and regular meetings and updates for organizations working in the field of organ transplantation; grief counseling and reporting of potential donation for families of recently deceased people; nonfinancial incentivization to families of potential organ donors; expert committees and standard operating protocols for use of marginal donor organs, donation after circulatory death programs, and machine perfusion; maintenance of transparency and ethics in organ donation, allocation, and transplantation as directed by governmental, nongovernmental, and intergovernmental entities; and regular audit of progress and registry data.

Brain Death , Organ Transplantation , Tissue Donors/supply & distribution , Tissue and Organ Procurement , Attitude to Death , COVID-19 , Health Education , Health Knowledge, Attitudes, Practice , Health Services Needs and Demand , Humans , India , Religion and Medicine , Time Factors
Psychodyn Psychiatry ; 49(3): 384-387, 2021.
Article in English | MEDLINE | ID: covidwho-1394603


The author, an experienced psycho-oncologist, offers clinical insights that consider the importance of death anxiety in psychodynamic psychotherapy treatments during the COVID-19 pandemic. He reviews the contributions of Ernst Becker, Wilfred Bion and Sheldon Solomon, and formulates ideas of his own based on decades of experience treating patients with cancer. This short essay focuses on how to help patients during the COVID-19 pandemic work through fear and uncertainty while developing adaptive skills.

Anxiety/psychology , Anxiety/therapy , Attitude to Death , COVID-19/psychology , Psychotherapy, Psychodynamic/methods , Adaptation, Psychological , Fear , Humans , Pandemics , SARS-CoV-2 , Uncertainty
Medicine (Baltimore) ; 100(34): e27016, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-1376351


ABSTRACT: Nursing students are the main force of future nursing development, and their hope and death anxiety are important aspects of their coping styles and clinical practice.The present study examined the relationships between hope, death anxiety and simplified coping style scores of nursing students during the outbreak of COVID-19.Between February and April 2020, a cross-sectional descriptive study was performed using a Sojump online survey, and 870 nursing students completed the herth hope (HH), death anxiety scale (DAS) and simplified coping style questionnaire. The data were analyzed using t-tests, one-way analysis of variance (ANOVA), and multiple linear regression in SPSS 23.0 (IBM Corp, Armonk, NY).The average HH, DAS and active and passive coping scores of the 870 nursing students were 3.07 ±â€Š0.32, 3.01 ±â€Š0.37, 2.84 ±â€Š0.48, and 2.25 ±â€Š0.50, respectively. Participants with contact experience with individuals with suspected or confirmed COVID-19 were more likely to adopt passive coping styles than students without contact experience (t = 5.019, P = .025). Being older and having higher inner positive readiness and expectancy, a lower inner sense of temporality and future, and lower time awareness were predictors of passive coping styles (P < .05). Living in cities (vs towns) and having a higher inner positive readiness and expectancy, a higher inner sense of temporality and future and lower cognition of death were predictors of active coping styles (P < .05).The findings of this study suggest that hope and death anxiety are important aspects of the coping styles of nursing students. Nursing educators should emphasize the role of hope, further deepen the death education mode, and perform scientific and reasonable death education programmes to reduce the death anxiety level of nursing students to promote their coping styles in crisis.

Adaptation, Psychological , Anxiety/epidemiology , Attitude to Death , COVID-19/epidemiology , Hope , Students, Nursing/psychology , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Male , SARS-CoV-2 , Young Adult
Palliat Support Care ; 18(5): 623-624, 2020 10.
Article in English | MEDLINE | ID: covidwho-1338515
Rev. baiana enferm ; 34: e37007, 2020. tab
Article in Portuguese | LILACS (Americas) | ID: covidwho-1328337


Objetivo: conhecer as implicações sociais e para a saúde que acometem pessoas enlutadas pela morte de familiares vítimas da COVID-19. Método: trata-se de revisão narrativa realizada na plataforma PubCovid-19. Resultados: foi desenvolvido um quadro apresentando as características das dez publicações segundo título, autoria, ano de publicação, país e periódico. Conclusão: as implicações sociais e de saúde que acometem pessoas enlutadas pela morte de familiares por COVID-19 decorrem do distanciamento social que gera a impossibilidade da realização de rituais de despedida prejudicando a vivência normal do luto, levando ao luto complicado e ao possível adoecimento psíquico.

Objetivo: conocer las implicaciones sociales y para la salud que afectan a las personas en luto por la muerte de familiares víctimas de COVID-19. Método: esta es una revisión narrativa realizada en la plataforma PubCovid-19. Resultados: se elaboró un cuadro que presenta las características de las diez publicaciones por título, autoría, año de publicación, país y periódico. Conclusión: las implicaciones sociales y para la salud que afectan a las personas en luto por la muerte de familiares por la COVID-19 se derivan del distanciamiento social que genera la imposibilidad de realizar los rituales de despedida, perjudicando la vivencia normal del luto, provocando el complicado luto y la posible enfermedad psíquica.

