Adolescent coping with grief after the death of a loved one

The purpose of this article was to describe adolescent coping after the death of a loved one. Data were obtained by two self-report questionnaires filled in by 14-16-year-old pupils in two secondary schools in Finland. The sample consisted of 89 adolescents (70% girls) who had each experienced the death of a loved one. The instrument used in the study was developed by Hogan and DeSantis. The article reports the responses to two open-ended questions. The data were analyzed using content analysis. The most important factors that helped adolescents cope with grief were self-help and support from parents, relatives and friends. However, the official social support system was not experienced as very helpful. No one reported help, for example, from school health services. According to the adolescents, fear of death, a sense of loneliness and intrusive thoughts were factors that hindered coping with grief. Some respondents felt that parents or friends were an additional burden on them. The results are discussed in terms of identifying the different impact of social support, the importance of self-help and professional help. Knowledge of factors that have an effect on adolescent coping with bereavement is important for families, effective nursing practice, school health services and parents.     

ICU新护士护理癫痫持续状态病人真实体验的质性研究

[目的]探讨重症监护室(ICU)新护士护理癫痫持续状态病人的真实体验。[方法]采用半结构式访谈,访谈在ICU护理过癫痫持续状态病人的新护士11人,采用Colaizzi现象学研究法分析资料。[结果]ICU新护士护理癫痫持续状态病人真实体验可归纳为四大主题,主题1:病人的发作症状影响ICU新护士的反应;主题2:护理时的心理状态,包括紧张、慌乱、恐惧、担心、怀疑自己的能力、无奈;主题3:抢救中需要支持;主题4:加强和改变培训方式。[结论]增强新护士的工作信心,减轻新护士的心理压力和应激,加强新护士学习癫痫持续状态的相关知识可提高新护士的抢救和护理癫痫持续状态病人的综合能力。     

Identifying and Treating Complicated Grief in Older Adults

Grief is the natural, instinctive response to the death of a loved one. Adaptation to loss often occurs, but for some, grief persists and can be so severe that it affects functioning and quality of life. This condition is called complicated grief (CG) or persistent complicated bereavement disorder. This article focuses on identifying CG in older adults, some of whom are often not recognized as living with grief. As the body of evidence for CG expands, we review the latest evidence-based practices for treating CG and recommend grief-conscious practice changes for the primary care setting.     

Emergency Department Grief Support: A Multidisciplinary Intervention to Provide Bereavement Support After Death in the Emergency Department

BackgroundThe nature of death in the emergency department (ED) may put survivors at higher risk for complicated bereavement. Access to bereavement care could mitigate this, but many EDs do not include bereavement follow-up as part of their routine practice.ObjectiveWe describe the implementation at our institution of ED Grief Support, a program developed to extend care to the bereaved through in-person, telephone, and e-mail follow-up for 1 year after the death of a loved one.MethodsBereavement follow-up was preferentially extended to survivors of patients <45 years of age who were chosen because of the higher likelihood of unexpected death in this age group. Detailed records of each case were collected prospectively using online data management software and outcomes were recorded. Successful strategies to navigate communication and resource referrals are discussed.ResultsWe enrolled 192 patients during our 2-year period of observation. The majority died from trauma and parents were the most common next-of-kin to be contacted. Commonly requested services included: clarification of the circumstances of death, the interpretation of autopsy reports, referral to community bereavement resources, and family meetings. Challenges included supporting the emotional well-being of staff and the resource-intensive nature of the follow-up. Staff members who worked with ED Grief Support find it meaningful and note a positive influence on their well-being as providers.ConclusionsLongitudinal bereavement follow-up from the ED is feasible and had a perceived positive impact on the bereaved as well as ED staff.     

Grief responses and coping strategies among infertile women after failed in vitro fertilization treatment

Scand J Caring Sci; 2010; 24; 507–513
Grief Responses and coping strategies among Infertile Women after failed in vitro fertilization Treatment Reproductive technology has increased the childbearing potential for many infertile women, but in vitro fertilization (IVF) failures are common, which often trigger grief responses and coping strategies to manage the stressful life event. The present cross‐sectional study investigated 66 women who had experienced at least one failure with IVF treatment. The data were gathered by a self‐administered structured questionnaire, and included the participant’s personal profile, grief responses and the Jalowiec’s coping scale. The most common grief response among the respondents was bargaining, followed by acceptance, depression, anger, denial, and isolation. The order of coping strategies used, from highest‐to‐lowest, were confrontative, optimistic, self‐reliant, fatalistic, supportive, evasive, palliative, and emotive. Use and self‐perceived effectiveness among all coping strategies had a high correlation, except emotion. Bargaining, the most common grief response, was associated with a variety of coping strategies. All coping strategies were correlated with grief responses. The results of identifying the grief responses and associated coping strategies of women who have undergone failed IVF treatment may assist nurses and other health care professionals in their efforts to provide appropriate information, care and psychological support.     

