Widows and Widowers and Social and Psychological Impact
Young Widows and Widowers,Stages or Phases of Grief,Series of Tasks,Research Outcomes
Young Widows and Widowers
widowed persons rather than focusing mainly upon older widows, However,
researchers have continued to concentrate upon the relatively short period of
bereavement rather than the longer term circumstances of living alone.
Common
concepts surrounding bereavement include: grief, stress, adaptation, coping,
and social support. The work reflects four perspectives on bereavement:
(a) as
loss
(b) as a process of phases and stages
(c) as a stressor
(d) as a
series of tasks
Loss. Bacon, Condon, and Fernsler (2000) considered support and
coping as key factors enabling adjustment to loss of a spouse. They explained
why young widowed mothers might find it difficult to participate in a
traditional support group.
In a descriptive study, they detailed the
perceptions of 21 widows (age 31-50 years) about taking part in an electronic
self help group. Responses to closed questions were reported using descriptive
statistics; Responses to an open question soliciting feelings about
participation were submitted to content analysis.
Most of the women had not
taken part in an internet self help group previously. They rated the experience
positively in reducing the sense of isolation and coping with loss.
Impact of Loneliness on Widow
An intervention of four support group sessions was tested to
determine its influence upon the affect and loneliness of widows over age 55
years (Stewart, Craig, MacPherson, & Alexander, 2001). With repeated
measures, within subjects design standardized tools: tapped outcomes related to
social support, affect, and loneliness. Perceptions of the intervention’s
impact were analyzed qualitatively. The intervention decreased the need for
other support, enhanced positive affect, and increased satisfaction with
support.
Stages or Phases of Grief
Process of phases and stages. Hegge and Fischer (2000)
differentiated grief responses of 22 senior widows (age 60-74 years) and 17
older widows (age 75-90 years). Concept analysis was used to detail frequent
and troublesome problems, coping strategies, support systems, and goal
adjustments.
There were no major differences by age groups. Grieving had four
overlapping phases (numb shock, emotional turmoil, disorganization, and
acceptance), which were briefer and less intense for older widows. Loneliness
was the most common problem for both groups.
Duration and Stages of Grief
Steeves (2002) did a hermeneutic analysis of field notes and
interviews with 29 older bereaved spouses in the rural South to capture data
about the duration of grieving. The interviews began before a spouse’s death and
continued for up to 30 months. The rhythm of grief had three fluid stages:
numbness, grief attacks or waves, and loneliness.
Stressor. Referring to a spouse’s death as a very stressful life
event, Constantino, Sekula , and Rubinstein (2001) studied the effectiveness of
the Bereavement Group Postvention (BGP) and the Social Group Postvention (SGP)
on bereavement outcomes for 60 widowed survivors of the spouse’s suicide.
Participants were randomized into the BGP or the SGP, taking part in a weekly
90-minute session for 8 weeks. There were no significant differences between
groups on depression, psychological distress, grief, or social adjust ment at
any time point (pretest, immediate, 6-month, and 12-month postvention).
For
both groups, there was a significant reduction in depression, distress, and
grief over time, and a significant increase in social adjustment. There was no
evidence of a confounding effect due to duration of widowhood, but Constantino
and colleagues did not rule it out.
Because there was no evidence of a
differential effect for the two interventions, they suggested that
participation in any social group might be beneficial. In a descriptive,
mixed-methods study, sources and nature of social support perceived by 218
Finnish widows and widowers, aged 30 to 87 years, were discerned ( Kaunonen
, Tarkka , Paunonen , &Laippala , 1999).
A standardized tool was used to
appraise dimensions of grief, and qualitative data about coping sources were
submitted to content analysis. The most common support sources were friends and
family, and their time was the most precious resource offered.
Daggett (2002) referred to spousal bereavement as a stressor
requiring coping. Daggett used a phenomenological method to describe the grief
experience of 8 middle-aged men who had been widowed from 6 months to 6 years.
Under a major theme of irreconciledable loss, the two categories responding to
the loss and living through the loss were simultaneous occurrences, moving over
time to reclamation and reconstruction of a life.
Daggett described the
categories in terms of time based parameters, much like stages, although she
had stated that stage based theories of bereavement did not capture individual
differences in grief experiences.