Objective: to know the social and health implications that affect people bereaved by the death of relatives who were victims of COVID-19. Method: this is a narrative review carried out on the PubCovid-19 platform. Results: a chart was developed presenting the characteristics of the ten publications by title, authorship, year of publication, country and journal. Conclusion: the social and health implications that affect people bereaved by the death of family members by COVID-19 derive from the social distancing that generates the impossibility of performing farewell rituals, damaging the normal experience of mourning, leading to complicated mourning and possible psychic illness.

Humans , Psychiatric Nursing , Bereavement , Attitude to Death , Mental Health , Coronavirus Infections
BMC Palliat Care ; 20(1): 116, 2021 Jul 20.
Article in English | MEDLINE | ID: covidwho-1319461


BACKGROUND: Understanding public attitudes towards death and dying is important to inform public policies around End of Life Care (EoLC). We studied the public attitudes towards death and dying in Wales. METHODS: An online survey was conducted in 2018. Social media and the HealthWiseWales platform were used to recruit participants. Data were analysed using descriptive statistics and thematic analysis. RESULTS: 2,210 people participated. Loss of independence (84%), manner of death, and leaving their beloved behind were the biggest fears around death and dying. In terms of EoLC, participants sought timely access to care (84%) and being surrounded by loved ones (62%). Being at home was less of a priority (24%). Only 50% were familiar with Advance Care Planning (ACP). A lack of standard procedures as well as of support for the execution of plans and the ability to revisit those plans hindered uptake. The taboo around death conversations, the lack of opportunities and skills to initiate discussion, and personal fear and discomfort inhibited talking about death and dying. 72% felt that we do not talk enough about death and dying and advocated normalising talking by demystifying death with a positive approach. Health professionals could initiate and support this conversation, but this depended on communication skills and manageable workload pressure. Participants encouraged a public health approach and endorsed the use of: a) social media and other public platforms, b) formal education, c) formal and legal actions, and d) signposting and access to information. CONCLUSIONS: People are ready to talk about death and dying and COVID-19 has increased awareness. A combination of top-down and bottom-up initiatives across levels and settings can increase awareness, knowledge, and service-utilisation-drivers to support health professionals and people towards shared decisions which align with people's end of life wishes and preferences.

Attitude to Death , Health Knowledge, Attitudes, Practice , Patient Preference , Terminal Care , Adolescent , Adult , Advance Care Planning , Aged , Aged, 80 and over , COVID-19 , Communication , Fear , Female , Humans , Male , Middle Aged , Qualitative Research , SARS-CoV-2 , Wales , Young Adult
J Appl Psychol ; 106(6): 839-855, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1275875


The COVID-19 pandemic-as an omnipresent mortality cue-heightens employees' awareness of their mortality and vulnerability. Extant research has identified two distinct forms of death awareness: death anxiety and death reflection. Because researchers have exclusively examined death anxiety and death reflection as independent and unique variables across individuals while overlooking their interplay and co-existence within individuals, we know little about whether and why employees can have different combined experiences of two forms of death awareness over a certain period of time (e.g., during the pandemic), and how these different employee experiences relate to theoretically and practically important work-relevant consequences. To address this gap in our knowledge, we adopted a person-centered approach using latent profile analysis to consider death anxiety and death reflection conjointly within employees during the COVID-19 pandemic. Across two studies, we identified three distinct death awareness profiles-the disengaged, calm reflectors, and anxious reflectors-and found membership in these profiles systematically varied according to health- (e.g., risk of severe illness from COVID-19), work- (e.g., job-required human contact), and community-related (e.g., the number of regional infections) factors influencing the self-relevance of COVID-19 as a mortality cue. In addition, we found that these death awareness profiles differentially predicted important employee outcomes, including well-being (i.e., depression and emotional exhaustion) and prosocial behaviors at work (i.e., organizational citizenship behaviors and pro-diversity behavior). (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Anxiety/psychology , Attitude to Death , Awareness , COVID-19/psychology , Adult , Female , Humans , Male , Pandemics , SARS-CoV-2
BMJ Glob Health ; 6(6)2021 06.
Article in English | MEDLINE | ID: covidwho-1255587


Dealing with excess death in the context of the COVID-19 pandemic has thrown the question of a 'good or bad death' into sharp relief as countries across the globe have grappled with multiple peaks of cases and mortality; and communities mourn those lost. In the UK, these challenges have included the fact that mortality has adversely affected minority communities. Corpse disposal and social distancing guidelines do not allow a process of mourning in which families and communities can be involved in the dying process. This study aimed to examine the main concerns of faith and non-faith communities across the UK in relation to death in the context of the COVID-19 pandemic. The research team used rapid ethnographic methods to examine the adaptations to the dying process prior to hospital admission, during admission, during the disposal and release of the body, during funerals and mourning. The study revealed that communities were experiencing collective loss, were making necessary adaptations to rituals that surrounded death, dying and mourning and would benefit from clear and compassionate communication and consultation with authorities.

