Rozprawy doktorskie na temat „Peer support for grief or loss”

Någon gång i livet kommer de flesta individer tvingas möta på de svårigheter som en sorg för med sig. Sorg är en reaktion på en förlust. Syftet med studien var att belysa stödformer som kan hjälpa individer i deras sorgeprocess. Där sorgeprocessen i detta fall relaterar till förlusten av en närstående. Deltagarna var 23 stycken kvinnor mellan åldrarna 19-62 som hade upplevt en sorgeprocess till följd av närståendes bortgång. Materialet bestod av en enkät med öppna frågor. De insamlade enkäterna analyserades genom en meningskoncentrering för att bilda övergripande teman. För att kontrollera reliabiliteten i analysen genomfördes ett interbedömarreliabilitetstest. Studien resulterade i att familj, partner och vänner ansågs som det mest betydelsefulla stödet. Hur man upplever och hanterar sorg är individuellt. Därmed är även tidsaspekten för en sorgeprocess varierande.

This research aims to develop the ability of Malaysian Chinese funeral directors to offer grief and loss support to their clients. Providing support is now deemed essential due to the continual transformation of the funeral industry in response to the increased social awareness of life and death processes and a shift towards increasing input and demands from the bereaved regarding elements of the funeral ritual. Advances in the Malaysian Chinese funeral industry in recent years are evident and encouraging, yet comparatively less than those seen in the industry in the United Kingdom, United States, China and Taiwan. This is attributed to professional training carried out at the discretion of individual companies rather than coordinated bodies, and to lesser regulation of the industry in general. A greater understanding of the profession in Malaysia will help clarify current practices and the challenges necessary to underpin future interventions to foster increased professionalism and attend specifically to the needs of the Chinese funeral worker with regards to providing grief and loss support.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology
Griffith Health
Full Text

Studiens syfte är att undersöka äldres upplevelser av stöd i samband med sorg, vid förlust av livskamrat, samt att undersöka professionellas erfarenheter av sörjandestöd för äldre. Syftet preciseras genom följande frågeställningar: Vilket stöd finns att tillgå äldre i sorg, utifrån samhällets insatser? Vilka eventuella brister finns i sörjandestödet för äldre? Vilka aspekter har varit avgörande för de äldres sorgebearbetning? Studien har genomförts utifrån kvalitativ metod med semistrukturerade intervjuer som datainsamlingsmetod. Intervjuer har genomförts med två respondentgrupper, den ena med tre äldre personer vilka erfarit förlust av livskamrat, den andra med tre professionella vilka via sitt arbete kommer i kontakt med äldre. De teoretiska utgångspunkterna har utgjorts av kristeori, rollteori och ålderism. Studiens resultat visar att det finns visst stöd att tillgå för sörjande äldre men att det är begränsat och till viss del svårtillgängligt. Vidare visar resultatet att de brister och begränsningar som idag finns inom sörjandestödet till stor del kan förklaras utifrån ekonomiska aspekter. Resultatet belyser även faktorer, utöver det professionella stödet, vilka kan ha betydelse för sorgeprocessen.
The study aims to examine the elderly’s experiences of support in grief at the loss of a life partner and to explore professionals' experiences of bereavement support for elderly. The aim defined by the following questions: What support is available from society for elderly in grief? What possible deficiencies are there in bereavement support for elderly? What aspects have been crucial for elderly in their grieving process? The study was conducted using qualitative methodology with semi-structured interviews as data collection method. Interviews have been conducted with two respondent groups, one with three elder people who have experienced the loss of a life partner, the other with three professional who through their work get in contact with elderly. The theoretical approaches have consisted of crisis theory, role theory and ageism. The results of the study show that there is some support available for bereaved elderly, but it is limited and partly inaccessible. Furthermore, the results show that the deficiencies and limitations that currently exist within the bereavement support can largely be explained by economic factors. The result also highlights aspects, in addition to professional support, which may be important for the grieving process.

Perinatal loss (stillbirth or the death of a neonate) can result in considerable psycho-social disruption for mothers. As women grieve, they try to make meaning of the death of their baby. In contexts of social and economic deprivation, perinatal loss often occurs alongside other difficulties which may affect and limit women's ability to make meaning. A narrative approach was used to explore how meaning-making functions in such contexts. In-depth interviews were conducted with 15 women who had experienced perinatal loss while attending a state maternity hospital. Narratives which the mothers constructed of the event were examined in order to understand what meanings they derived from the loss, and how these were (or not) achieved. These narratives were often linked to other stories of pervasive life difficulties. Despite their difficult contexts, the bereaved mothers engaged in meaning-making in similar ways to those described in previous studies in more affluent settings: they attempted to integrate the loss with their identity and goals, they affirmed the baby as a real person to be mourned and they searched for reasons for the loss. The effect of their contexts on meaning-making was mediated by social support and personal agency. Where one or both of these were present, the bereaved mothers were able to find meaning in their loss; women who had neither seemed unable to do so. Those who portrayed themselves as agentic were able to reflect on their experience and make decisions to change their lives. Mothers with strong social support made meaning through conversations, social validation of the loss and social help which mitigated against the sense of helplessness engendered by their loss and circumstances. It is recommended that hospital and counselling services implement practices which help to build or consolidate personal agency and social support to facilitate successful meaning-making following perinatal loss.