Series of Tasks
Series of interwoven tasks. Zonnebelt Smeenge and DeVries (2003)
explained that stage based theories had given way to task theories of
bereavement (Rando, 1993; Worden , 1991) involving spiraling or interwoven
behaviors over time (Bowlby, 1981).
Zonnebelt Smeenge and DeVries highlighted
the dual process model (Stroebe, M., &Schut , 1999) of simultaneous
grief work relative to loss and to restoration. (Thus, the living through loss
while responding 668/832 was not original to Daggett [2000].)
Viewing the model
as consistent with task-related theory, they cited five bereavement tasks
(Rando; Worden) and created a tool to determine the frequency and
effectiveness of widowed persons’ task-related interventions. They reported
preliminary findings with 115 widowed persons (age 24 to 90 years, MD = 54).
Women found it more important to engage in activities leading to acceptance of
the reality of death, whereas more men than women undertook activities to
expediter age 45 years felt more positive about the future; More people older
than 65 years had taken part in support groups.
Variables of resolution were
positively correlated with duration of widowhood. Relatively few participants
engaged in work to summarize and store memories of the spouse, so practitioners
were encouraged to suggest activities enabling bereaved persons to directly
address this task.
Research Outcomes
Two interpretive phenomenological studies were done with older
rural widows. With five women, Swensen (1998) explored attachment to place,
finding that home was the center of self, caring, and reach. DC Roberts and
Cleveland (2001) studied the experience of living alone for nine widows who
lived on islands near Maine.
The three essential themes were characterized as
nautical metaphors, such as securely anchored in a safe harbor. Although the women
were actively engaged, resilient, and resourceful, access to health care was a
problem.
Porter has used descriptive phenomenology to explore the essence of
“older widows” health-related experiences. EJ Porter (1998a) found that 16
older urban and rural widows sought to keep the generations separate by
continuing to live alone and by trying not to burden the children.
The
intention of 9 older rural widows to stay close to shore for health care
resulted in a new interpretation of access to care as familiarity with the care
locale (Porter, EJ, 1998b). In a longitudinal study, EJ Porter (2001) described
the transition of an older widow from her home to assisted living, secondary to
changes in payment policies affecting the rural home care agency.
Several studies were not focused on widowhood per se; instead, the
researchers were interested in health as a variable affecting widowed persons.
In the group studied by Wallace, Molavi , Hemphill, and Fields (1999), which
consisted of 931 African Americans over the age of 65 years, neither the
ability to perform activities of daily living nor the use of health care
services was influenced by widowhood .
Among other issues, Crane and Warnes
(2001) examined the role of widowhood as an influence upon homelessness in 18
persons over the age of 55 years. The authors concluded that although widow
hood had a greater impact on men than on women, it can result in dramatic
changes in lifestyle and living arrangements.
Finally, TR Fitzpatrick and Bosse
(2000) studied the effects of employment on the health of $10 widowers (aged 39
to 86 years) up to 3 years after the spouse’s death. Employment had a positive
effect on the physical health of the widowers, but there was no evidence of an
effect upon their mental health.
Nurse researchers have tended to focus on older widowed persons
(WP), primarily women (Porter, EJ, 2000). Recently, there has been a new and
noteworthy interest in younger widows and WP of both genders.
However, without
regard to age or gender, there has been an overemphasis on the relatively short
period of bereavement and a neglect of the long-term issue of life as a WP.
In
bereavement studies, most researchers have reviewed generic theories of coping
or loss and undertaken qualitative studies with vague methods (such as concept
analysis) and small samples. The work of Zonnebelt Smeenge and deVries (2003)
is a notable exception.
Duration of widowhood is a critical variable in research on
bereavement as well as studies of life alone, although few researchers noted
this other than Constantino and colleagues (2001), Fitzpatrick and Bosse
(2000), and Zonnebelt Smeenge and deVries ( 2003 ) .
Most nurse researchers
other than Steeves (2002) and EJ Porter (2001) have used cross sectional
designs; Longitudinal designs yield more information about living alone. Nurse
researchers must explore the health related needs of vulnerable subgroups, such
as widowers at risk for suicide and widows at risk for breast cancer.
Finally,
scholars must attend to revealing the variations in the experience of widowhood
among groups of WP who share key demographic characteristics.