Bereavement affinities: A qualitative study of lived experiences of grief and loss.

Attending to bereaved peoples' lived experiences offers considerable potential for better understanding how to improve support following loss. In-depth interviews (n = 36) and solicited diaries (n = 23) were conducted with bereaved adults following a death in palliative or residential aged care. A constructivist grounded theory approach guided data analysis, through which three themes were derived: making sense of the lived experience of bereavement; relationships in bereavement; and bereavement over time. The results reveal the nuances within everyday experiences of bereavement, in particular the multiplicity of affinities, present or lacking, in social support and recognition.

Voicing the perspectives of stroke survivors with aphasia: A rapid evidence review of post-stroke mental health, screening practices and lived experiences.

A rapid evidence review (RER) of empirical literature was conducted to explore aphasic stroke survivors' mental health outcomes and lived experiences, as well as the screening instruments for this cohort. The RER was informed by a critical disability theory approach and synthesised qualitative and quantitative evidence within and across 29 studies, published between 2000 and 2021, from a systematic search of three databases. Understanding the relationship between post-stroke aphasia and mental health outcomes is essential for developing comprehensive treatment strategies and designing appropriate long-term care. Available screening instruments currently only detect depression and anxiety, which are then used to detect further mental health issues. The RER revealed that the current screening instruments demonstrate reliability; however, research remains limited regarding their validity. Furthermore, limited studies include aphasic patients as participants and decision-makers in stroke research. Methodological limitations across studies include comparators and small sample sizes. Importantly, across the studies, there is a lack of representation of culturally diverse and minority participants. Overall, the RER results found a high prevalence of aphasic stroke survivors experiencing depression and other mental health outcomes, indicating that implementing mood screening in a timely manner is essential. In addition, the results support that psychological care pathways must be developed and evaluated in consultation with aphasic patients' and carers' lived experiences to identify stepped levels of care and establish appropriate screening instruments. Furthermore, the health system requires consistency, which would ideally be achieved by establishing staff roles and responsibilities regarding mood screening and supportive care in these psychological care pathways. Including mental health specialists such as social workers and establishing specialist training in the multidisciplinary team would support this endeavour. There is a need for further research regarding mood screening instruments, a diversity of aphasic stroke survivors' lived experiences and the clinical expertise of those providing psychological support.

A scoping review of adult survivors' experiences of shame following sexual abuse in childhood.

Shame following childhood sexual abuse (CSA) can be intensely painful and destructive to one's sense of self and place in the world. Organised around an internalised core belief of worthlessness, extreme shame presents as a major therapeutic challenge in therapy with many CSA survivors. A range of clinical and empirical literature, alongside recounts of survivors lived experience, shows that shame is an effect of CSA for many survivors. Yet research has rarely focused specifically on survivors' qualitative or lived experiences of shame. This article reports the results of a scoping review of the empirical research investigating adult survivors' experiences of shame following sexual abuse in their childhood. Conducted in March 2018, the search strategy involved on-line searches of English language, peer review and select grey literature repositories for articles published up to the end of 2017. Of the 28 peer reviewed studies included in the review, only three studies specifically investigate adult survivors lived experiences of shame. The synthesised findings from the studies identify five themes demonstrating the pervasive and detrimental influence of shame following CSA: (1) Psychological effects and trauma symptoms; (2) Relationships and social connections and disconnections; (3) Disclosure; (4) Self concept; and, (5) The process of recovery. These findings resonate with conceptual literature and broader research on the influence of shame following violence and highlight areas for future research and clinical practice. This scoping review identifies three key gaps: a need for further research across specific populations and groups; research evaluating therapeutic interventions responding to shame; and research that specifically investigates adult survivors' lived experiences of shame following CSA.

Help-seeking experiences of bereaved adolescents: A qualitative study.

Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provided a critical appraisal of positive and negative experiences, and noted barriers and facilitators for help-seeking. As adolescents bereaved through suicide may receive less social support, professional help is a much-needed auxiliary. Parental encouragement is important in accessing adequate professional help.

"Don't bother about me." The grief and mental health of bereaved adolescents.