I denna kvalitativa studie har enkäter insamlats från barn och unga som deltagit i stödgruppsverksamhet för barn och unga med en avliden nära anhörig i Dalarnas län. Syftet med studien har varit att beskriva deltagarnas erfarenheter av stödgrupperna. Genom kvalitativ innehållsanalys har tre kategorier identifierats; bearbetning, gemenskap och strukturens betydelse. Studien visar främst på betydelsen av att få träffa andra barn och unga i liknande situation samt indikerar till att deltagarnas KASAM (känsla av sammanhang) förhöjts genom deltagandet i stödgruppen.
In this qualitative study, questionnaires were collected from children and adolescents who had participated in a support group in Dalarnas län for children and adolescents with a deceased close relative. The purpose of this study was to enhance knowledge of children and adolescents’ experiences of participating in support groups through their descriptions in qualitative questionnaires. Qualitative content analysis was conducted and three categories were identified; kinship, processing and the significance of structure. The result highlights the importance of having the opportunity to meet other children and adolescents in similar situations, and indicates that the participants Sense of coherence enhanced through the participation in the support group.

The present study examined the role of religious coping efforts of children and adolescents, ages 8 to 18, following residential fire. Two types of children's religious coping, spiritually based coping and religious discontent, were examined in response to loss of resources in residential fires. The study further examined the influence and potential moderating effects of internal resources including global self-worth, as well as external resources including social support received from parents, teachers, and friends, and the family religious environment. Consistent with the general coping literature, these resources were expected to beneficially influence and predict spiritually based coping. Contrarily, the lack of these resources was expected to predict religious discontent. Children and adolescents' post-traumatic stress disorder (PTSD) symptoms were also assessed and compared to their coping responses. Religious discontent was found to be positively associated with greater levels of loss, PTSD symptoms and negatively associated with global self-worth and low socio-economic status. It was also significantly predicted by loss and an interaction between loss and social support, where higher social support predicted lower levels of religious discontent under high levels of loss. Post hoc analyses revealed peer social support to interact significantly with loss to buffer religious discontent. Spiritually based coping was found to be significantly predicted by loss, race, age, and family religious environment, where African Americans, and children reported greater spiritually based coping than European Americans, and adolescents. Lastly, loss was significantly and negatively associated with global self-worth and positively associated with PTSD symptoms.
Master of Science

Cette recherche vise à évaluer le risque de développement d’un trouble du deuil compliqué et l’apport d’un soutien psychologique (personnel, de groupe et sur internet) à la suite d’une perte périnatale. 29 parents français ont été rencontrés au total cinq fois : une première fois, puis 3, 6, 12 et 18 mois après la première réunion. Une méthodologie mixte a été utilisée, s'appuyant sur des entretiens qualitatifs (évalués avec l'Interpretative Phenomanological Analysis et le programme Alceste) et à l’aide de deux questionnaires (l'Inventory of Complicated Grief et le General Health Questionnaire-28).21 femmes (72%) et 8 hommes (28%) sont les parents rencontrés avec une moyenne d’âge de 31,4 ans. Le délai maximal entre le décès de l’enfant et la première réunion était d’environ 10 mois, le délai minimum était quant à lui de 22 jours. 44% des décès étaient dus à des problèmes médicaux et 35% à une interruption médicale de grossesse. Seulement 22% des enfants étaient mort-nés (maximum 96 jours) et 79% étaient décédés in utero.Notre recherche a confirmé que la perte périnatale est un événement difficile et risqué pour les parents. Ce n’est que 18 mois après la perte de l’enfant que les parents ont rejoint le niveau du deuil non compliqué. La participation à des groupes de parole s’est révélée utile, tandis que les groupes sur internet peuvent mener au développement de troubles psychopathologiques. Le rôle social et les contraintes culturelles liées au genre influencent la façon dont s’exprime le chagrin des parents. Au niveau du soutien émotionnel, la proximité et l’aide du partenaire et de la famille sont très importantes. Se souvenir et commémorer l'enfant malgré le temps qui passe et les grossesses ultérieures est fondamental pour aller de l’avant
This research aims to evaluate the risk of complicated grief disorder (CG) and the contribution of psychological support (professional, or personal and group, and online) following a perinatal loss. 29 bereaved French parents were met for a total of five meetings : the first one, 3, 6, 12 and 18 months after the first meeting. A mixed methodology was used, drawing on qualitative interviews (evaluated through the Interpretative Phenomenological Analysis and the Alceste programm) and two questionnaires (Inventory of Complicated Grief and General Health Questionnaire 28).The parents were 21 women (72%) and 8 men (28%), with a mean age of 31.4 years old. The maximum time between the child’s death and the first meeting is about 10 months, while the minimum is 22 days. 44% of deaths occurred due to medical problems and 35% to a Late Termination of Pregnancy. Only 22% of children lived (up to a maximum of 96 days) and 79% died in utero. Our research confirmed that perinatal loss is a difficult and risky event. Only more than 18 months a half after the loss, the parents reached the uncomplicated grief threshold. Participation in support groups has proved useful while online groups can influence the development of psychopathological disorders. The social role and cultural impositions of gender influence the expression of grief. Regarding the emotional support, the closeness and help of the partner and family are very important. Remembering and commemorating the child despite the passing of time and subsequent pregnancies are fundamental to move forward