Attitude to Death , COVID-19 , Pandemics , COVID-19/mortality , Humans , Qualitative Research , United Kingdom/epidemiology
J Soc Work End Life Palliat Care ; 17(2-3): 158-163, 2021.
Article in English | MEDLINE | ID: covidwho-1246633


The arrival of COVID-19 brought about many disruptions to our world and communities. The hospital visitation restrictions were one of the more, if not most, challenging aspects of psychosocial care for patients and families. It was difficult to anticipate the emotional toll that visitation restrictions would take on patients, families, and staff. Once hospital visitation restrictions were in place, new strategies for patient/family connection and team communication had to be established. The Palliative Care team at a large, urban, Midwestern academic medical center created an interprofessional Family Support Team in the spring of 2020 to address the psychosocial needs of the families of critically ill COVID-19 patients.

COVID-19/psychology , Family/psychology , Palliative Care/psychology , Quality of Life/psychology , Social Support , Attitude to Death , Humans , Patient-Centered Care
Ann Intern Med ; 174(4): 493-500, 2021 04.
Article in English | MEDLINE | ID: covidwho-1218704


BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has affected the hospital experience for patients, visitors, and staff. OBJECTIVE: To understand clinician perspectives on adaptations to end-of-life care for dying patients and their families during the pandemic. DESIGN: Mixed-methods embedded study. ( NCT04602520). SETTING: 3 acute care medical units in a tertiary care hospital from 16 March to 1 July 2020. PARTICIPANTS: 45 dying patients, 45 family members, and 45 clinicians. INTERVENTION: During the pandemic, clinicians continued an existing practice of collating personal information about dying patients and "what matters most," eliciting wishes, and implementing acts of compassion. MEASUREMENTS: Themes from semistructured clinician interviews that were summarized with representative quotations. RESULTS: Many barriers to end-of-life care arose because of infection control practices that mandated visiting restrictions and personal protective equipment, with attendant practical and psychological consequences. During hospitalization, family visits inside or outside the patient's room were possible for 36 patients (80.0%); 13 patients (28.9%) had virtual visits with a relative or friend. At the time of death, 20 patients (44.4%) had a family member at the bedside. Clinicians endeavored to prevent unmarked deaths by adopting advocacy roles to "fill the gap" of absent family and by initiating new and established ways to connect patients and relatives. LIMITATION: Absence of clinician symptom or wellness metrics; a single-center design. CONCLUSION: Clinicians expressed their humanity through several intentional practices to preserve personalized, compassionate end-of-life care for dying hospitalized patients during the SARS-CoV-2 pandemic. PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research and Canadian Critical Care Trials Group Research Coordinator Fund.

Attitude to Death , COVID-19/epidemiology , Family/psychology , Infection Control/organization & administration , Personnel, Hospital/psychology , Terminal Care/psychology , Aged , Empathy , Female , Humans , Male , Pandemics , Professional-Family Relations , SARS-CoV-2
Indian J Med Ethics ; VI(2): 1-4, 2021.
Article in English | MEDLINE | ID: covidwho-1206584


The Covid-19 pandemic has been a leveller of sorts; across communities, cities, and countries. All healthcare workers are doing their best beyond the call of duty. With many patients recovering and others succumbing every day, they are facing extreme situations. Sometimes, both the good and the bad occur within in a matter of minutes which can be emotionally exhausting. A single Covid-19 test report whether positive or negative has many implications, the rest depends on the healthcare staff who diagnose, treat and more importantly, convey the diagnosis to the patients. Here is an experience of what healthcare workers face and how they handle it. Brave are those who still hold on to their grit and spirit.

Attitude to Death , Attitude to Health , COVID-19/psychology , COVID-19/therapy , Health Personnel/psychology , Pandemics , Adult , Female , Humans , Male , Middle Aged , SARS-CoV-2
Public Health ; 194: 146-148, 2021 May.
Article in English | MEDLINE | ID: covidwho-1203256


OBJECTIVE: The aim of the study was to investigate the impact of the COVID-19 pandemic and prevention measures on religious practices after death, by ethnic grouping, in an opportunistic/convenience sample of UK adults. METHODS: We distributed a questionnaire online and in hard copy between May 1 and June 18, 2020, via social media, post and face-to-face contact in Leicester, a multi-ethnic city in the UK. RESULTS: From 980 adults providing consent, 665 completed some or all survey items and provided ethnicity data. More than double the proportion of Black and South Asian individuals reported religious practices relating to death, burials or funerals being affected by COVID-19 than White groups. Of the 151 participants reporting practices being impacted, a greater proportion of ethnic minority groups reported restricted access/alteration to eight death-related practices (e.g., funeral attendance) compared with White groups (significantly different for all practices, P < 0.05). CONCLUSION: The initial phase of the COVID-19 pandemic in the UK has negatively impacted on the ability to conduct religious practices after death in all ethnic groups, but the impact appears greater in ethnic minority populations than in White groups. There is a need for further qualitative research on the impact of the COVID-19 pandemic on death and burial practices of minority ethnic groups.

COVID-19/epidemiology , Funeral Rites , Minority Groups/statistics & numerical data , Religion , Adult , African Americans/statistics & numerical data , Aged , Attitude to Death , COVID-19/prevention & control , Female , Humans , Male , Middle Aged , Pandemics , Qualitative Research , SARS-CoV-2 , Social Media , Surveys and Questionnaires , United Kingdom , /statistics & numerical data