Grief In Individuals With Family Members Dying From Covid-19 Agus Waluyo Bunda Delima Nursing Academy Bandar Lampung.
Indonesia corresponding author: waluyoagus243@gmail.
ABSTRACT
The Covid-19 pandemic has resulted in 6 million deaths of the world's population.
Deep sorrow for the families of covid 19 patients left behind.
The rapid spread of the covid 19 virus has worried countries in the world so that they impose restrictions on interactions between residents, this has an impact on limiting interactions for close families of covid 19 patients until death occurs in covid 19 patients without the presence of close family.
The purpose of this study is to look at the conditions of grief in individuals with family members dying from covid 19.
The methods this scientific paper was conducted in a qualitative systematic review to explain the condition of family grief over the death of a family member due to Covid-19.
Article searches were conducted through Google Scholar.
Elsevier.
Wiley.
Sage.
ProQuest and Taylor and Francis.
The publication time range between 2019-2022 obtained 239 articles and then reduced/selected 7 articles that fit the inclusion criteria.
The results of the study show that in the era of the co-19 pandemic throughout 2020-2021 it resulted in many casualties or deaths of the world population, this is of course directly proportional to the increasing number of grief in the families left behind.
The grief that occurs in the family of a covid 19 patient who dies becomes a complicated process that must be faced by the family, namely: .
the closest family cannot accompany the patient in the last moments of the patient's life or the absence of a final .
family members who die cannot be buried in a normal way, but with special protocols that must be carried out.
the family's unpreparedness for a "sudden" separation is also a factor in this grieving process being a difficult condition to accept.
The conclusion three things were obtained about the conditions of grief that occurred in families with family members who died due to covid 19 and it became a condition of grief that was very rare and became a difficult process compared to the grieving process in general.
Keywords: Grieving.
Covid-19 Pandemic.
Family 1st International Health Conference STIKes Panca Bhakti (IHCPB) BACKGROUND In March 2020 the World Health Organization (WHO) declared COVID-19 a pandemic after there were 200 thousand patients with 8000 deaths in more than 160 countries.
Sohrabi et al.
stated that the COVID-19 pandemic caused various impacts on human life.
According to the Indonesian Ministry of Health's Health Research and Development Agency, cases of death due to Covid-19 which continue to show an increase every day are due to the number of referral hospitals starting to be unable to stem the increasing number of positive Covid-19 patients and health workers who are starting to show crisis conditions so that positive Covid-19 patients cannot be handled responsively and strategically.
(Indonesian Ministry of Health, 2.
Death cases due to Covid-19 in Indonesia have reached 1 million cases since mid-February 2021 (COVID-19 Handling Task Force, 2.
Quoted from (Worldodometers, 2.
where information has been obtained that cases of death due to Covid-19 reached a percentage of 3.
as of December 2020.
The survey results above show that the percentage of death cases due to Covid-19 in Indonesia exceeds the percentage of death cases due to Covid-19 in the world.
The results of a survey conducted by the Indonesian Covid-19 Handling Task Force team in the top 15 provinces infected with the covid-19 virus, there are two largest age groups related to death cases due to Covid 19, namely 21% in the age range of 60 years and over and 36% in the age range of 41 to 60 years, with the biggest comorbid factors, namely with congenital diseases such as hypertension, diabetes, heart and lung diseases such as asthma and bronchitis.
The Covid-19 pandemic with its various social impacts has traumatized millions of people, adults and children.
Shock and disbelief are common, but unwavering denial will be detrimental due to unpreparedness for the reality of having to deal with Covid-19.
Vagueness about diagnosis, symptoms, and severity prevents patients from getting emergency care, and many patients end up dying.
In the end, the patient's family members blame themselves for not understanding the risks or acting quickly to prevent the death of their family member and feel afraid of what will happen next.
1st International Health Conference STIKes Panca Bhakti (IHCPB) The human tragedy of illness and death in the spread of Covid-19 makes the suffering of families with deceased family members invisible, stigmatizes the possibility of contagion around Covidrelated deaths fosters misinformation, and alienates infected patients and families, so the health care, mental health support and social support that would normally be available to patients and families is lost.
When a person faces the imminent death of a family member or a close relative that he loves, usually he will accompany him at the last moment, as a sign of farewell for the last time or perform funeral rituals but during the Covid-19 Pandemic this is difficult or cannot be done.
The Covid-19 pandemic not only causes physical illness for sufferers but also has a drastic socioemotional impact on people of various ages.
Balk and Vesta in (Hasan et al.
, 2.
state that, the early adult group .
-25 year.
experiences problematic responses to loss more often than is This age group is associated with academic/knowledge levels, and can impact on developmental, occupational, and social tasks associated with early adulthood.
Brent in (Hasan et al.
, 2.
states, in fact, grieving early adults more often experience intense and prolonged grief, decreased health, increased doctor visits for physical and emotional problems, and increased use of drugs, alcohol, after experiencing loss.