Bakgrund: Av alla graviditeter är 2–3 % extrauterina och innebär i stort sett alltid en förlorad graviditet eftersom infästningen av det befruktade ägget oftast sker i äggledaren.En extrauterin graviditet kan skapa olika typer av lidande hos kvinnan som kan leda till långvariga psykologiska konsekvenser och i värsta fall kvinnans död. Det är sjuksköterskans ansvar att stödja kvinnan och lindra hennes lidande. Syfte: Att belysa kvinnors upplevelse av lidande i samband med extrauterin graviditet. Metod: En kvalitativ studie har utförts baserad på 11 bloggar som analyserats på en manifest nivå med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier: En psykisk kamp, Att bli ignorerad samt En fysisk kamp. Samt sju underkategorier. En stor del av kampen var sorgen över ett förlorat barn. Konklusion: Det visade sig att en extrauterin graviditet involverade livslidande, vårdlidande och sjukdomslidande. Det var inte bara fysiskt smärtsamt att vara med om utan också psykiskt påfrestande och ledde till en stor sorg som påverkade kvinnan i flera år. För en snabbare återhämtning av sorgen var det viktigt med professionellt och socialt stöd. Det var även av stor vikt att kvinnornas sorg togs på allvar av vården för att minska risken för vårdlidande.
Background: Of all pregnancies, 2–3% are ectopic and almost always ends in a pregnancy loss because the attachment usually takes place in the fallopian tube. An ectopic pregnancy can create different types of suffering that can lead to long-term psychological consequences and in the worst case result in the death of the mother. It is the nurse's responsibility to support the woman and alleviate her suffering. Purpose: To illustrate women's experience of suffering associated with ectopic pregnancy. Method: A qualitative study has been conducted based on 11 blogs that have been analysed at a manifest level with a qualitative content analysis. Results: The analysis resulted in three categories: Amental struggle, Being ignored and A physical struggle. As well as seven subcategories. Abig part of the struggle was the grief over a lost child. Conclusion: It turned out that anectopic pregnancy involved suffering of life, suffering of care given and suffering of illness. It was not only physically painful but also psychologically stressful and led to agreat grief that affected the women for several years. For a faster recovery from grief, professional and social support was important. It was also of great importance that women's grief was taken seriously by health care professionals to reduce the risk of suffering from care.

Tidigare forskning gällande barn som förlorat en förälder genom dödsfall pekar på att det finns tydliga tendenser att fokus ofta läggs på den kvarvarande föräldern och att barnet många gånger kommer i skymundan eller glöms bort. Syftet med studien är att undersöka professionellas uppfattningar och yrkeserfarenheter om barns behov av stödinsatser då en förälder avlidit. Studiens teoretiska ansatser är; det salutogena perspektivet, ”den nya barndomssociologin” samt den konstruktivistiska struktureringsteorin. Metoden fenomenografi har använts för att fånga professionellas uppfattningar och materialet har samlats in genom sju semistrukturerade intervjuer. Resultatet och slutsatserna visar att professionella utgår från någon form av modell i sitt arbete och modellen vägleder den professionelle i hur barnet kan få information, råd och stöd. Barnets behov av stöd är oftast att finna nya strategier, för att hantera sin vardag och för att skapa en identitet utan ena föräldern. Olika stödinsatser kan hjälpa barnet att avdramatisera och normalisera sina känslor då en förälder avlidit. Ambitionen för de professionella är att lyssna till det enskilda barnet och dennes familjesituation. Detta eftersom barn inte är en homogen grupp och för att på bästa sätt tillmötesgå det behov av stöd det enskilda barnet har. Det viktigaste är att barnet inte upplever att denne även förlorar närvaron och omsorgen från den kvarvarande föräldern genom förälderns egen sorgebearbetning.
Previous research of children with parental loss shows visible tendencies that focus is on remaining parent and that the child easily tends to fall in shadow or becomes forgotten. The study aims to investigate professional´s views and experiences of children´s needs for support when losing a parent. The theoretical views of the study are; the perspective of salutogenic, ”the new sociology of childhood” and the theory of structuration in a constructive perspective. The study was performed with a phenomenographic methodological approach to capture professional´s views and experiences and the material consists of seven semi-structured interviews. The result and conclusions shows that professionals proceed from some kind of model in their work and the model then guide the professionals in giving information, support and advice to the child. The child´s needs of support is mainly to find new strategies to deal with everyday life and the creation of identity when losing a parent. Different inputs of supports can help the child to defuse and normalise their expression of emotions in losing a parent. The ambition of the professionals is to listen to the child in order to meet each individual child and his/hers family situation, since children are not an homogenous group, their needs also vary. Most important is that the child doesn´t feel that he/she also is losing the remaining parent´s attendance and caring for him/her, through the parent´s own grieving process.

