• Korean Journal of Hospice Care
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• v.5 no.1
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• pp.42-49
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• 2005

To determine which are the culturally specific factors of Korean bereavement, this chapter focuses on the view of death and the traditional mourning process which reflect Korean values and norms. The formation of the Korean view and understanding of death has been strongly influenced by three of its major traditional religions: Shamanism, Buddhism, and Confucianism (Park:1994: Hao:1999) and Christianity more recently. Each religion has a different view of death and the appropriate expression of mourning. Korea accommodates funeral customs and rules strictly as a cultural system and has retained these traditions over a long period; hence, some of the traditional funeral rituals still remain in modern Korean life, although some of the rites have been simplified. We have looked at the various ways in which grief and mourning is displayed and shared in a collective manner over a long period of time. This fits in well within the other Eastern cultures that are collectively organized, and contrary to the Eurocentric models do not hastily seek to detach the living from the dead and recognize that grief is a long process, and different individuals may take different amounts of time to recover from the grief. The view of death and bereavement in Korea has sprung from the roots of three Korean religions, together with the recent addition of Christianity, although they mainly result from the three earlier religions. The beliefs of these religions are still closely linked together in the rituals of Korean bereavement on both conscious and unconscious levels. The influence of these religions is evident in practice through the bereaved family's mourning reactions, funeral rites and customs and its views about death. Korea used to have a period of mourning for three years, following traditional mourning rites; then the chief mourner and the bereaved families could return to their normal life. In spite of this long mourning process for the bereaved family, once the funeral ceremony is finished, people expect the bereaved family not to express their grief in public; even the bereaved family does not like to talk about death. The process for bereaved people is related to mourning processes in terms of detachment from the deceased in order to start a new life. Relatives and the community recommend the performance of the kut ceremony for relieving the grief of the bereaved. When one family member dies in an unlucky way, the bereaved family may have some fear or other psychological reactions of grief such as pain, depression, insomnia and nightmares, hallucinations or other physical reactions. Unlucky deaths give the bereaved a very painful time and these types of reactions are often more serious than reactions to natural death. But through the kut ceremony, the bereaved family can start to make a new relationship with the deceased. The taboo of this type of death and death generally remains a crucial aspect of the isolation that bereaved people might face and the collective nature of mourning(even where it is still present) is unable to address this aspect of the privatization of grief.

• Journal of the Korean Home Economics Association
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• v.38 no.1
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• pp.155-170
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• 2000

The purpose of this study was to examine to the effect of self-efficacy and perceived social support on adjustment in terms of depression. The subject was composed of 174 bereaved older adults in the first 10 years of their spousal bereavement. The major results of findings were as fellowing: 1. Bereaved old persons experienced emotional loneliness(35.8%) as the most stressful life event. 2. Bereaved old persons perceived higher self-efficacy and social support showed lower level of depression than those who perceived lower self-efficacy and social support. 3. The factor to have influence on the depression of bereaved old persons most relatively was appeared as self-efficacy.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.233-239
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• 2016

Purpose: Little is known regarding the factors associated with the willingness of family caregivers of terminal cancer patients to participate in a bereaved survey. This study aimed to ascertain the pre-loss factors that predict actual participation in a bereaved survey. Methods: We conducted a prospective observational study using data from two multi-center surveys at the end-of-life and after loss. In order to identify the pre-loss factors associated with participating in the bereaved survey, we used a step-wise multivariate logistic regression analysis. Results: Among 185 bereaved individuals, 30 responded to the survey (response rate: 16.2%). There were differences between the participation group and the non-participation group regarding religion, economic status, and perceived quality of care as assessed by the Quality Care Questionnaire-End of Life. A final multivariate model revealed that bereaved individuals who professed a religion (adjusted odds ratio [aOR]=5.01; P=0.008), had a high income (aOR=4.86, P=0.003), and satisfied with the care for familial relationship (aOR=4.49, P=0.003) were more likely to engage in the bereaved survey. Conclusion: Our finding suggests that improving the quality of end-of-life care may promote actual participation in a bereaved survey through easing post-loss distress. More attention should also be paid to those bereaved individuals who are hesitant to participate in a bereaved survey.

• Journal of Korean Academy of Nursing
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• v.33 no.6
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• pp.847-855
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• 2003

Purpose: This study was done to develop a bereaved family care program by identifying characteristics of a grief healing process in a child loss. Method: The subjects were five bereaved mothers who have lost their children with cancer. Data was collected with in-depth interviews using grief phase assessment tool and grief reaction assessment tool from 1, February, 2001 to 31 August, 2002. Data was analyzed on the basis of two tools. Result: Process of grief in general was as follows: evading phase was within one week - one month, confrontation phase was 5 - 12 months, and reconciliation phase was after 9 months and still going on when the study was finished. Grief reaction in five (physical, cognitive, emotional, social, and spiritual) dimensions was stabilized when the phase moved into reconciliation phase. Influencing factors were intimacy and expectation towards child, social support, personality, prior loss experience, coping style, religion, culture, family cohesion, openness of communication, and stress events. Conclusion: These results suggest that a bereaved family care program considering characteristics of Korean culture should be developed and activated.

