Restorative retelling (RR) is an evidence-based procedure for facilitating adaptation following traumatic bereavement. In this paper, we introduce performative retelling (PR), a variation on RR, which fosters healing from personal losses and portrays personal reactions to collective tragedy. We describe our collaboration with an ex-offender reentry program, the Memphis Police Department, and Playback Theatre to use improvisational community theatre to bridge the gap between law enforcement and the citizens they serve. We review program outcomes to-date and illustrate its impact using participant stories. We argue that training police and citizens in PR can potentially transform broken narratives of police-community relations.
This article chronicles the process of reducing the 10 week restorative retelling (RR) group model (Rynearson & Correa, Accommodation to violent dying: A guide to restorative retelling and support, Violent Death Bereavement Society, 2006) into a 3 day retreat for families of homicide loss. Strategies used to address the intensity of the condensed version of the treatment model are described for both the participants and treatment team. The twists and turns of how the therapeutic retreat unfolded are presented through case examples. The authors explicate the risks and rewards of conducting the RR model at speed, identify the challenges they faced, and give impressions for overall treatment efficacy.
Reenactment imagery that remains fixating after violent dying is associated with diminished psychological resilience. The nonresilient teller struggles to maintain an integrative orientation within the recounting. Reestablishing the resilient capacities of pacification (mastery of terror through self-calming), partition (mastery of intrusive thoughts through self-differentiation), and perspective (mastery of self-determination through self-transcendence) is an important preparatory goal with intervention. Without these resilient capacities, premature exposure increases the risk that patients will experience a dysfunctional merger with the possessive reenactment representation. A preliminary model of resilient “offenses” to be reinforced in the traumatized subject as a first stage of intervention is presented.
Un Prince vient se réfugier au fin fond de la forêt. Il est désespéré de tristesse, de honte et de culpabilité de ne pas avoir été là quand tous ses amis et sa famille se sont faits tuer par leurs ennemis. Il ne peut plus parler, le coeur débordant de chagrin. Le chant d'un grand oiseau va le consoler et lui redonner le goût de la vie.
Cancer is a major cause of mortality and morbidity in Korea. However, there has been no previous nursing literature review on the phenomenon of resilience among cancer patients in Korea. The purpose of this study was to identify information about theories, instruments, correlates, and outcomes of resilience in the cancer experiences of Korean adults. This was a scoping review that searched Ovid MEDLINE, CINAHL, Google Scholar, DBpia, and the Korean Studies Information Service System between 2000 and 2016 in order to identify English and Korean research reports. The review yielded 17 quantitative studies, including 2 resilience theories and 6 resilience-specific instruments. The factors self-efficacy, hope, social supports, self-esteem, anxiety, and depression were associated with resilience, regardless of the type of cancer. Quality of life and coping were commonly investigated outcome variables for resilience. This review suggests that a nursing theory reflecting Korean culture and qualitative research concerning the phenomenon of resilience should be conducted as research priorities as the foundation for developing culturally appropriate tools for resilience. This will lead to enhanced quality of life among Korean cancer patients, which is the core of palliative nursing care.
Widowhood researchers have been increasingly interested in the construct of resilience and identifying factors which contribute to adaptive responses to conjugal loss. Available measures of general resilience were validated on nonwidowed samples and broadly lack face validity for use with widowed people. This article reports the development and validation of a resilience scale specific to widowhood, the Widowhood Resilience Scale. Initially, qualitative responses from 744 widowed people were analyzed and cross-referenced with existing literature on resilience to develop 49 items. The 49 items were tested on a sample of 1,188 widowed people, resulting in a 6-factor, 25-item scale.
CONTENT: Burnout is common amongst palliative care clinicians. Resilience helps to reduce burnout, compassion fatigue and is associated with longevity in palliative care.
OBJECTIVES: We aimed to study palliative care clinicians who have remained in the field for longer than 10 years to deepen our understanding on their views on burnout and resilience.
PATIENTS AND METHODS: We conducted a qualitative study using semi-structured interviews and purposive sampling on 18 palliative care clinicians - 5 doctors, 10 nurses and 3 social workers who worked in various palliative care settings (hospital palliative care team, home hospice and inpatient hospice). The mean age of the interviewees was 52 years old and the mean number of years practicing palliative care was 15.7 years (ranging from 10 -25 years). The interviews were recorded verbatim, transcribed and analysed using a grounded theory approach.
