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Complicated grief knowledge and practice: a qualitative study of general practitioners in Ireland

Published online by Cambridge University Press:  22 January 2021

Abiola Muhammed ,
Anne Dodd ,
Suzanne Guerin Open the ORCID record for Suzanne Guerin [Opens in a new window] ,
Susan Delaney  and
Philip Dodd
Abiola Muhammed
Affiliation:
UCD School of Psychology, University College Dublin, Dublin, Ireland
Anne Dodd
Affiliation:
UCD School of Psychology, University College Dublin, Dublin, Ireland
Suzanne Guerin*
Affiliation:
UCD School of Psychology, University College Dublin, Dublin, Ireland
Susan Delaney
Affiliation:
Irish Hospice Foundation, Dublin, Ireland
Philip Dodd
Affiliation:
UCD School of Psychology, University College Dublin, Dublin, Ireland
*
*Address for correspondence: Suzanne Guerin, UCD School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. (Email: suzanne.guerin@ucd.ie)
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Abstract

Objective:

Complicated grief is a debilitating condition that individuals may experience after losing a loved one. General practitioners (GPs) are well positioned to provide patients with support for grief-related issues. Traditionally, Irish GPs play an important role in providing patients with emotional support regarding bereavement. However, GPs have commonly reported not being aptly trained to respond to bereavement-related issues. This study explores GPs’ current knowledge of and practice regarding complicated grief.

Methods:

A qualitative study adopting a phenomenological approach to explore the experiences of GPs on this issue. Semi-structured interviews were carried out with a purposive sample of nine GPs (five men and four women) in Ireland. Potential participants were contacted via email and phone. Interviews were audio-recorded, transcribed and analysed using Braun & Clarke’s (2006) model of thematic analysis.

Results:

GPs had limited awareness of the concept of complicated grief and were unfamiliar with relevant research. They also reported that their training was either non-existent or outdated. GPs formed their own knowledge of grief-related issues based on their intuition and experiences. For these reasons, there was not one agreed method of how to respond to grief-related issues reported by patients, though participants recognised the need for intervention, onward referral and review.

Conclusions:

The research highlighted that GPs felt they required training in complicated grief so that they would be better able to identify and respond to complicated grief.

Keywords

Complicated griefgeneral practitionersknowledge and practicequalitative
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 40 , Issue 3 , September 2023 , pp. 330 - 335
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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Footnotes

