• Journal of Hospice and Palliative Care
• /
• v.10 no.3
• /
• pp.120-127
• /
• 2007

Bereavement is the state of loss resulting from death. Grief is the emotional response associated with loss, intense and acute sorrow resulting from loss. Complicated grief represent a pathological outcome involving social, physical, emotional, cognitive, spiritual morbidity. The common psychiatric disorders associated complicated grief or abnormal grief responses include clinical depression, anxiety disorders, alcohol abuse or other substance abuse, and dependence, psychotic disorders, and post-traumatic stress disorder (PTSD). Grief tasks involve a series of stage or phases following an important loss that gradually permit adjustment and recovery. Three phases of grief involve phase 1 (walking the edges), phase 2 (entering the depths), and phase 3 (reconnecting the world). For intervention to be effective they need to be individually tailored to abnormal grief reaction or unresolved grief reaction. Clear understandings of complicated grief, abnormal responses, factors increasing risk after bereavement will often enable us to prevent psychiatric disorders in bereaved patients.

• Journal of Korean Academy of Nursing
• /
• v.48 no.1
• /
• pp.59-69
• /
• 2018

Purpose: The purpose of this study was to investigate variables and construct paths that affect complicated grief. Methods: Participants in this cross-sectional, descriptive study were 164 bereaved spouses of cancer patients at least 12 months before the death. Data were collected from October 2016 to February 2017 using self-report structured questionnaires and were analyzed using IBM SPSS 21.0 and AMOS 20.0. Results: The variables affecting complicated grief of bereaved spouses of cancer patients were the quality of end-of-life care (${\gamma}=.15$, p<.001), preparedness for death (${\beta}=-.06$, p=.005), and coping with bereavement (${\beta}=-.24$, p<.001), whereas the quality of death and dying did not show any effects. Preparedness for death had multiple mediating effects in the relationship between the quality of end-of-life care and complicated grief (z=-2.20, p=.028), and in the relationship between the quality of end-of-life care and coping with bereavement (z=2.11, p=.035). Coping with bereavement had a mediating effect on the relationship between preparedness for death and complicated grief (z=-2.39, p=.017). Conclusion: This study revealed that preparedness for death and coping with bereavement play a prominent role in complicated grief. Therefore, it is important to help in preparing for death and enhancing coping with bereavement of spouses providing end-of-life care to cancer patients. In addition, investigating cultural differences in the relationship between the quality of end-of-life care and complicated grief is recommended.

• 한국노년학
• /
• v.39 no.1
• /
• pp.21-35
• /
• 2019

The purpose of this study was to empirically verify the effects of spousal bereavement and complicated grief level on death anxiety of the elderly. The sample consisted of 1,998 adults who were aged 65 or older. Dependent variable was measured with the Death Anxiety Scale-Korean version (DAS-K). Independent variable was measured with both spousal bereavement and the Inventory of Complicated Grief-Korean version (ICG-K). Multiple regression analysis was performed using SPSS 23.0, adjusting for demographics, psycho-social and health variables. The results indicated that death anxiety level was lower among the bereaved with normal grief (p<.01) than non-bereaved. In contrast, death anxiety level was higher among the bereaved with complicated grief than non-bereaved (p<.01). The study result suggests that the most risky factor for death anxiety is complicated grief rather than the bereavement. Although the bereavement can be a universal experience, the severity and duration of symptoms after the bereavement may not be general. The unhealed emotional and physical pain after the bereavement stimulates death anxiety, and senior citizens who suffer from complicated grief often fail to integrate the bereavement and loss into reality, therefore, may not accept the death phenomenon itself. Anxiety and fear of death can emerge when they cannot acknowledge the bereavement. To manage complex sorrows and mitigate death anxiety, intervention programs should be provided to increase adaptability to the bereavement.

• Science of Emotion and Sensibility
• /
• v.26 no.3
• /
• pp.101-114
• /
• 2023

Pets are increasingly becoming vital companions in human life, prompting researchers to focus on understanding the grief experiences of pet owners. Unlike other forms of loss, pet loss often leads to complicated grief, characterized by intense and prolonged sorrow. This is likely due to the comparatively lower societal value placed on the human-pet relationship, which may restrict pet owners from feeling truly understood by others. The subjective perception of these "social constraints" significantly hampers the process of recovering from pet loss and contributes to the development of complicated grief. In this study, we hypothesize that the perceived social constraints could intensify the transition from the initial shock of pet loss to complicated grief. The results confirm that pet owners' perceived social constraints play a moderating role in the relationship between the shock of pet loss and complicated grief. Notably, pet owners experience heightened levels of complicated grief when perceiving greater social barriers and constraints. By highlighting the pivotal role of perceived social constraints in comprehending the experiences of pet loss and grief, this study underscores the importance of social awareness and improvement.