RESULTS: 4 major themes emerged from our analysis - Struggling, Changing Mindset, Adapting and Resilience (SCAR). Intervening conditions such as self-awareness, reflection, and evolution were also important factors. The core phenomenon of our study was that of 'Transformational Growth' - a process which palliative care clinicians have to go through before they achieve resilience. We also further classified resilience into both personal and collective resilience.
CONCLUSION: Our findings highlight the evolving process of transformational growth which palliative care clinicians must repeatedly undergo as they strive towards sustained resilience and longevity. It also stresses the importance of taking individual and collective responsibility towards building a culture of personal and team resilience.
Objectives: In 2015 we identified three profiles of adaptation following spousal bereavement: Vulnerables; Copers and Resilients (Spahni, Morselli, Perrig-Chiello, & Bennett, 2015 ). However, adaptation to spousal bereavement is a dynamic process. Thus, we examine the trajectories of the same participants longitudinally over two years. We identify the stability and change in profiles of adaptation to widowhood; probability of stability and change; factors that influence trajectories in profile membership.
Methods: Data stem from a longitudinal questionnaire study of 309 older widowed people. The questionnaire included five measures of well-being, serving as the dependent variables of this analysis, and measures of personal resources and contextual factors, including social support, marital happiness, psychological resilience, and demography. Data was analysed using latent transition analysis of the variables loneliness, hopelessness, depressive symptoms, life satisfaction, and subjective health.
Results: The analysis replicated the three Wave 1 profiles as the best theoretical fit: Vulnerables; Copers; and Resilients. Stability was most common, but some participants moved to more or less adaptive profiles, the former being more frequent. Younger age, longer time since widowhood, new life perspectives facilitated adaptation. Those transitioning to less adaptive profiles were more likely to be women and older. Discussion: The path to adaptation was not linear. Many of the explanatory variables contributed both to positive and negative adaptation. These include previous caring experience, education, psychological resilience and personal strength. This suggests these explanatory variables do not act in isolation but are likely to interact with each other, and with other, yet not measured, factors.
BACKGROUND: Resilience is important to sustain hospice nurses through a challenging career. Clinical supervision is a commonly cited support strategy, but there is limited evidence which focuses on its influence on the development of resilience in hospice nurses.
AIMS: To explore how group clinical supervision might affect the development of resilience in hospice nurses.
METHOD: A pragmatic approach and mixed methods research design was employed. Quantitative questionnaire data and qualitative focus group data were collected from community hospice nurses participating in group clinical supervision.
FINDINGS: The findings identified the importance of an effective group reflective process on the benefits to be gained from clinical supervision. Clinical supervision was found to affect the development of resilience by developing confidence at work, regulating emotions, offering a coping strategy, managing expectations, and developing self-awareness. This was dependent upon individual preference and experience, the local organisational context, and wider social and political factors.
CONCLUSION: This research contributes insight into group clinical supervision as an intervention to support resilience in hospice nurses. It offers recommendations for practice, to enhance the development of resilience through clinical supervision, and recommendations for future research.
PURPOSE: This study attempted to examine the influence of resilience, life satisfaction, and psychological well-being on attitude to death.
METHODS: A predictive correlational design was used. The participants were 184 nursing students from three universities of Korea. They responded to a self-report questionnaire, with items on demographics, resilience, life satisfaction, psychological well-being, and attitude to death.
RESULTS: The mean score for attitude to death was 2.77±0.39 (range, 1-4), and a significant difference was observed depending on age, grade, and death-related education. Attitude to death was positively correlated with death-related education, resilience, life satisfaction, and psychological well-being. Results of the hierarchical multiple regression analysis indicated that death-related education and psychological well-being were significant predictors of attitude to death, explaining 26.6% of the latter. The most important factor was psychological well-being.
CONCLUSION: Although death-related education and psychological well-being are two of the most influential factors among nursing students, no more than 30.4% of this study's participants received death-related education. Death-related education is necessary to help nursing students so that they can cope positively with stressful situations by finding positive meaning. It is necessary to develop a systematic curriculum so that these students can establish a positive attitude to death.
