Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

"What should be taught to future clinicians and health-care professionals regarding grief reactions  in the cancer field?" (#430)

Léonor Fasse 1 , Cécile Flahault 2 , Anne Brédart 1 , Sylvie Dolbeault , Serge Sultan 3
  1. Institut Curie, Paris, France
  2. Université Paris Descartes, Boulogne Billancourt, France
  3. Psychologie, Université de Montréal, Montréal, Québec, Canada

Aims: While Prolonged Grief Disorder (PGD) is proposed for inclusion in the DSM V, current literature suggests that health professionals often report some gap of knowledge regarding this condition and more widely concerning grief reactions emerging during the end-of-life and after death. This study aims at measuring this gap and at gathering accurate data to provide refined training to professionals facing bereavement after cancer.

Three complementary studies were conducted: (1): a systematic review of the literature concerning professional training in grief and coping with bereavement, in Medline and PsycInfo. (2) One hundred French psychology graduate students were asked to formulate a diagnosis and recommend a follow-up on the basis of a case study including a cancer history (a bereaved spouse after a loss to cancer, meeting symptoms of PGD). (3) Ten nurses were asked about their needs and expectations regarding training in end-of-life and bereavement issues.

Results: the first study yielded 10 results, which reveals the paucity of empirical investigation of these topics. Responses of the 110 participants of studies 2 & 3 (82 women, mean age=27.2) indicate: 1/Critical needs of communication routine skills with grieving families, especially with children; 2/ Difficulties in distinguishing what pertains to adaptive grief reactions, and what is a matter of mental-health professionals attention; 3/ Questions regarding what a “good death” is. Finally the review of literature underlines the necessity of early and regular training in the nursing and psychology curricula, based on integrative and specific techniques.

Conclusions: the findings suggested that future psychologists and nurses described themselves as resourceless when they need to screen for particularly distressed relatives during the end-of-life and after the death of the patient. Difficulties in identifying accurate criteria to offer relevant psychological support may hinder a coherent intervention. Key-elements of relevant training are discussed, as well as clinical implications.