Bakgrund: Missfall är den vanligaste komplikationen under en graviditet, cirka 10-20% av alla påbörjade graviditeter avbryts spontant. Kvinnor som har genomgått missfall upplever en individuell förlust som kan uttrycka sig i olika känslor, vilket gör att de upplever ett behov av stöd. För att sjuksköterskan ska kunna ge god omvårdnad behövs det en förståelse för kvinnors upplevelser vid missfall. Syfte: Syftet med litteraturstudien var att belysa kvinnors upplevelser och erfarenheter vid missfall. Metod: En litteraturstudie baserad på 12 vetenskapliga artiklar med en kvalitativ ansats. Litteratursökningen gjordes i databaserna PubMed och Cinahl. De utvalda artiklarna kvalitetsgranskades och analyserades med hjälp av innehållsanalys. Resultat: Resultatet av denna litteraturstudie visar att upplevelsen av att genomgå ett missfall påverkar kvinnan psykiskt, fysiskt och emotionellt. Resultatet delades in i tre huvudteman, dessa huvudteman är: Upplevelser och erfarenheter efter en oväntad förlust, behov av stöd och brister i sjukvården. Konklusion: Bristande stöd och information från sjuksköterskor var något som kvinnorna upplevde. Genom de fem stegen i Swansons omvårdnadsteori kan sjuksköterskan få en förståelse för kvinnans upplevelse av missfall. Det behövs mer forskning gällande kvinnornas individuella behov för att uppnå god omvårdnad vid missfall.
Background: Miscarriage is the most common complication during a pregnancy, where 10-20% of all pregnancies ends with a spontaneous abortion. Women who have gone through a miscarriage experience an individual loss expressed in different emotions leading to a need of support. In order for the nurse to provide good care an understanding for the women's experience of miscarriage is required. Aim: The purpose of this literature review was to illustrate how women experience miscarriage.  Method: A study based upon 12 scientific articles following a qualitative design. The article search was made through the databases PubMed and Cinahl and the chosen articles were analysed and quality reviewed through the application of content analysis.  Result: The result indicates that a woman’s experience of miscarriage affects her psychologically, physically and emotionally. Further did the analysis of the articles result in three main themes. The main themes are: Experiences following an unexpected loss, the need of support and insufficient nursing.  Conclusion: Women did in general experience a lack of care, support and information from nurses. Through the application of Swanson’s theory of caring in five steps, nurses may gain a fuller understanding for how women experience miscarriage. Future research is desired to illustrate the individual needs of the women in order to achieve better nursing care in case of miscarriage.

The purpose of the study is to provide an understanding of the emotional and cultural needs Latinos experience when grieving the loss of a loved one. Current research shows that the Latino community is less likely to seek mental health treatment including end of life and bereavement services. This study uses a qualitative approach examining participant’s experiences during the bereaved phase focusing on emotional needs. The study reveals that Latinos experience emotional distress during bereavement and grief. It also identifies a scarcity of programs designed to meet the needs of the bereaved of Latino communities in the Inland Empire where this study takes place. The study explores different barriers that prevent Latinos from accessing and utilizing bereavement services among Latino communities, social work professionals, and organizations focusing on emotional and mental health. The study reveals that Latinos have a need for culturally sensitive programs to help them process feelings of grief and loss; language, values, and traditions are identified as main cultural characteristics including family and religion. The study identifies support groups, counseling, home visits, and phone calls as the top bereavement services needed in Latino communities as well as professionals who can understand their cultural needs.

El presente estudio tuvo como objetivo describir cómo es el duelo de las mujeres frente a la pérdida de la fertilidad en diagnósticos de infertilidad primaria. Las participantes fueron 6 mujeres entre 26 y 40 años, con deseo de ser madres y no hayan logrado un embarazo clínico después de 12 meses o más de haber mantenido relaciones sexuales sin protección. Se realizó un estudio cualitativo con diseño fenomenológico a través de una entrevista semiestructurada. Además, se organizó la información a través de un análisis temático y se utilizó la triangulación de datos. Los resultados mostraron que frente a la infertilidad se da un proceso de duelo o fases emocionales que se desarrollan a través de “Shock”, “Enfado”, “Negociación”, “desesperanza” y “Aceptación”. Además, se encontró la importancia de las Redes de Apoyo en el área familiar, conyugal y amistad. Se concluye que, frente al diagnóstico de duelo, las mujeres transitan por un proceso de duelo distinto al de otras pérdidas pues se duela un anhelo o ilusión.
This research was conducted with the objective of describing grief in women mourning loss of fertility in diagnoses of primary infertility. The participants were 6 women between 26 and 40 years old, with a desire to be a mother and had not achieved a clinical pregnancy after 12 month or more unprotected sex. A qualitative study with phenomenological design was carried out through a semi- structured interview. In addition, the information was organized through a thematic analysis and data triangulation. The findings suggest that in the face of infertility there is a grieving process or emotional phases that develop through “Shock”, “Anger”, “Negotiation”, “hopelessness” and “Acceptance”. Also, the importance of Social Support in the family, conjugal and friendship, areas was found. It was concluded that when a woman is diagnosis with infertility, they go through a process of mourning different from that of other losses because a longing or illusion.
Tesis