INTRODUCTION: End-of-life (EoL) care professionals are prone to burnout given the intense emotional nature of their work. Previous research supports the efficacy of art therapy in reducing work-related stress and enhancing emotional health among professional EoL caregivers. Integrating mindfulness meditation with art therapy and reflective awareness complementing emotional expression has immense potential for self-care and collegial support. Mindful-compassion art therapy (MCAT) is a novel, empirically informed, and highly structured intervention that aims to reduce work-related stress, cultivate resilience, and promote wellness. This study aims to assess the potential effectiveness of MCAT for supporting EoL care professionals in Singapore.
METHODS: This is an open-label waitlist randomized controlled trial. Sixty EoL care professionals, including doctors, nurses, social workers, and personal care workers, are randomly allocated to one of two groups: (i) an intervention group that receives MCAT immediately and (ii) a waitlist-control group that receives MCAT after the intervention group completes treatment. Face-to-face self-administered outcome assessments are collected at three different time points-baseline (T1) for both groups, post-intervention (T2), and 6-week follow-up (T3) for intervention group-as well as pre-intervention (T2) and post-intervention (T3) for the waitlist-control group. The primary outcome measure is burnout, and secondary measures include emotional regulation, resilience, compassion, quality of life, and death attitudes. Between- and within-participant comparisons of outcomes are conducted, and the appropriate effect size estimates are reported. An acceptability and feasibility study is to be conducted by using a triangulation of qualitative data with framework analysis.
DISCUSSION: The outcomes of this study will contribute to advancements in both theories and practices for supporting professional EoL caregivers around the world. It will also inform policy makers about the feasibility, acceptability, and effectiveness of delivering a multimodal psycho-socio-spiritual intervention within a community institutional setting. The study has received ethical approval from the institutional review board of Nanyang Technological University.
Cet ouvrage présente dix-neuf récits amusants, cruels ou tendres autour de la thématique de la fin de vie. La relation à la mort des divers personnages, enfant, personnes âgées, citadin, campagnard ou aventurier révèle leur manière d'envisager la vie, sereinement ou avec désespoir.
Un témoignage de résilience et de courage d'un homme atteint de la maladie de Charcot, syndrome neurodégénératif également appelé sclérose latérale amyotrophique (SLA). Lorsque lui est annoncé qu'il n'a plus que trois ans à vivre, l'auteur, déployant des ressources inespérées, décide de se battre et de continuer à vivre pour ses proches et pour lui-même malgré sa tétraplégie.
Grief research has typically centered on one time point, without considering the impact of multiple losses over time. In this study, 546 bereaved emerging adults were divided into three groups: those who experienced a recent loss (0-2 years ago), a past loss (>2 years ago), or a combination of both recent and past losses. Differences between the groups on resilience, depression, and grief symptomatology were examined. Those who had experienced both losses (recent and past) and recent losses endorsed significantly more grief symptoms than those in the past loss group. Findings highlight how multiple losses impact grief.
OBJECTIVES: This study examined trajectories of emotional functioning in three domains (depressive symptoms, emotional and social loneliness) for individuals who experienced spousal bereavement, and investigated cross-domain adaptation. We hypothesized that emotional difficulties after bereavement would be more detectable in emotional loneliness than depressive symptoms or social loneliness.
METHOD: Using latent class growth analysis, we modelled changes in depressive symptoms, emotional loneliness and social loneliness from 12 years pre- to 12 years post-bereavement on data from 686 older adults to identify trajectories indicating adaptive and maladaptive functioning in each domain.
RESULTS: Most participants reported depressive symptoms below the clinically relevant threshold by showing a resilient (15.5%) or a slightly elevated (53.5%) trajectory post-bereavement. One-third (31%) reported clinically relevant depressive symptoms. More than half of the sample reported emotional loneliness post-bereavement, varying form prolonged (17%), increasing and prolonged (28.3%), and chronically high (8.9%) levels. Remaining participants displayed resilience (13.5%) or recovery (32.3%). Social loneliness showed four trajectories: very low and resilient (43.3%), low and resilient (27.5%), increasing (20.2%), and chronically high (9%) levels. One third of participants maintained adaptive, whereas 12% displayed maladaptive, functioning across all domains post-bereavement.
DISCUSSION: An increase in emotional loneliness was the most commonly observed change after spousal bereavement. This highlights the central role of emotional loneliness in depression after bereavement.
BACKGROUND: Nurses in inpatient palliative care are frequently exposed to death and dying in addition to common stressors found in other nursing practice. Resilience may mitigate against stress but remains ill-defined and under-researched in the specialist palliative care setting.
OBJECTIVE: The aim of this systematic review was to understand resilience from the perspectives of inpatient palliative care nurses.