According to Freud in (Prigerson et al.
, 2.
, grieving is a natural and natural reaction to the loss of a loved one.
Grieving is a complex emotion that involves ways to keep the memory of the person who has passed alive and on other things to deal with the reality of the loss (Brinkmann et al.
, 2.
Shear in (Hasan, 2.
states another definition of grieving is a common psychological instinctual response to the experience of losing someone dear.
According to Kubler-Ross in (Andrian, 2.
there are 5 stages of grieving that will be experienced, namely.
Denial phase.
Anger phase.
Bargaining phase.
Depression phase.
Acceptance phase.
Based on the description that has been presented above, the author is interested in making a literature review with the aim of seeing the condition of Grief in Individuals With Family Members Dying Due to Covid-19.
1st International Health Conference STIKes Panca Bhakti (IHCPB) METHODS This scientific literature review is to identify, assess, and interpret all findings on the research topic, to answer the research objectives with a systematic qualitative review approach.
The keywords used used Indonesian and English, namely.
Grieving.
Covid-19 Pandemic and Family.
Literature searches were obtained from the Google Scholar electronic database.
The results obtained were 239 articles.
After screening with the time range, and journal type, 239 articles were obtained.
And selected again articles that can be accessed full text and obtained 7 articles.
Furthermore, the articles found were used to answer research questions.
The article selection process is shown in the Prism Flow Diagram and the research results are shown in the data extraction table.
1st International Health Conference STIKes Panca Bhakti (IHCPB) Prisma Flow Diagram Identification Pubmed n= 6 Google Scholar n= 233 Overall article results n = 239 Screening Screening .
= .
Screening:
Journals published within 2019-2022 Journals that discuss the phenomenon of grieving in individuals due to covid-19.
Journals that can be accessed Screening Results Google schoolar n = 233 Pubmed = 6 Eligibility Accessible articles (Full Tex.
Included Articles that met the inclusion .
= .
1st International Health Conference STIKes Panca Bhakti (IHCPB) Full text Google scholar = 2 Pubmed = 5 Inclusion Criteria Journals related to the phenomenon of grieving in individuals with family members dying from Google scholar n = 2 Pubmed n = 5 RESULTS and DISCUSSION The search results obtained 296 relevant articles and then reduced or selected 7 articles that fit the inclusion criteria.
The results of Carlos H et.
's research, 2021 in Spain, stated that thousands of people died without the company of their loved ones, without a goodbye, all because of the lockdown policy implemented.
Families of covid 19 victims must mourn under unprecedented conditions.
This is described through phrases such as: "I couldn't say goodbye to him.
I felt it was like an abduction", "the family called at the houses of his relatives' residences, as if he had not died, even though he had died", "they kept talking to their loved ones' roommates", "kept watching the phone to listen to the voice of the deceased on voice mail".
Goveas J.
S, and Shear M.
, described in their research in the United States in 2020, which began when Alice refused to visit her brother (Carle.
for fear of contracting the covid 19 virus, so Carles died and was only accompanied by hospital staff and corpse coordinators.
Then Carles was cremated without her presence and his ashes were sent to her.
A few weeks later there was regret that Alice left her dying brother alone.
At this time Alice desperately wanted to be with Carles and Alice still couldn't believe that he was gone.
Alice's moods fluctuated between numbness, overwhelming sadness, and intense guilt.
Alice couldn't stop thinking that she had let her brother down.
Alice had difficulty sleeping, weight loss, but did not meet the criteria for major depression.
Hasan A.
et, al's research in 2021 in Indonesia describes the responses of the three respondents when they found the death of their family members due to the Covid 19 pandemic, including not being able to communicate directly with the closest people who wanted to die, not being able to accompany the victim in the last moments of his life, not being able to witness directly / up close the process after death until the funeral.
This can happen not only to one relative, but even to several relatives in close proximity.
Feeling disbelief, upset, anger, sadness, shock, and feeling physical pain such as immobility or weakness are things experienced by relatives of victims who died due to covid 19.
1st International Health Conference STIKes Panca Bhakti (IHCPB) Research by Mortavazi et.
in 2021 in Iran.
Iranians can still take part in funeral activities for victims of covid 19, activities starting with bathing the body, wrapping it in a shroud, praying and then burying it, although most of them are done privately and attended by close family.
Ambiguity and hopelessness are common feelings experienced by relatives of victims of the covid 19 pandemic and the wider community in Iran, due to the rapid onset and spread of the disease, uncertainty about the effectiveness of therapeutic interventions by medical personnel, the dichotomy between hope - despair, and the fear of medical staff.
People feel that there is no control over any stage of this covid 19 disease, which develops a sense of hopelessness.
Paul A.
April 19, 2020 in Chicago USA.
Told in an article in the TCA regional news newspaper about Jack Richard Pimm/Pimm.