Transitioning to boarding school during the middle years of childhood impacts upon the social, emotional and academic wellbeing of young people (Bramston & Patrick, 2007; Connell & Wellborn, 1991; Deci, Vallerand, Pelletier, & Ryan, 1991; Earls & Carlson, 2001). Students who live at school as boarders, may experience greater transitional changes in all three components of wellbeing due to the extent of change experienced during this transition. While research addressing transitioning to school has indicated the importance of connectedness to school, bonding, friendships and a sense of autonomy (Eccles et al., 1993), there is limited research addressing the transitioning experiences of boarding students and their families. This mixed methodology study sought to understand how boarding students experience transitioning into boarding school, its possible association with connectedness to the boarding house, reported levels of staff support, loneliness, homesickness and help-seeking for homesickness. Focus groups and interviews were used to better understand how parents experience the transitioning of their children into boarding school. This thesis used data collected from a Healthway funded Starter Grant. The research was cross-sectional by design involving a purposeful sample of 267 students, 59% male and 41% female, aged 12 - 15 years, who lived in one of eight metropolitan and regional boarding settings in Western Australia (WA) in 2011, and 37 of their parents. Data for this project were collected from October, 2010 to September, 2011 The first research question used qualitative data to explore the experiences of boarding parents. Findings suggested parents appeared to be more affected by their children leaving home than did the majority of boarding students. The following strategies were suggested as helpful to support positive transitions: preparing both parents and their children effectively for the move; making contact with other boarding parents at least six months prior to the transition; having meaningful connections with the staff caring for their children communicating and visiting their children regularly; co-developing with their children communication and visiting plans; and, keeping busy. Research questions two to five analysed quantitative data collected through a student survey. The following transitioning activities were found to be either very helpful and / or associated with other benefits (as listed above): tour of the boarding house; sleepover with or without parents; separate information targeting students and parents sent or given to boarding families, up to date information on the Internet; Orientation Day; peer mentors; staff telephoning students prior to transition; and, boarding staff meeting with each family individually on or following Orientation Day. Homesickness was most commonly experienced during the first two weeks of boarding and when students returned after their holidays. Girls, younger students and International students reported experiencing more homesickness. Three factors: psychosomatic symptoms; separation distress; and, grief and loss, best explained how students in this study experienced homesickness. Help-seeking behaviours comprised the factors contacting parents, keeping busy and conversing with staff and students. A number of activities were associated with reductions in both psychosomatic symptoms and separation distress; however, for those students who experienced grief and loss, going on leave with their parents and knowing when their parents would next be visiting or taking them on leave appeared to be the only activities that reduced students’ grief response. Help-seeking was most evident for students who experienced psychosomatic symptoms or feelings of separation distress. Students who experienced grief and loss were less likely to report seeking help. Girls and younger students reported utilising the most help-seeking strategies. The findings of this study and the subsequent recommendations will assist families and staff to better understand the experiences of boarding students and their families as students transition into boarding.

Bakgrund: Att förlora ett barn är en stor sorg som uttrycks på olika sätt hos olika individer. Sorgen drabbar inte bara familjen utan även vårdpersonal som upplever att det får svårigheter att identifiera föräldrars behov och stödja dem i deras sorgeprocess. Därför är det viktigt att få reda på hur föräldrar upplever vårdpersonalens stöd efter att deras barn dött. Syfte: Syftet med litteraturöversikten var att beskriva föräldrars upplevelser av vårdpersonals stöd efter att deras barn dött. Metod: Studierna berör föräldrars upplevelser av vårdpersonals stöd efter att deras barn dött och valdes från databasen CINAHL complete och genom två manuella sökningar. Litteraturöversikten har utgått från Fribergs metod och presenterar resultat från tio vetenskapliga engelskspråkiga artiklar. Resultat: Resultatet innefattar tre huvudteman: Behovet av samtal och information, Behovet av kontinuitet och en god relation och Behovet av uppföljning och engagemang. Diskussion: Metoddiskussionen beskriver litteraturöversiktens styrkor och svagheter och vad som kan ha påverkat både utformningen och tillvägagångssättet. I litteraturöversiktens resultat diskuteras hur föräldrar vars barn dött på sjukhus upplevde vårdpersonalens stöd efter beskedet om barnets diagnos, vad som är viktigt vid dödsögonblicket samt efter det att barnet dött och hur uppföljning påverkar föräldrar. I resultatet diskuteras även vad föräldrar önskar av vårdpersonalen i de olika faserna. Resultatet diskuteras även utifrån Travelbees omvårdnadsteori med fokus på begreppet människa.
Background: Losing a child is a great sadness that is expressed in different ways by different individuals. Grief affects not only the family but also health professionals who describe difficulties identifying parents' needs for support. Therefore, it is important to explore how parents perceive the health care professionals support after their child died. Aim: The aim of this literature review was to describe the parents' perceptions of support from health care professionals after the death of their child. Method: The studies concern parental perceptions of health professionals’ support after their child died and was selected from the database CINAHL complete and through two manual searches. The literature review was based on Friberg’s method and presents results from ten English scientific research articles. Results: The result includes three main themes: The need for conversation and information, The need of continuity and a good relationship and The need of follow up and commitment. Discussion: Method discussion describes the literature reviews strengths and weaknesses and what may have influenced both the design and approach. The literature reviews results discusses how parents whose children died in hospitals experienced health care professionals support after information about the child's diagnosis, what is important at the moment of death and after the child died and how follow-up affects parents. The result also discusses what parents want from health care professionals in the different phases. The results are also discussed based on Travelbees nursing theory with focus on the concept of man.