DESIGN: A thematic synthesis of qualitative studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
DATA SOURCES: Academic Search Ultimate, Cumulative Index to Nursing and Allied Health Literature, Medline Complete, PsycINFO and Scopus.
REVIEW METHODS: The review stages were searching for relevant literature, selecting relevant papers, data extraction, critical appraisal and thematic synthesis.
RESULTS: Eight studies revealed 10 subthemes, 3 descriptive themes and 1 analytical theme: resilience occurs when nurses incorporate stressful aspects of their personal or professional lives into a coherent narrative that enhances their ability to cope with the demands of their role.
CONCLUSION: Palliative care nursing is more stressful if patients or situations remind nurses of personal experiences. Nurses cope better with adequate support; however, coping does not necessarily imply increased resilience. Resilience occurs when nurses cognitively process their experiences, articulate their thoughts and feelings into a coherent narrative, and construct a sense of meaning or purpose. Future research could explore how nurses understand resilience and how it could be enhanced in the palliative care inpatient setting. With resilience, nurses may remain in the profession longer and improve the quality of care when they do.
INTRODUCTION: Grief among bereaved parents is known to cause psychological distress and physical illness, but knowledge concerning factors that can contribute to health promotion after bereavement is scarce. Childhood cancer remains the most common non-accidental cause of death among children in Norway. The aim of the present study was to explore if resilience factors among cancer-bereaved parents could predict whether they will be able to come to terms with their grief 2-8 years following the loss.
METHODS: A Norwegian cross-sectional national survey was conducted among 161 cancer-bereaved parents using a study-specific questionnaire. Logistic regression was used to explore whether resilience factors predicted parents' grief outcome 2-8 years after their loss.
RESULTS: On the Resilience Scale for Adults (RSA), three of the resilience factors contributed significantly in predicting whether the parents in the present study would come to terms with their grief 2-8 years after the loss their child: "Perception of self "(OR 2.08, p = .048), "Social resources" (OR 2.83, p = .008) and "Family cohesion" (OR .41, p = .025). The results showed a negative relationship between time since loss (2-6 years) and whether the parents answered that they had come to terms with their grief (p = < .05). The loss of a parent (OR .30, p = .030) combined with the loss of their child had a negative and significant effect on whether they indicated that they had processed their grief.
CONCLUSION: The total score of RSA and three of the six resilient factors contributed significantly in predicting whether cancer-bereaved parents in the present study indicated that they had come to terms with their grief to a great extent. The present study supports hypotheses that regard resilience as an important contribution in predicting healthy outcomes in people exposed to adverse life events.
Caumes, 17 ans, jeune homme fragile et écorché vif, vit entouré de ses amis, de sa famille et d'Esther, dont il est amoureux. Mais sa vie va être bouleversée en 2015 par les attentats de Charlie Hebdo et du Bataclan, et surtout par la mort d'Hakim, son ami qui meurt sous les coups de jeunes fachos.
Vient le moment du deuil, de la dépression et de la volonté d'en finir.
Pour s'en sortir, il écrit l'histoire qu'il vient de vivre et affronte les conséquences de ce choix.
End-of-life caregiving is a highly stressful experience often fraught with conflict and tension. However, little is known about the ways family conflict manifests for informal caregivers of home hospice patients (IHCs). Framed by relational dialectics theory, the purpose of this study was to provide nurses and other health care professionals with an empirical understanding of how IHCs experience family conflict and tensions associated with caregiving. A second aim was to determine what strategies IHCs use to manage these family conflicts. Data used in this qualitative secondary analysis were originally collected as part of a randomized clinical trial of an IHC support intervention. Based on thematic analysis of data from 25 IHCs who reported family conflict, a conceptual model of caregiver resilience was developed from the themes and categories that emerged during the coding stage. Autonomy was identified as a central tension. IHCs used several strategies to address family conflict including communication, formal support, and emotional self-care.
This study aimed to develop a conceptual framework of the experience of persons who have lost a family member to suicide in Japan. The authors conducted in-depth interviews with 24 such family members. They conceptualized their experience as a process of regaining my new life. Initially, their lives were out of their hands, but gradually they learned striving skills and recuperative conditioning, and integrated the skills to regain their lives. Some participants eventually reached a state of living a redefined life. How individuals underwent this process varied. The authors identified two types of people dealing with this issue: dialoguers and mood changers.