Death of a relative or friend is a potentially disruptive event in the lives of adolescents. To provide targeted help, it is crucial to understand their grief and mental health experiences. Thematic analysis of 39 semistructured telephone interviews yielded two themes: Grieving apart together and Personal growth. High self-reliance and selective sharing were common. Feelings of guilt and "why" questions seemed more pronounced among the suicide bereaved. There was strong evidence of personal growth, increased maturity, and capacity to deal with personal mental health/suicidality. Despite its devastating effects, experiencing a death can be a catalyst for positive mental health.

Supporting Family Members to View the Body after a Violent or Sudden Death: A Role for Social Work.

Supporting family members to view the body of their relative after a traumatic death is a critical role for social workers in hospital and morgue settings; however, this role has had little attention in the literature. In-depth interviews with 48 bereaved family members explored their experiences of helpful and unhelpful aspects of support when viewing the body of their deceased relative. A central theme of "support as a relational interaction" was identified. Aspects of the connection and communication valued by participants within this relational interaction included: "permissions and possibilities," "information and preparation," "presenting with care," "time and timing," and "tuning to family." These results are considered with grief practice and theory, to suggest the need for social workers to actively engage with working in the interface between the deceased body and the grieving family. This includes advocating a private location for time with the body and using interpersonal skills to provide paced and dosed information for preparation to view that is consistent with the capacities and needs of the individual and family.

A preliminary study to develop an intervention to facilitate communication between couples in advanced cancer.

OBJECTIVE: Psychosocial interventions directed to couples where one has advanced cancer can reduce distress, enhance communication, and provide an opportunity for relational growth. The present study aimed to develop an intervention to facilitate communication about living with advanced cancer using the Patient Dignity Inventory (PDI) as the focus of a clinical interview with couples toward the end of life. METHOD: Couples were recruited from oncology and palliative care services at a Sydney hospital. After the PDI was developed and manualized as an intervention for couples, the PDI-Couple Interview (PDI-CI) was delivered by a clinical psychologist and comprised the following: (1) the patient completed the PDI; (2) the patient's identified partner completed the PDI about how they thought the patient was feeling; and (3) the clinician reviewed the results with the couple, summarizing areas of concurrence and discordance and facilitating discussion. RESULTS: Some 34 couples were referred, of which 12 consented, 9 of whom completed the clinical interview. Reported benefits included enabling couples to express their concerns together, identifying differences in understanding, and giving "permission to speak" with each other. The focus of the interview around the PDI provided a structure that was particularly acceptable for men. Most couples confirmed that they were "on the same page," and where differences were identified, it provided a forum for discussion and a mutual understanding of the challenges in managing advanced cancer within a supportive context. SIGNIFICANCE OF RESULTS: Participant couples' experiences of the PDI-CI provide valuable insight into the benefits of this intervention. This preliminary study indicates that the intervention is a relatively simple means of enhancing closer communication and connection between couples where one has advanced cancer and may be an important adjunct in helping prepare couples for the challenges inherent toward the end of life. Further investigation of feasibility with a larger sample is recommended.

Signs of post-traumatic stress disorder in caregivers following an expected death: a qualitative study.

BACKGROUND: Complications of grief are an important area of investigation with potential to improve the well-being of palliative care caregivers. There has been little study of the prevalence or significance of post-traumatic stress disorder for those bereaved after an expected death. AIM: To identify evidence suggestive of post-traumatic stress disorder symptoms in a population of bereaved caregivers of patients who have died of ovarian cancer. DESIGN: Caregivers' recollections of their end-of-life experiences were coded and analysed, using qualitative data obtained from interviews 6 months after the patient's death. SETTING/PARTICIPANTS: Australian Ovarian Cancer Study-Quality of Life Study is a population-based epidemiological study using mixed methods to explore caregivers' experiences following the expected death of a woman with ovarian cancer. Thirty-two caregivers from the Australian Ovarian Cancer Study-Quality of Life Study participated in semi-structured telephone interviews 6 months post-bereavement. RESULTS: When describing the patient's death at their 6-month interview, all interviewees used language consistent with some degree of shock and traumatisation. For the majority, there was also evidence suggesting resilience and resolution. However, a number of interviewees describe intrusive memories associated with physical sights and sounds that they witnessed at the deathbed. CONCLUSIONS: This exploratory study demonstrates the phenomenon of the 'shocked caregiver'. If trauma symptoms are present in bereaved carers in palliative care, it has implications for palliative care provision. Given that trauma symptoms may be distinct from prolonged grief disorder, this may also have implications for provision of bereavement counselling. Further research into this phenomenon is required.