However, this model has limited empirical support. In this model, the five stages of grief were identified as denial, anger, bargaining, depression, and acceptance. The most well-known model was developed for medical student education and used a series of clinical interviews with terminally ill patients. Some models have organized grief-related symptoms into phases or stages, suggesting that grief is a process marked by a series of phases with predominant characteristics. Most models hypothesize a normal grief process differentiated from various types of complicated grief. When specific information about the care of children is available, it is summarized under its own heading.Ī number of theoretically derived models of normal grief have been proposed. The evidence and application to practice related to children may differ significantly from information related to adults.
In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. Where available, studies that have focused on cancer are emphasized. The following information combines theoretical and empirical reviews of the general literature on grief, bereavement, and mourning and is not specific to loss via cancer. The important developmental issues of children and grief are presented, and a section on cross-cultural responses to grief and mourning concludes the summary. Psychosocial and pharmacological treatments are explained. It then distinguishes the grief reactions of anticipatory grief, prolonged complicated grief, normal or common grief, models of normal grief, and complicated or prolonged grief. This summary first defines the constructs of grief, mourning, and bereavement. The effect of grief on the patients themselves and on the loss of their future should also be considered by providers and patients’ social networks.
The following factors affect how a person will express grief externally and adjust to the loss internally:Įven the sense of a relationship’s completeness can influence the grieving process. How people grieve depends on the personality of the grieving individual and his or her relationship with the person who died. Multiple factors may influence how an individual or a social network adjusts to a death. Some may even find that the cancer experience, although it is difficult and trying, may lead to significant personal growth for the patient and others in the patient’s family and social network. Most people will experience common or normal grief and will, with time, adjust to the loss others will experience more severe grief reactions such as prolonged or complicated grief and will benefit from treatment. The progression from advanced cancer to death is experienced in different ways by different people. Individual diversity, family and social networks, and micro- and macrocultural influences contribute to the way one experiences and expresses grief. Health care providers will encounter bereaved individuals throughout their personal and professional lives.