CCU护士职业认同水平与应对方式及职业倦怠的关系

[目的]探讨心脏病重症监护室(CCU)护士职业认同水平与应对方式及职业倦怠感的关系。[方法]应用职业认同感量表、应对方式及职业倦怠感(MBI)量表对40例CCU护士及50例心内科护士进行调查,对比分析不同科室护士职业认同感量、应对方式及职业倦怠感情况,应用Pearson单因素分析CCU护士职业认同水平与应对方式及职业倦怠感的关系。[结果]CCU护士职业认识评价、职业社交技巧、职业社会支持、职业自我反省、职业挫折应对及总分均低于对照组(P0.05);CCU护士自责、幻想、退避及合理化等应对方式维度评分低于对照组(P0.05);CCU护士去人格化、情感耗竭维度评分高于对照组(P0.05),而个人成就感低于对照组(P0.05);Pearson单因素分析可知,CCU护士职业认同总分与自责、幻想、退避及合理化、去人格化、情感耗竭维度呈负相关(P0.05),而与人成就感呈正相关(P0.05)。[结论]CCU护士职业认同感水平较心内科护士低,与其消极的应对方式及明显的职业倦怠感有关。护理管理者可通过提高CCU护士职业认同感而促进其积极面对工作中的问题,减轻其职业倦怠感。     

Grief reaction model of families who experienced acute bereavement in Japan

The present study clarified the structure of factors that affect grief reactions of families who experienced acute bereavement in critical care settings in Japan. Sixty-four families who experienced acute bereavement answered a questionnaire. The questionnaire included the Miyabayashi Grief Measurement, recognition of bereavement, Multidimensional Scale of Perceived Social Support, and the Tri-Axial Coping Scale. We analyzed the causal structure regarding the relationship of stress recognition, coping, and grief reactions using structural equation modeling. The greatest influence on grief reactions of bereaved families was stress recognition. Factors that influenced stress recognition were subjective degree of sadness, acceptance of bereavement, regret for bereavement, and recognition of a peaceful death. These results show that the quality of end-of-life care in critical care settings is an important factor that affects bereaved families' stress recognition and grief reactions. Nurses and medical staff must provide end-of-life care to help family members accept the death of their loved one and reduce regrets as much as possible.     

Engaging nurses to strengthen medication safety: Fostering and capturing change with restorative photographic research methods

We used participatory photographic research methods adapted from the field of ecological restoration to engage Brazilian intensive care unit nurses in a critical review of medication safety in their work environment. Using focus groups, practitioner‐led photo walkabouts with photo narration, and photo elicitation focus groups in iterative phases of data collection and analysis, nurses developed and implemented several practical and cultural improvements for their unit. Participants focussed on organizing the medication room for efficient workflow and accessible supplies, improving reporting practices, and reconsidering how they could manage safety issues in their unit and in the hospital as a whole. Our results demonstrated that restorative photographic research methods enabled participants to (re)think and redesign their work environment in keeping with several recommended practices for improving medication management. It also validated the need for continuous evidence‐informed improvements if nurses hope to optimize medication safety in the complex systems of intensive care.     

国外护士间横向暴力应对策略的研究进展及启示

文章综述了国外护士间横向暴力的应对策略,包括关键对话、结构授权、团队建设、认知演习与"零容忍"等。国内医院管理者应结合我国现状,借鉴国外研究成果培训护士长处理横向暴力的能力,加强团队凝聚力,为低年资护士提供相关培训,以达到减少横向暴力发生的目的。     

Practice nurses and the facilitation of self-management in primary care

Title. Practice nurses and the facilitation of self‐management in primary care. Aim. This paper is a report of a study to explore practice nurse involvement in facilitation of self‐management for long‐term conditions. Background. In the United Kingdom chronic disease services have shifted from secondary care to general practice and from general practitioners to practice nurses. A new United Kingdom General Practice contract requires adherence to chronic disease management protocols, and facilitating self‐management is recognized as an important component. However, improving self‐management is a relatively new focus and little is known about the ways in which nurses engage with patient self‐management and how they view work with patients in chronic disease clinics. Method. Semi‐structured interviews with 25 practice nurses were carried out in 2004–2005. Interviews were audio‐taped and transcribed verbatim. Analysis was informed by the ‘trajectory model’ and ‘personal construct’ theories. Findings. Main themes in the early stages of work with patients were: categorization of patients, diagnosis, and patient education. First impressions appeared to determine expectations of self‐management abilities, although these were amenable to change. Intermediate stages were ‘ways of working’ (breaking the task down, cognitive restructuring and addressing dissonance, modelling ‘good’ behaviour, encouragement, listening, involving carers and referral) and maintaining relationships with patients. However, in the longer‐term nurses seemed to lack resources beyond personal experience and intuitive ways of working for encouraging effective self‐care. Conclusion. The ways of working identified are unlikely to be sufficient to support patients’ self‐management, pointing to a need for education to equip nurses with techniques to work effectively with patients dealing with longer‐term effects of chronic illness.