Many adolescent girls experience the death of a peer, which is often sudden and at times violent. These deaths are typically viewed as preventable, which can complicate the grief reactions of adolescent girls. The impact of peer death on adolescent girls involves a number of physical, emotional, social, and cognitive grief responses. Negative outcomes include school problems, depression, substance abuse, and suicidal ideation. This study examines the efficacy of the Adolescent Grief and Loss (AGL) group, a six-week group designed to address the needs of adolescent girls who have experienced the death of a peer within the past two years. The goal of the AGL group was to reduce or lessen physical, emotional, social, and cognitive responses to grief, and to foster mutual support and connection to others via various tasks associated with each group session. The AGL group was conducted in four different public high schools in Central Texas, with a sample size of 20 girls. A mixed methods design was utilized for this study, integrating both quantitative and qualitative research designs. The quantitative component employed a non-experimental simple time-series design, using two pre-test and three post-test time points. The qualitative component was based on a phenomenological analysis of adolescent grief and loss response, which included open-ended questions developed to capture each adolescent girl’s individual experience of peer death. Questions were also asked to elicit the girls’ experience of participating in the AGL group. The quantitative results of the study indicate that adolescent girls benefited from participation in the AGL group as evidenced by significantly reduced scores on the Loss Response List for all domains of physical, emotional, social, and cognitive grief responses. The qualitative findings yielded five overarching themes of experience of peer death: the story, physical reactions, emotional reactions, social reactions, and cognitive reactions. Integration of the quantitative and qualitative findings of this research study strongly support the benefits of providing a grief and loss group to adolescent girls who have been impacted by the experience of peer death.
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碩士
國立成功大學
電腦與通信工程研究所
101
Due to more and more viewers using DVB-T to watch live streaming in vehicle, watching live streaming in vehicle will cross weak signal strength areas or signal blocked by high building. Packet loss problem occurs when the signal strength is weak and affects the video quality. Viewers will join the p2p networks for packet loss repair. Because the source of video streaming is from DVB-T and just request for lost packet from p2p network, our solution can reduce the usage of network bandwidth. In recently years, there are many strategies researching into packet loss repair problem. Using p2p network as the repair system is a hot issue. We reference and analyze their strategies, and then propose an efficient caching mechanism. In this thesis, we propose a Hierarchical Caching Mechanism that viewers should join the p2p network and cache partial of video streaming. They can repair the lost packet from the p2p network. In our mechanism, we can dynamic control chunk replications according to the number of peers in the p2p network. It is used to avoid number of some video chunks’ replication is high and some low.

Masters Coursework - Master of Clinical Psychology (MClinPsych)
Grief and growth are potential psychological sequelae of miscarriage but little is known about predictors of, or temporal changes in, these outcomes. This study aims to examine the impact of social support, partner support and marital satisfaction after miscarriage on the outcomes of grief and growth among women and men following unplanned pregnancy loss. Because social support is thought to facilitate the resolution of distress after trauma and to be associated with psychological growth we hypothesised that the use of support after miscarriage would be associated with improved outcomes in relation to grief and growth. This study investigated predictors of grief and growth among 496 participants (248 couples) following miscarriage. Participants completed the following measures: the Significant Others Scale (SOS), Coping Response Inventory (CRI), Index of Marital Satisfaction (IMS), Perinatal Grief Scale (PGS) and Stress-Related Growth Scale (SRGS). Measures were taken at one and four months after miscarriage. The study employed a correlational design; data were entered utilising stepwise regression analysis. Grief and growth were taken as dependent variables in separate analyses. Sociodemographic characteristics and measures of support, marital satisfaction and coping were taken as predictor variables. Favourable grief outcomes were associated with support satisfaction one month after miscarriage, marital satisfaction and coping style (with more use of behavioural avoidance and less use of cognitive approach strategies predicting lower PGS scores). Growth was predicted by marital satisfaction. In unexpected findings a negative association was identified between support satisfaction and growth and no association was identified between coping style and growth. These findings highlight the importance of social support and the quality of the marital relationship to individuals after miscarriage. Assessment by health professionals of salient aspects of support among individuals who have experienced miscarriage may lead to identification of those individuals who lack appropriate support resources and thus to interventions to enhance support which in turn could contribute to optimal psychological outcomes after miscarriage.

碩士
國立臺北護理健康大學
生死與健康心理諮商研究所
108
This study aimed at the exploration of the pet groomers’ end-of-life work experiencing with the pet-loss owners, and the way the pet groomers encountered the pet-loss owners’ grieving process. “Holistic-content＂and “categorical-content＂ analysis in narrative study was used for this study. Semi-structural interviews were conducted with five pet groomers. Followings were the data analysis results accordingly: 1.The pet groomers’ end-of-life work experiencing with the pet-loss owners 1) Assisting in grooming the dead body of pet; 2) Providing information about funeral and related arrangements with a calming manner; 3) Supporting and respecting the pet owners; 4) Reassuring the pet owners and changing their mindset with viewpoints of religious. 2. The way the pet groomers encounter the pet-loss owners’ grieving process 1) The emotion-involving level affecting their grieving process; 2) Grieving feelings affected by the pet owners; 3) Managing their own psychological difficulties; 4) Reassuring by religions viewpoints 5) Building family-like relationship with pet owners; 6) Protecting self with professional knowledge. Lastly, Conclusions and suggestions were made for workers who are in pet-service related fields.