• Journal of Korean Academy of Psychiatric and Mental Health Nursing
• /
• v.28 no.2
• /
• pp.156-164
• /
• 2019

Purpose: The aim of this study was to identify factors influencing on the mental health in bereaved adults. Methods: A descriptive and correlational study was conducted in 160 adults who had experienced bereavement. The collected data was analyzed using descriptive statistics, Pearson's correlation, and hierarchical multiple linear regression analyses with SPSS 26.0. Results: The participants' mental health showed a positive correlation with complicated grief (r=.31, p<.001) and a negative correlation with grief and meaning reconstruction (r=-.30, p<.001). Sex, sleeping time, intimacy with the deceased, grief reaction, and grief and meaning reconstruction were significant factors influencing on the mental health. The total explanatory power of these variables was 31.8%. Conclusion: It is necessary to explore the persistent and impairing grief after experiencing bereavement. Our study findings will be fundamental evidence to develop nursing interventions to improve adult mental health dealing with bereavement and grief.

• Journal of Hospice and Palliative Care
• /
• v.24 no.2
• /
• pp.130-134
• /
• 2021

In the era of coronavirus disease 2019 (COVID-19), social distancing and strict visitation policies at hospitals have made it difficult for medical staff to provide high-quality end-of-life (EOL) care to dying patients and their families. There are various issues related to EOL care, including psychological problems of patients and their families, difficulties in EOL decision-making, the complicated grief of the bereaved family, moral distress, and exhaustion of medical staff. In relation to these issues, we aimed to discuss practical considerations in providing high-quality EOL care in the COVID-19 pandemic. First, medical staff should discuss advance care planning as early as possible and use the parallel planning strategy. Second, medical staff should play a role in facilitating patient-family communication. Third, medical staff should actively and proactively evaluate and alleviate dying patients' symptoms using non-verbal communication. Lastly, medical staff should provide care for family members of the dying patient, who may be particularly vulnerable to post-bereavement problems in the COVID-19 era. Establishing a system of screening high-risk individuals for complicated grief and connecting them to bereavement support services might be considered. Despite the challenging and limited environment, providing EOL care is essential for patients to die with dignity in peace and for the remaining family to return to life after the loved one's death. Efforts considering the practical issues faced by all medical staff and healthcare institutions caring for dying patients should be made.

• 한국노년학
• /
• v.40 no.3
• /
• pp.477-483
• /
• 2020

Purpose: The aim of this study is to test a brief modified version of intervention for problem drinking monitoring program for bereaved men who lost their loved one. Methods: Inclusion criteria were experiencing the recent loss of a spouse and providing informed consent for participation. Of the 32 referred individuals who met the inclusion criteria, 26 participants were recruited. Study participants were randomly assigned into Alcohol problem monitoring(APM) group (N=13) or comparison group (N=13). Results: Older men receiving APM substantial decreased in problem drinking during three months of intervention. Improvement over time was observed on the outcomes, particularly in the Short Michigan Alcoholism Screening Test-Geriatric Version(SMAST-G). Conclusion: The findings that a modified version of APM for bereavement helped improve complicated grief symptoms and social impairments and reduce levels of problem drinking, provide important insights into the interventions for psychological and alcohol-related difficulties in bereavement.

• Anxiety and mood
• /
• v.14 no.1
• /
• pp.44-52
• /
• 2018

Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

• Journal of the Korean Society of Costume
• /
• v.58 no.3
• /
• pp.49-62
• /
• 2008

The purpose of this study was to analyze the signification system between color and clothes systematically in black and white clothes. For this purpose, after examining the images of black and white clothes, we selected 55 clothes that represented as black and white and analyzed their meanings and the sources using semiotic framework, based on the work of Saussure and Barthes. The results as follows: First, the meaning in black and white clothes was generated from original color image. White clothes of religious person like Virgin Mary, Angel expressed pure and sacred color image. And black clothes like funeral dress expressed grief and death. Next, the meaning of black and white clothes was regenerated into modern color image by new environment. After industrial revolution, black was considered as a traditional men's fashion color. With diverse leisure activities, white sports wear appeared as active and clean image. Finally the source of the meaning of the clothes was the designer or the wearer. A little black dress by Chanel who was interested in simplicity and function represents an ideal of simple and sexy object. The situation is complicated by the fact that these three kinds of explanation may be found singly or mixed together.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.31 no.4
• /
• pp.177-184
• /
• 2020

Objectives: This study aims to examine the effect of adolescent suicide survivors' experience on suicide death risk, and the effect of referral to mental health services (hereafter referral) in this regard. Methods: This study used the data of 878 suicide-deceased and suicide-attempted adolescents aged 8-19 years, managed by the Suicide and School Mental Health Institute from 2016 to 2018. Results: Regression analysis for main effects showed that although suicide experience had no direct effect on suicide death, non-referral status was associated with a greater risk of death by suicide. While the "non-suicide survivor with non-referral" and "suicide survivor with non-referral" groups showed 1.87 [adjusted odds ratio=1.87, 95% confidence interval (CI)=1.21-2.89] and 4.59 (adjusted odds ratio=4.59, 95% CI=2.02-10.42) times higher odds of suicide death, respectively, the "suicide survivor with referral" group showed no difference compared to the "non-suicide survivor with referral" group. Conclusion: From these findings, there is a need to strengthen referral to mental health services and apply complicated grief treatment to improve the mental health of adolescent suicide survivors.