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

• Korean journal of food and cookery science
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• v.30 no.2
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• pp.228-238
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• 2014

This study identified the importance and performance perceptions of funeral foodservice service quality toward funeral foodservice employees, chief mourners/the bereaved and funeral visitors. Data were collected using self-administered questionnaires from 102 funeral foodservice employees, 71 chief mourners/the bereaved and 293 funeral visitors. According to the result of the survey, 'hygienic food production process' was recognized as the most important attribute while 'neat appearance of food' had the least performance. By comparing the importance of service quality attributes between three subject groups, it can be identified funeral foodservice employees had the highest recognition while funeral visitors had the lowest (p<0.001). Furthermore, funeral foodservice employees had a significantly high performance level compared to chief mourners/the bereaved in all 19 service quality attributes (p<0.001). The IPA result toward funeral foodservice employees indicated the following attributes that required improvements: 'reasonable menu price' and 'kindness of helpers'. Another IPA result from chief mourners/the bereaved recognized 'reasonable menu price' as a service priority. Overall, implications for funeral foodservice managers regarding service quality improvement are discussed.

• The Korean Journal of Food And Nutrition
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• v.27 no.2
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• pp.310-317
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• 2014

The purposes of this study were to identify the relative importance attributes, deduct the ideal combination of total utility and establish the marketing strategies for quality improvement of foodservice at funeral halls of medical centers. Data were collected using self-administered questionnaires from 102 funeral foodservice employees and 71 chief mourners or the bereaved. According to the results from a conjoint analysis, among foodservice employees at funeral hall, the relatively important attributes were 'taste (52.84%)', 'menu variety (24.419%)' and 'price (22.741%)'; among chief mourners or the bereaved, they were 'taste (50.004%)', 'price (31.388%)' and 'menu variety (18.008%)'. The ideal combination of total utility was different between funeral foodservice employees and chief mourners or the bereaved; it was higher among chief mourners or the bereaved (1.211) compared to funeral foodservice employees (1.169). Thus, there should an endeavor to improve the foodservice quality in funeral halls of medical centers through better taste, low price and similar menu variety.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.134-141
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• 2014

Purpose: This study was conducted to identify the current status of studies of bereaved families in Korea. Methods: We reviewed 97 studies of bereaved families, which were published between 1994 and 2013 in Korea. The studies were classified in three groups according to time, subjects, and topic. Results: First, the number of bereaved family-related studies has increased since 2010. Second, most studies focused on the whole family, and middle-age widows were also popular subjects. Third, the most popular topic was a relationship between certain variables. Conclusion: First, variables and their relations among themselves should be approached through an integrated study. Second, a systematic review is needed to assess the effects of interventions on the bereaved. Third, a qualitative research method is needed to broaden and deepen our understanding about the middle-age widowers, parents who lost their children and children who lost their parents.

• Journal of Hospice and Palliative Care
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• v.26 no.3
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• pp.126-139
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• 2023

Purpose: This study aimed to analyze interventions for bereaved families and evaluate their effectiveness, with the ultimate goal of supporting evidence-based nursing for bereaved families. Methods: Research trends were identified based on a search of domestic databases from January 2000 to December 2022, and a meta-analysis was conducted on interventions for bereaved families. Forty-five papers were selected, and information was extracted on participants, research design, and interventions. A meta-analysis of seven papers was performed, and the effect size was calculated. Results: Fourteen papers dealt with interventions for middle-aged women who had lost their spouses, 20 used qualitative research methods, and 20 were on art therapy programs. Thirty studies had fewer than 10 participants, and most interventions had 60~120 minutes per session and 9~16 sessions in total. There were seven randomized controlled trials, and all studies included in the quality evaluation showed a low risk of bias. Four papers measured grief as an outcome, and the effect size was -1.9577 (95% CI: -2.9206 to -0.9947), indicating that the treatment significantly decreased grief (P<0.001). Six papers measured depression as an outcome, and the effect size was -1.6775 (95% CI: -2.1835 to -1.1716), showing that the treatment significantly decreased depression (P<0.001). Conclusion: Intervention programs for bereaved families were shown to be effective in relieving grief and depression. However, programs should be developed that target middle-aged men who have lost their spouses and children who have lost their parents. Randomized controlled trials should also be conducted on interventions to reduce grief and depression.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.27-41
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• 2023

Purpose: Pediatric palliative care is a rapidly developing multidisciplinary approach that supports children with life-limiting conditions and their families. However, there is limited evidence on how to effectively support bereaved parents and siblings. The purpose of this study is to explore the therapeutic impact of art therapy for bereaved families, in accordance with John Bowlby's four-stage theory of mourning. Methods: This single-case study employed the consensual qualitative research method. Art therapy records of bereaved families were reviewed individually, and records from one case were selected. Verbal statements made during the art therapy sessions and photocopies of the artworks were analyzed to understand the mourning process of the family. Results: A total of 113 statements and 12 artworks from 19 art therapy sessions were analyzed. As the art therapy progressed, each family member exhibited a pattern of engaging in more positive and healthy conversations in daily life, demonstrating the final stage of mourning: reorganization and recovery. The family dynamics also revealed that they reconstructed their inner world and redefined the meaning of loss, which is the final stage of mourning. The art therapy provided a safe environment for the family, allowing them to fulfill their wishes and regain the strength needed for recovery. Conclusion: This study suggests that art therapy supports bereaved families in alleviating their psychological difficulties, engaging in a healthy mourning process, and functioning as members of society. Further research is needed to better understand the effect of art therapy as a bereavement support tool in pediatric palliative care.