†

Muhammed and Dodd should be recognized as joint first authors.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publications: Washington DC.Google Scholar
Bergman, EJ, Haley, WE (2009). Depressive symptoms, social network, and bereavement service utilization and preferences among spouses of former hospice patients. Journal of Palliative Medicine 12, 170–176.CrossRefGoogle ScholarPubMed
Boelen, PA (2016). Improving the understanding and treatment of complex grief: an important issue for psychotraumatology. European Journal of Psychotraumatology 7, 32609.CrossRefGoogle ScholarPubMed
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.CrossRefGoogle Scholar
Charlton, R, Dolman, E (1995). Bereavement: a protocol for primary care. British Journal of General Practice 45, 427–430.Google ScholarPubMed
Clark, S, Marley, J, Hiller, JE, et al. (2006). A grief diagnostic instrument for general practice. Omega – Journal of Death Dying 52, 169–195.CrossRefGoogle Scholar
Dodd, A, Guerin, S, Delaney, S, Dodd, P (2017). Complicated grief: knowledge, attitudes, skills and training of mental health professionals: a systematic review. Patient Education & Counseling 100, 1447–1458.CrossRefGoogle ScholarPubMed
Dooley, BA, Fitzgerald, A (2012). My World Survey: National Study of Youth Mental Health in Ireland. Headstrong and UCD School of Psychology: Dublin.Google ScholarPubMed
Ghesquiere, A, Shear, MK, Duan, N (2013). Outcomes of bereavement care among widowed older adults with complicated grief and depression. Journal of Primary Care and Community Health 4, 256–264.CrossRefGoogle ScholarPubMed
Ghesquiere, AR, Patel, SR, Kaplan, DB, Bruce, ML (2014). Primary care providers’ bereavement care practices: recommendations for research directions. International Journal of Geriatric Psychiatry 29: 1221–1229.CrossRefGoogle Scholar
Irish College of General Practitioners (2019). ICGP Curriculum for GP Training in Ireland. Irish College of General Practitioners: Dublin.Google Scholar
Kelly, M, Teljeur, C, O’Kelly, F, Ni Shuilleabhain, A, O’Dowd, T (2019). Structure of General Practice in Ireland. Irish College of General Practitioners: Dublin.Google Scholar
Lichtenthal, WG, Nilsson, M, Kissane, DW, et al. (2011). Underutilization of mental health services among bereaved caregivers with prolonged grief disorder. Psychiatric Services 62, 1225–1229.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M, Lloyd-Williams, F (1996). Palliative care teaching and today’s general practitioners – is it adequate? European Journal of Cancer Care 5, 242–245.CrossRefGoogle ScholarPubMed
Low, J, Cloherty, M, Wilkinson, S, et al. (2006). A UK-wide postal survey to evaluate palliative care education amongst general practice registrars. Palliative Medicine 20, 463–469.CrossRefGoogle ScholarPubMed
Lundorff, M, Holmgren, H, Zachariae, R, et al. (2017). Prevalence of prolonged grief disorder in adult bereavement: a systematic review and meta-analysis. Journal of Affective Disorders 212, 138–149.CrossRefGoogle Scholar
Main, J (2000). Improving management of bereavement in general practice based on a survey of recently bereaved subjects in a single general practice. British Journal of General Practice 50, 863–866.Google Scholar
McGrath, P, Holewa, H, McNaught, M (2010). Surviving spousal bereavement: insights for GPs. Australian Family Physician 39, 780–783.Google ScholarPubMed
Nagraj, S, Barclay, S (2011). Bereavement care in primary care: a systematic literature review and narrative synthesis. British Journal of General Practice 61, e42–e48.CrossRefGoogle Scholar
National Office for Suicide Prevention (2016). You Are Not Alone: Directory of Bereavement Support Services. Health Services Executive: Dublin.Google Scholar
Nic an Fhailí, M, Flynn, N, Dowling, S. (2016). Experiences of suicide bereavement: a qualitative study exploring the role of the GP. British Journal of General Practice 66: e92–e98.CrossRefGoogle ScholarPubMed
Nurullah, AS (2012). Received and provided social support: a review of current evidence and future directions. American Journal of Health Studies 27, 173–188.Google Scholar
O’Brien, BC, Harris, IB, Beckman, TJ, et al. (2014). Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine 89, 1245–1251.CrossRefGoogle ScholarPubMed
O’Connor, M, Breen, LJ (2014). General practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education 14, 59.CrossRefGoogle ScholarPubMed
Ollerenshaw, A (2009). Internet toolbox for rural GPs to access mental health services information. Rural and Remote Health 9, 1094.Google Scholar
Parkes, CM (1998). Coping with loss: bereavement in adult life. British Medical Journal 316, 856–859.CrossRefGoogle Scholar
Rosner, R, Bartl, H, Pfoh, G, et al. (2015). Efficacy of an integrative CBT for prolonged grief disorder: a long-term follow-up. Journal of Affective Disorders 183, 106–112.CrossRefGoogle ScholarPubMed
Rosner, R, Pfoh, G, Kotoucˇová, M (2011). Treatment of complicated grief. European Journal of Psychotraumatology 2, 7995.CrossRefGoogle ScholarPubMed
Schut, H, Stroebe, MS (2005). Interventions to enhance adaptation to bereavement. Journal of Palliative Medicine 8, 140–147.CrossRefGoogle ScholarPubMed
Shear, K, Frank, E, Houck, PR, Reynolds, CF (2005). Treatment of complicated grief: a randomized controlled trial. Journal of the American Medical Association 293, 2601–2608.CrossRefGoogle ScholarPubMed
Shear, KM, Jackson, CT, Essock, SM, et al. (2006). Screening for complicated grief among Project Liberty service recipients 18 months after September 11, 2001. Psychiatric Services 57, 1291–1297.CrossRefGoogle ScholarPubMed
Simon, NM (2013). Treating complicated grief. Journal of the American Medical Association 310, 416–423.CrossRefGoogle Scholar
Stroebe, M, Schut, H, Stroebe, W (2007). Health outcomes of bereavement. The Lancet 370, 1960–1973.CrossRefGoogle ScholarPubMed
Vachon, ML, Stylianos, SK (1988). The role of social support in bereavement. Journal of Social Issues 44, 175–190.CrossRefGoogle Scholar
Wagner, B, Knaevelsrud, C, Maercker, A (2006). Internet-based cognitive-behavioral therapy for complicated grief: a randomized controlled trial. Death Studies 30: 429–453.CrossRefGoogle ScholarPubMed
Wiles, R, Jarrett, N, Payne, S, Field, D (2002). Referrals for bereavement counselling in primary care: a qualitative study. Patient Education & Counseling 48, 79–85.CrossRefGoogle ScholarPubMed