Death Notification in Italian Critical Care Unites and Emergency Services. A Qualitative Study with Physicians, Nurses and Relatives

This qualitative study was conducted in critical care units and emergency services and was aimed at considering the death notification (DN) phenomenology among physicians (notifiers), patient relatives (receivers) and those who work between them (nurses). Through the qualitative method, a systemic perspective was adopted to recognise three different categories of representation: 23 clinicians, 13 nurses and 11 family members of COVID-19 victims were interviewed, totalling 47 people from all over Italy (25 females, mean age: 46,36; SD: 10,26). With respect to notifiers, the following themes emerged: the changes in the relational dimension, protective factors and difficulties related to DN. With respect to receivers, the hospital was perceived as a prison, bereavement between DN, lost rituals and continuing bonds. Among nurses, changes in the relational dimension, protective factors and the impact of the death. Some common issues between physicians and nurses were relational difficulties in managing distancing and empathy and the support of relatives and colleagues. The perspective of receivers showed suffering related to loss and health care professionals’ inefficacy in communication. Specifically, everyone considered DNs mismanaged because of the COVID-19 emergency. Some considerations inherent in death education for DN management among health professionals were presented.

‘Many pieces one family’: An elaboration of one family’s bereavement experiences

There has been considerable research on bereavement and the concept of continuing bonds. However, there is a distinct absence of research considering bereavement, continuing bonds and family dynamics post-bereavement. The paper reports on a study utilising a family systems approach combined with narrative methods, tools of conversation analysis and systemic theory. This integration of approaches is used to consider how one family offers an account of their experience of bereavement. An exploration of their conversation along with visual presentation in the form of button sculpts is employed. The findings support the suggestion that it is useful to consider bereavement experiences as part of a family system. Clinical implications of the research are outlined to consider how best to support bereaved families.

Exploring an Extended Conception of Grief: Sense of Presence and Grief Reactions in German Widows

This study explores sense of presence (SOP) as an important feature of continuing bonds (CB) in the context of normal grief. A community sample of widows ( N = 51) filled in a multidimensional grief questionnaire and a depression scale. A moderate positive association between sensing the deceased husband´s presence and cognitive and emotional impairments emerged. A positive relationship between SOP and guilt was found only if the influence of religiosity was controlled for statistically. There were no significant associations of SOP with long-lasting positive reactions to loss, such as personal growth and increase in sensitivity for others. Widows with clinically relevant depression indicated a stronger SOP than those with lower depression scores. These differentiated findings may stimulate the elaboration of an extended conception of grief beyond the focus on clinically relevant impairments

Till Death Do Us Part?: Exploring the Influence of Deceased Romantic Partners on the Lives of Older Women

Recent research integrating the hierarchical mapping technique (HMT) and the continuing bonds framework has suggested that deceased individuals may be influential social convoy members. Building off this pilot work, the current qualitative descriptive study focused on how older women viewed the role of a longstanding deceased romantic partner in their current social network. Twenty women (Mean age = 78 years), recruited via social media and snowball sampling, participated in one 90-minute semi-structured interview. Each discussed their bereavement journey and completed a HMT diagram to comment on their social network and the presence or absence of the deceased within it. Nineteen participants described the deceased as being an active member of their convoy. Interestingly, 15 women placed them within the innermost circle of the diagram, separate from their other network members. Thematic analysis of interview transcripts expanded upon the HMT diagram exercise to reveal five major themes: “We’re part of each other,” “I think he supports me,” “He would want me to be happy,” “I just feel so grateful,” and “I think about him every day but I don’t talk about him every day". Perceptions that deceased romantic partners continue to play a key role in participants' lives offers researchers and practitioners with a unique opportunity to examine how losses are experienced and carried into old age. Further, this study may assist with the development of interventions that help support bereaved individuals, specifically, interventions that focus on destigmatizing continuing bond expressions and provide assistance with communicating memorialization preferences.

Reconciling the Uniquely Embodied Grief of Perinatal Death: A Narrative Approach

The death of a baby, stillborn or living only briefly after birth, is a moral affront to the cycle of life, leaving parents without the life stories and material objects that traditionally offer comfort to the bereaved, nor—in an increasingly secularized society—a religious framework for making sense of their loss. For the grieving mother, it is also a physical affront, as her body continues to rehearse its part in its symbiotic relationship with a baby whose own body is disintegrating. Attempting to forge continuing bonds with her child after death makes special demands upon the notion of embodied spirituality, as she attempts to make sense of this tragedy in an embodied way. This paper, which reconciles the distinct perspectives of bereaved mothers and children’s doctors, proposes that the thoughtful re-presentation of medical insight into pregnancy and fetal development may assuage parents’ grief by adding precious detail to their baby’s life course, and by offering the mother a material basis to conceptualize her own body as part of the distributed personhood of her baby.

“He’s Still There”: How Facebook Facilitates Continuing Bonds With the Deceased

This study explored the processes involved when the bereaved use Facebook to continue bonds with the deceased. Grounded theory was used to analyze Facebook pages and interviews with bereaved Facebook users. Individual attempts at connection, such as posting about the deceased person, were bolstered by others witnessing and replying to the posts. Collective reminiscence occurred through the sharing of memories about the deceased, which sometimes led to learning new things about them. These individual and collective processes helped to maintain and transform a connection with the deceased person, who for some participants was “still there” on Facebook.