Families in Grief: Need for Psychological Care and Support for Those Who Lost Loved Ones to COVID-19.

The COVID-19 pandemic has caused notable changes in all areas of our lives. Pandemic-coping strategies include attention and care at various levels, for different people and in various scenarios. Death is one of the most feared consequences of COVID-19 for both patients and their families; for the latter, the grief and adaptation processes to loss require that care for grievers be an important part of the public health response to the COVID-19 pandemic. Grief from losses due to COVID-19 has distinctive features: it is not anticipatory (with virtually no time or progressive stages to facilitate adaptation to loss); closure or goodbyes are not possible (in-person social support decreases due to distancing to minimize risk of infection); it may affect various close relationships (a relevant predictor of complicated grief); it may imply stigmatization by peers, friends and neighbors; it is preceded by a period of absence of fluid and in-person communication between family members and the hospitalized patient; and those who break the news of the death are often professionals in red zones who are stressed and do not always have the skills or the ability to properly communicate bad news. The death of a family member from COVID-19 generally causes an unexpected crisis in the family, which is already affected by the pandemic and its daily consequences. This has prompted an analysis of COVID-19 loss on family life and how best to mitigate its consequences. During the COVID-19 pandemic, care and monitoring of the grief of family members and those who were close to the deceased require psychological action within a framework of comprehensive care, which demands preparation of healthcare professionals. Experiences described are taken from some actions developed in Cuba.

Psicología de la Salud cubana: apuntes históricos y proyecciones en los inicios del siglo XXI / Cuban Health Psychology: historical notes and projections in the early 21st century

Se sistematizan aspectos históricos del desarrollo de la Psicología de la Salud cubana a lo largo de más de 42 años de su inserción en el Sistema Nacional de Salud, considerando tres grupos de determinantes: en el primer grupo, se combina la aparición de una nueva forma de pensamiento con el reconocimiento del modelo biopsicosocial tras la transformación del viejo modelo biomédico, la nueva conceptualización del proceso salud-enfermedad y el conocimiento creciente de factores psicológicos y sociales asociados a este proceso, la transición en los perfiles epidemiológicos, la irrupción de los conceptos de bienestar y calidad de vida relacionada con la salud, la incorporación de la atención primaria como ámbito fundamental para muchas acciones de salud y la importancia del trabajo en equipos interdisciplinarios. El segundo, está relacionado con los cambios sociales ocurridos en Cuba después de la década de los 60 y que materializaron estas nuevas concepciones con un enfoque preventivo, de proyección social. El tercero, vincula el desarrollo mismo de la Psicología con campos específicos de actuación. Además, se intentan identificar las tareas prioritarias para la Psicología de la salud cubana en el presente y formular sus proyecciones básicas, para los próximos años en el contexto de las tendencias mundiales en esta disciplina.

Historical aspects of the development of Cuban Health Psychology have been systematised for more than 42 years, since their incorporation in the National Health System, focusing on three groups of determinants. In the first group the appearance of a new way of thinking is combined with the recognition of the bio-psychosocial model following the change from the old biomedical model, the new conceptualization of the health-illness process, and the growing knowledge of psychological and social factors associated with this process, the transition in the epidemiological profiles, the impact of the concepts of wellbeing and health-related quality of life, the incorporation of primary health care as a fundamental scenario for many health-related actions, and the importance of working in interdisciplinary teams. A second group covers the social changes that occurred in Cuba after the decade of 60's, which gave shape to these new conceptions with a preventive approach with a social perspective. The third group of determinants is related to the development of Psychology itself, with specific fields of action. In addition, the immediate tasks for Cuban Health Psychology are being determined for the present time, as well as the formulation of its basic perspective in the context of world trends in this discipline for the future.

São sistematizados aspectos históricos no desenvolvimento da Psicología da saúde cubana ao longo de mais de 42 anos da sua inserção no Sistema Nacional de Saúde, considerando três grupos de determinantes. No primeiro grupo são combinados a aparição de uma nova forma de pensamento, com o reconhecimento do modelo biopsicossocial depois da transformação do velho modelo biomédico, a nova conceptualização do processo saúde-doença e o conhecimento crescente de fatores psicológico e sociais associados a este processo, a transição nos perfis epidemiológicos, a irrupção dos conceitos de bem-estar e qualidade de vida relacionada com a saúde, a incorporação da atenção primaria como âmbito fundamental para muitas ações de saúde e a importância do trabalho em equipes interdisciplinares. Um segundo grupo está relacionado com as mudanças sociais ocorridos na Cuba depois da década dos sessenta e que materializaram estas novas conceições com um enfoque preventivo, de projeção social. No terceiro grupo de determinantes vincula o desenvolvimento mesmo da psicologia com campos específicos de atuação. Além, intentou-se identificar as tarefas prioritárias para a psicologia da saúde cubana no presente e formular suas projeções básicas no contexto das tendências mundiais em esta disciplina para os próximos anos.