This doctoral dissertation's topic is mourning in people with intellectual disabilities who have lost a loved one. The research focuses mainly on the loss of parents, but also includes the loss of other people, such as grandparents. By loss we mean death, but the results of the work can also be used for losses of a different nature. The aim of this work is to understand grief in people with intellectual disabilities and to suggest appropriate ways to support their grieving process, with emphasis on grief support groups. As part of the research, we set up and implemented 2 support groups for grieving people with intellectual disabilities, each lasting at least 2 months and meeting once a week. At the very beginning of our research, we carried out one support group of the same length as a pilot study. The pilot study was first evaluated and the proposal of the support group according to the original foreign script was modified to better meet the needs of Czech citizens with intellectual disabilities. After the pilot study, we enriched the research with a questionnaire test of our own design, capturing a possible change in process of mourning in people involved in our support groups. We presented the questionnaire test to the participants before the start of the support groups and immediately after...

abstract: The aim of this research was to better understand the experience of bereaved individuals following their return to work, and the ways in which they communicatively negotiate their relationships at work and at home. One of the most salient facts of life is that everyone will all experience the death of a loved one. The amount, frequency, type, and recovery response for the bereaved may be vastly different, but inevitably everyone has to cope with death. Even though it is an integral part of life, the bereavement experience often is acknowledged as one of the most traumatic and stressful processes that occurs in individuals’ lives (McHorney & Mor, 1988; Miller & McGowan, 1997). In fact, roughly 5% of the workforce is affected by the passing of a close family member each year, and this number excludes those who experience the deaths of close friends (Wojcik, 2000). Evidence suggests that bereavement affects the physical and mental health of survivors, many of whom are in the workforce (Bauer & Murray, 2018; Hazen, 2003, 2008, 2009; Wilson, Punjani, Song, & Low, 2019). In order to explore how work-life roles are integrated into the lives of bereaved individuals, this dissertation qualitatively analyzed 36 interviews with bereaved employees (12), cohabitants (12), and coworkers (12). Through the use of procedural coding (Saldaña, 2009) and emergent codes, this dissertation answered the five posited research questions and their sub-questions. The results of this analysis have numerous implications for social support, emotion at work, grief, and bereavement leave policy. The following dissertation delineates the significance of this research, the literature review providing rationale for study of bereaved employees, qualitative methodological design, analysis of the data, and conclusions about bereavement and work-life relationships.
Dissertation/Thesis
Doctoral Dissertation Communication 2020

The research deals with the losses the 7-11 year old child in die single parent family may experience. The research has been conducted from a practical theological (pastoral) perspective. The goal of the study was to investigate and elaborate upon the various losses the child may experience on a physical, cognitive, social, spiritual and an emotional level. In order to complement and verify the literature study, empirical methods of research were utilised. Focus groups were conducted within the framework of Gestalt Play Therapy. Parent interviews were used as an additional method of research. It became apparent, as a result of the literature and empirical studies, that the loss of a parent (whether by divorce/ abandonment/unmarried status/ death) affects the child on all levels of his/her development. Guidelines for the support of such a child are suggested.
Die navorsing handel oor die verlies(e) wat die 7-11 jarige kind in die enkelouergesin mag beleef. Die navorsing geskied vanuit 'n prakties-teologiese (pastorale) perspektief. Die doel van die studie was om die verliese wat die kind op fisiese, kognitiewe, emosionele, sosiale en geestelike vlak mag ervaar, te ondersoek en omskryf. Om die literatuurstudie aan te vul en te verifieer, al dan nie, is daar van empiriese navorsing gebruik gemaak. Fokusgroepe het plaasgevind binne 'n gestalt spelterapeutiese raamwerk. Oueronderhoude was as nog 'n wyse van ondersoek gebruik. Vanuit die literatuurstudie en empiriese navorsing het dit duidelik geword dat die verlies aan 'n ouer (vanwee egskeiding/ verlating/ongetroude status/ sterfte) die kind op al die vlakke van sy/haar ontwikkeling beinvloed. Riglyne tot ondersteuning aan hierdie kind is voorgestel.
Social work
M.Diac. (Youth Work)