Pimm was a 71-year-old man who loved meeting his family and community.
A few weeks ago many gathered to celebrate Pimm's life, a life he so freely shared with everyone from his children, grandchildren, fellow Brownsville church members and Linn county farmers.
A family tradition dating back 62 years was that they would sing "When the Roll Is Called up Yonder" when a family member died.
Today Pimm was buried at Oakville Cemetery, with only a few family members in attendance and most of the mourners sitting in cars, not standing around their father/grandfather's casket.
It took time for family members to come to terms with the fact that there was no traditional funeral service for their father/grandfather, "it was very emotional", there was a ban on large events such as traditional funerals from the regional authorities.
The family still tried to honor the deceased family member as specially as possible, a tree on the family farm was felled, cut into pieces to get the wood to use as a coffin, the coffin was made by Pimm's son and grandson (Rick and Gle.
by hand, other children and grandchildren were invited to write/draw a special note on the coffin lid.
The funeral service was led by a pastor in the courtyard of the family home.
Due to Covid 19 restrictions of no more than 10 people being able to attend the funeral and 10 people including funeral staff and personnel from the funeral home, the family chose to have the funeral led by a pastor in a separate location.
A recording of the live funeral was made to guide the proceedings in a separate location.
1st International Health Conference STIKes Panca Bhakti (IHCPB) The covid 19 pandemic has changed the way funerals are conducted, bereaved families have the choice of burial by attendants or by cremation.
If by cremation the family has the option to keep their loved one's ashes, or bury them at a later date after the pandemic ends.
Verret G.
A et, al.
his research in Canada in 2021 described the beginning of the grieving process as a painful situation, starting with the prohibition / impossibility of being able to visit and be present in the last weeks or days of life of his relatives due to the Covid 19 pandemic.
This is expressed with the phrases: "We are cut off from our loved ones, and we cannot accompany them when they This disconnection led to feelings of helplessness, anger, regret, guilt and despair for most Some respondents found out about the death of their relatives by phone hours later, some even days after the death of their relatives.
Widyataqwa A.
and Rahmasari D.
's research in 2021 in Indonesia, told about grief when a life partner died due to covid 19, both participants felt that they seemed to lose their lives when they found out their life partner had died.
One participant revealed that he was unable to say much about what he felt, this is illustrated in the quoted words.
"the sadness cannot be explained, it's called losing a partner who has been together for a long time, it feels like he doesn't have a life anymore", "shocked why this can be, want to be angry but who, at that time can only lament and rebel, and cannot think clearly".
Another participant stated: "not sad but I really felt lost.
I didn't know what to do at that time.
I tried to tell myself to be strong because I was in front of my If I keep thinking about being tired.
I think I just want to follow my husband".
Covid 19 has also become a bad outlook for the wider community and has an unfavorable influence on the families left behind.
This was told that the family had difficulty finding a burial place because several funeral places were rejected because the corpse died due to Covid 19.
Another thing was also felt by one of the participants, who was not visited by his relatives and neighbors when he was going to hold a funeral, this was thought to be due to people's fear of the covid 19 virus.
There are regulations given by the hospital / covid 19 task force for families who live in the same house with victims who died from covid 19 to carry out self-isolation for 14 days and swab / PCR tests to minimize the increase in new covid cases from the family cluster.
1st International Health Conference STIKes Panca Bhakti (IHCPB) Such is the grief experienced by family members who died from the covid 19 virus, things that are usually done to honor people who are about to die or who have just died cannot be done or are hampered.
When someone faces conditions approaching the death of a beloved family member, the family will usually accompany the last seconds as a sign of farewell for the last time, then the family, neighbors and colleagues during the life of the deceased will gather and help with the funeral process and accompany a few days after death.
People take varying amounts of time to adapt after the death of a loved one, eventually developing a new sense of normalcy to sustain life.
CONCLUSIONS
The conclusions that can be drawn from the literature review on Grief in Individuals With Family Members Dying Due to Covid-19 are: Grieving is a natural occurrence that humans will Generally this occurs due to the process of losing something valuable, in this study it is specific to the loss of family members.
In the era of the Covid-19 pandemic throughout 2020-2021, the grief that occurred in the families of covid 19 patients who died became a complicated process that the family had to face.
This happens because the closest family cannot accompany the patient in the last moments of the patient's life so that there is no final farewell moment between the family and the deceased family member.
The family's unpreparedness for the "sudden" separation is also one of the factors that make this grieving process a difficult condition to accept.
In the Covid 19 pandemic era, family members who died could not be buried in a normal way, but with special protocols that must be carried out.
The funeral ceremony is carried out by very limited personnel, cannot be attended directly by relatives or close friends of the victim.
course, this is a condition of grieving that is very rare and a difficult process compared to the grieving process in general.
1st International Health Conference STIKes Panca Bhakti (IHCPB) REFERENCE