Naissance d'un petit frère ou d'une petite soeur, séparation des parents, deuil d'un grand-parent... les enfants sont souvent confrontés à des situations déstabilisantes ; sans parler de l'actualité qui aborde des sujets sensibles tels que le chômage, le harcèlement, la guerre ou les attentats. Un moyen de trouver les mots Les parents se sentent bien maladroits pour aider leurs enfants à appréhender une réalité qui les bouleverse.
Comment expliquer en rassurant ? Comment trouver le ton juste et les paroles appropriées ? Une méthode pour communiquer sur tous les sujets délicats La psychologue Florence Millot propose de pratiquer ce qu'elle appelle la "méthode des sept portes" . Son principe ? Le dialogue, quel que soit l'âge de l'enfant.
Le médium Alain Joseph Bellet partage ses réflexions sur la mort, qu'il considère comme un retour du défunt à son véritable foyer. Il rapporte les propos des esprits avec lesquels il dit avoir communiqué afin de comprendre l'organisation du monde spirituel. Le deuil, la maladie, l'euthanasie, l'inhumation et l'incinération sont abordés.
Ce livre présente les réalités de la mort aux XIVe et XVe siècles, abordant les coutumes funèbres, le cérémonial funéraire et les représentations macabres. Il aborde également une réflexion sur la signification des gestes et des discours autour de la mort.
BACKGROUND: The death of a child is regarded as one of the most devastating events for a family. Families are reliant on nurses to not only provide end-of-life care but also to support and care for grieving families in a way that is sensitive to their cultural and religious needs and preferences.
AIMS: The aim of this study was to explore the perceived impact and influence of cultural diversity on how neonatal and paediatric intensive care nurses care for Muslim families before and after the death of infants/children.
DESIGN: A qualitative descriptive approach was used in this study, conducted in Saudi Arabia.
METHODS: Semi-structured interviews were used to gather data from a convenience sample of registered nurses working in neonatal and paediatric intensive care, with experience in providing end-of-life care. Interviews were conducted between July and November, 2018. Interviews were audio-recorded and transcribed for analysis.
RESULTS: Thirteen registered nurses participated; all were born overseas, identified with various faiths and spoke English in the workplace. A respect for diversity and care of the family was prioritized yet impacted by communication challenges. Caring and respect was demonstrated by facilitating important cultural and religious practices important in the Muslim faith. Self-care was identified as important, transcending the culturally diverse nature of the nursing workforce.
CONCLUSIONS: Significant challenges exist for a culturally diverse nursing workforce in providing care to a Saudi Muslim population of infants/children and families, before and after a death. Their overriding commitment to respect for others, and an openness to cultural diversity and difference, aided in overcoming the inherent challenges in providing culturally sensitive end-of-life care that meets the needs of Muslim families. These findings provide valuable insights for intensive care clinicians in other countries to address challenges associated with cultural diversity.
OBJECTIVE: Thiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer. However, it has not been recognized to date in bereaved partners after spousal loss from cancer.
METHOD: From a series of bereaved partners who lost a spouse to cancer, we report on those who developed TD after bereavement. ResultCase 1 was a 57-year-old woman who sought consultation at our "bereavement clinic." Her husband had been diagnosed with pancreatic cancer one year earlier and had died one month previously. At the first visit, she was observed to suffer depression, anxiety, and decreased appetite. Neurological, blood, and biochemical examinations did not reveal any noteworthy findings. She was diagnosed with uncomplicated bereavement. Detailed examination revealed that her appetite had been markedly decreased for approximately five weeks. The diagnosis of TD was supported by her abnormally low serum thiamine level. Case 2 was a bereaved 73-year-old male who had lost his wife to hypopharyngeal cancer one month previously after a five-year illness. He had shown a lack of energy for the month preceding his wife's death, but because there was no improvement after her death, his family recommended he seek consultation at our "bereavement clinic." He was suffering from major depressive disorder. Detailed examination revealed that his appetite had been decreased for more than two weeks. Again, the diagnosis of TD was supported by his abnormally low serum thiamine level.
SIGNIFICANCE OF RESULTS: These reports demonstrate that there is a possibility that bereaved could develop TD after the loss of a loved one. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of the bereaved to prevent complications because of TD.
BACKGROUND: Personal experiences with death and dying are common among medical students, but little is known about student attitudes and emotional responses to these experiences. Our objectives were to ascertain matriculating medical students' experiences with death and dying, describe the range of students' emotional responses, and identify reactions, behaviors, and perceived roles related to these and future experiences with death.
METHODS: We provided a writing prompt to newly matriculated medical students asking them to "reflect on experiences you may have had with family or friends near the end of life." Content analysis was performed to identify themes in the responses.