Certaines personnes peuvent être stigmatisées quand elles présentent un attribut relié à une identité sociale qui est dénigrée dans un contexte particulier. Il existe plusieurs stéréotypes au sujet des personnes qui ont une perte d'audition. Le grand public associe souvent la perte d'audition à des comportements indésirables, au vieillissement et à une capacité intellectuelle réduite. Ces stéréotypes affectent négativement la participation des personnes ayant une perte auditive à diverses activités. Malgré les impacts évidents et importants que la stigmatisation a sur la participation sociale des personnes ayant une perte auditive et leur propension à recourir aux services de réadaptation, on constate une pénurie relative de recherche sur le stigmate lié à la perte d'audition. Ces dernières années, les chercheurs en sciences sociales ont fait de grands pas pour conceptualiser le stigmate selon la perspective des personnes qui sont la cible des attitudes nuisibles. La plupart de ces concepts peuvent s'appliquer au stigmate social lié à la perte d'audition. Le premier article de cette thèse tente de placer le stigmate lié à la perte d'audition dans un modèle de menace à l’identité induite par le stigmate (stigma-induced identity threat model). Ce chapitre explore comment les services pourraient être modifiés pour mieux soutenir les individus qui montrent des signes que leur identité personnelle est compromise à cause de leur perte d'audition. De façon générale, les buts de ce manuscrit sont a) de dresser un bref résumé de la question du stigmate lié à la perte d'audition ; b) de présenter un modèle spécifique de menace d'identité induite par le stigmate et d’incorporer des notions propres au stigmate lié à la perte d'audition à cette conceptualisation générale du stigmate et c) de réfléchir sur la pertinence de ce modèle pour la réadaptation audiologique. L'intention de la deuxième étude est de mieux comprendre comment le stigmate affecte les comportements de recherche d’aide des adultes ayant une perte d'audition acquise. Dix personnes ayant une perte d'audition, et appartenant à des groupes de soutien par les pairs ont participé à des entrevues semi-structurées audio-enregistrées. Les transcriptions de ces entrevues ont été analysées au moyen d’analyses thématiques. Les analyses ont indiqué que les répondants montre une plus grande propension à chercher de l'aide à la suite d’étapes charnières, où l’équilibre entre le stress négatif et l'énergie positive était rompu : a) un moment où le stress était de loin supérieur à l'énergie positive (première étape charnière) et b) un moment où l'énergie positive était de loin supérieure au stress négatif (deuxième étape charnière). On propose une série de représentations graphiques qui dépeignent comment les influences positives et négatives présentes dans l'environnement social et physique du répondant influencent la recherche d'aide. Le but de la troisième étude est d'identifier les facteurs qui amènent des individus à cacher ou révéler leur perte d'audition dans leur lieu de travail. Des entrevues semi-structurées ont été menées en utilisant une technique d’élicitation par photographies pour susciter des informations liées à la révélation de la perte d'audition. Les thèmes dégagés des entrevues incluent : l'importance perçue de la situation, la perception du sentiment de contrôle, l'affiliation à la communauté, le fardeau de communication et la présence de problèmes connexes à la perte d'audition. Les résultats de cette étude offrent un aperçu du monde caché des travailleurs ayant une perte d'audition. Cette étude sert à documenter certaines stratégies que les travailleurs avec une perte d'audition utilisent pour contrôler leur identité professionnelle et, plus spécifiquement, comment certains gèrent le dévoilement de leur perte d'audition dans leur lieu de travail. Les résultats fournissent des informations utiles pour le développement de programmes d'intervention appropriés pour des travailleurs ayant une perte d'audition.
Individuals are stigmatized when they possess, or are thought to possess, an attribute or characteristic that conveys a social identity that is devalued in a particular social context. There are several stereotypes, or commonly held (often erroneous) beliefs about people who have hearing loss. The general public often associate people with hearing loss to undesirable behaviours, ageing, and reduced intellect. Stereotypes such as these negatively impact upon activities of daily living engaged in by people with hearing loss. In spite of the obvious and important impacts that stigma has on social participation and inclination to use rehabilitative strategies, there has been a relative dearth of research on the stigma associated with hearing loss. In recent years, researchers in the social sciences have made great strides to conceptualize “stigma” from the perspective of people who are the target of prejudicial attitudes. Most of these concepts are applicable to the social stigma associated with hearing loss. The first study presented in this dissertation attempts to position hearing loss stigma within a model of stigma-induced identity threat. Overall, the goals of this paper are to a) offer a brief summary of hearing loss stigma; b) present a specific stigma identity threat model and incorporate ideas about hearing loss stigma into this general conceptualization of stigma; and c) reflect on the appropriateness of this model for the domain of rehabilitative audiology. The intent of the second study was to better understand how stigma impacted upon the help-seeking activities of adults with an acquired hearing loss. Ten people who had hearing loss, and were members of peer-support groups participated in audio-recorded semi-structured interviews. Thematic analyses of verbatim transcripts revealed that respondents experienced a heightened propensity to seek help following Critical Junctures, when negative stress and positive energy were out of balance: 1) a time when negative stress far outweighed positive energy (i.e., Critical Juncture One); and 2) a time when positive energy far outweighed negative stress (i.e., Critical juncture Two). A series of graphic representations are proposed that depict how positive and negative influences found in the respondent’s social and physical environment influenced help seeking. The purpose of the third study was to identify the factors that lead individuals to conceal or disclose their hearing loss in the workplace. We conducted semi-structured interviews using a photo-elicitation technique to aid in probing issues related to disclosure of hearing loss. Emergent themes included: Perceived importance of the situation, Perceived sense of control, Community affiliation, Burden of Communication and Coexisting issues related to hearing loss. This study serves to document some of the ways that workers with hearing loss manage their workplace identity, and more specifically, how some people manage revealing their hearing loss in workplace settings. The findings also inform the development of pertinent intervention programs for workers with hearing loss.

This study was undertaken as a qualitative needs assessment of emotional support to the adolescent with a terminally ill parent. Five participants in their adolescent life phase (14 to 18 years) with a terminally ill parent, participated in the study. Individual unstructured interviews were conducted with each participant, in order to assess their need for emotional support. With the consent of the parents and adolescents, the interviews were video-recorded and transcribed. Eight recurring themes were selected from the case studies and verified with the existing literature. The result of the study is the assessment of the need for emotional support to the adolescent with a terminally ill parent.
Social Work
M. Diac (Play Therapy)(Social Work)