RESULTS: The 104 students in the entering class submitted 90 individual free-text responses (87%). Most (57%) students specifically mentioned at least 1 personal experience with death, with a range of emotional responses including sadness (29%), surprise (14%), and guilt (12%). Distinct themes emerged on content analysis including personal experiences with death, anticipated response to death in future, changes in body or mind of the dying person, thoughts and observations about others, and cognitive or existential responses. Few students wrote about religion or spirituality (8%) or palliative or hospice care (2%).
CONCLUSIONS: An understanding of students' premedical school experiences and emotional reactions to death may help educators frame curricula around end-of-life care. Educators could apply enhanced awareness to help students process their own experiences as they begin caring for patients and to focus on areas that were underrepresented in students' comments, such as religion, spirituality, palliative care, and hospice.
OBJECTIVE: To describe children's anxiety, depression, behaviors, and school performance at 2-13 months after sibling neonatal/pediatric intensive care unit (NICU/PICU) or emergency department (ED) death and compare these outcomes by child age, sex, race/ethnicity, whether the child saw their sibling in the NICU/PICU/ED, and attended the sibling's funeral.
STUDY DESIGN: Children in 71 families were recruited for this longitudinal study from 4 children's hospitals and 14 other Florida hospitals. Children rated anxiety (Spence Children's Anxiety Scale) and depression (Children's Depression Inventory); parents rated child behaviors (Child Behavior Checklist) and reported school performance (detentions, suspensions, requested parent-teacher meetings) at 2, 4, 6, and 13 months post-sibling death. Analyses included repeated measures-ANOVA, t-tests, and 1-way ANOVA.
RESULTS: In total, 132 children and 96 parents participated. More children were female (58%), black (50%), and school-age (72%). Of the children, 43% had elevated anxiety and 6% had elevated depression over 13 months post-sibling death. Child-rated anxiety was higher for girls and black vs white children. Child-rated anxiety and depression were lower if they saw their sibling in the NICU/PICU/ED before and/or after the death, and/or attended the funeral. Teens were more withdrawn than school-age children at all time points. Children who did not see their deceased sibling in the NICU/PICU/ED after death had more requests for parent-teacher conferences.
CONCLUSIONS: Children's anxiety was more common than depression, especially in girls and black children. Children who saw their siblings in the NICU/PICU/ED before/after death and/or attended funeral services had lower anxiety and depression over the first 13 months after sibling death.
This article is an autoethnographic exploration of college faculty grief. Over a career, a college teacher is likely to encounter deaths of current and former students. The rich connections that can develop in a faculty-student relationship can make for strong grief. Issues that can complicate faculty grief include regrets that might be unique to faculty-student relationships and information about the deceased that the faculty member feels obligated to keep confidential and cannot mention while processing their grief with others. Faculty members may rarely have the benefit of attending funeral or memorial services for students and former students, but with the deaths of current or recent students, a faculty member is likely to have colleagues and students who knew the deceased with whom to talk. With deaths of students from long ago, a faculty member is likely to be limited to processing grief with people who never knew the deceased.
Most people avoid talking about death with children even when required, as they are unsure at what age children start understanding the concept of death. Although this question has been researched in the west, it has not been answered in the Indian context. Therefore, this study was conducted in India with 25 children (14 females, 11 males; 3-5 years), using play and joint story construction method, along with semistructured interviews. Results indicated that majority of the children understood that everyone has to die, including significant people like their own parents (i.e., universality) and also, many children understood that death is final (i.e., irreversibility). However, only few children understood that all cognitive/behavioral functions cease at death (i.e., nonfunctionality). In conclusion, only a small proportion of preschoolers seems to have had a mature concept of death.
Objectif: Plusieurs sociocultures camerounaises se trouvent dans un entre-deux culturel sur la question d’une vie après la mort. Mort immatérielle ou non, après la mort physique la séparation qui s’en suit est toujours douloureuse. L’objectif de cet article était dans un premier temps de renseigner sur l’ordre conçu et l’ordre vécu de la mort de l’enfant de suite d’un cancer en négroculture, pour en expliquer les comportements pré- et post-mortem dans un deuxième.
Matériel et méthodes: Au cours d’une enquête anthropologique de 20 mois, les données issues d’une recherche documentaire, d’entretiens semi-structurés avec les soignants et de 18 entretiens biographiques avec les familles d’enfants préalablement en rémission, puis admis en soins palliatifs ou ayant des pronostics désespérés, et d’observations directes d’expériences de mort imminente et du deuil ont été collectées. Ces données ont ensuite été analysées via le schème actantiel et interprétées sous le prisme conceptuel de l’euphémisation de Pierre Bourdieu.
Résultats: Bien que l’hôpital n’ait pas pour vocation explicite la prise en charge de la mort, les familles se rassurent que leurs enfants décèdent à l’hôpital pour se soulager de toute formes de culpabilité ou se disculper d’accusations. La mort impose une domination larvée autant sur les soignants que sur les soignés et leurs familles car selon l’ordre conçu de bien de sociocultures au Cameroun, la mort n’est pas qu’un épisode de vie, mais une forme d’esprit malfaisant qui s’attache à ceux qui l’évoquant, l’invoquent s’ils ne sont pas culturellement ou rituellement aptes à y faire face. D’où une forclusion collective qui, de façon manifeste a des allures de fuite en avant, alors qu’au fond la retenue langagière et proxémique n’est rien d’autre que la forme culturelle prégnante de l’expression de la prémonition de la mort.
Conclusion: Cet article interpelle sur la nécessité de faire muter les soins des enfants en rémission de leur maladie d’une culture palliative d’urgence s’apparentant aux soins de fin de vie, vers une culture de soins systématiques qu’ils soient curatifs ou palliatifs.
Nurse educators have a unique role to prepare nursing students for all aspects of patient and family care, from birth through death. Knowing that death is inevitable is not the challenge. Preparing nursing students to cope with death and address personal and community myths about death and dying are the challenges. Opportunities for students to examine personal and community associations with death are essential for nursing students preparing to enter the field. Biophysiological processes and treatment protocols are an essential part of each course; however, one course in a Department of Nursing in a small university in the Midwestern United States provides students the opportunity to reflect on death and dying and includes the experience of creating a tangible symbol to “hold on to” as they professionally and thoughtfully work with dying patients and their families, as well as cope with their own experiences of loss and grief in their careers.
Oncology nursing is a rewarding, challenging, and ever-changing specialty. Oncology affords the nurse an opportunity to care for individuals with unique, complex issues during his or her cancer journey. I assumed that, at some point, I would care for a patient who may not have a positive outcome. It became clear to me that I would be there during the dying process and, subsequently, face issues related to the death of a patient. I really thought I knew what I was getting into; however, I now understand that I was not sufficiently prepared.
This essay presents an account of the influence of the researcher's body within qualitative death research. It suggests that appropriate reflection on the researcher's subjectivity should consider his or her own bodily performances and experiences. At the beginning I offer some introductory thoughts in this regard, referring to Plessner's distinction between 'being a body' (Körper-haben) and 'having a body' (Leib-sein). Here, I highlight the importance of autoethnographic approaches for the understanding of bodily experiences, such as sensations, perceptions and their aesthetics. To demonstrate the importance of considering the researcher's body within the research process, I then draw on my own autoethnographic material, discussing how I experienced in my body frightening and disturbing feelings while dealing with the dead. This material was collected during a six-month internship from April to September 2016 at a small funeral home in Thuringia, Germany. I explain how I was socialised regarding my bodily behaviour towards the dead years ago and how I acquired the knowledge that touching a corpse is often taboo; describe my bodily reactions when I saw a dead body for the first time during my internship and how these reactions influenced my fieldwork; relate how my senses and perceptions when first touching a corpse led to extreme responses that drew most of my attention to the haptic and sensual dimension, making me unable to notice other information in the field; and show how these bodily experiences crossed borders and influenced my life beyond my field research.
While bereavement camps serve as a support for children, this study examines a therapeutic recreation-based camp for families who have lost a child. The study triangulated documents, researcher reflection, and staff interviews to highlight the themes of Searching & Finding, Getting to Know, Finding the Balance, and Joining. Developing opportunistically through internal and external factors, the camp's evolution represents a closing of the loop, from supporting families of living children to also supporting the families of children who have died. Understanding the camp's evolution may facilitate other programs by highlighting the challenges in developing the program and the lessons learned.
Though the adjustment of bereaved children is increasingly investigated through quantitative studies, their intimate representations regarding the loss of their parent remain unknown. This qualitative study aims at exploring how they give meaning to this experience. Nondirective interviews with bereaved children were conducted and submitted to an interpretative phenomenological analysis. Fourteen children (8 boys, 6 girls, mean age = 8.5 years) were recruited. Seven major themes depicting their grief experience were identified. The importance of the surviving parent is critically highlighted. Findings suggest that the remaining parent could become a fundamental actor in providing grief support for the bereaved children.
Bereavement carries consequences for the health and socioeconomic well-being of surviving family members. Using data from the National Longitudinal Study of Adolescent to Adult Health, the current study investigates whether formerly incarcerated individuals experience the death of a family member at higher rates than the general population. We find that relative to those without a history of incarceration, formerly incarcerated individuals are more likely to experience the death of an immediate family member by young adulthood. Subsequent analyses demonstrate that deaths occurring during or after a respondent was incarcerated were relevant for health and well-being.
Death awareness leads to aversion from bodily processes such as breastfeeding and sex, especially among low body esteem individuals. Using a modality bias task, we examined whether primes of death reduced attention to bodily sensations. We subliminally primed 72 undergraduates with either the word death or failed and assessed their attention to tactile and visual stimuli as a function of their body esteem. Results indicated that death primes significantly reduced attention to tactile stimuli relative to visual stimuli in low body esteem individuals. Dissociation from the body, therefore, may be an unconscious terror management strategy utilized by people with low body esteem.