Policy Science Unit, School of Medicine, Kyoto University, Kyoto, Japan
Department of Religious Studies, Tohoku University, Sendai, Japan.
Fam Med Community Health. 2022 Mar;10(1). doi: 10.1136/fmch-2021-001260.
Severe grief adversely affects the health of bereaved families, potentially burdening medical and community health services. Interventions for effective community health maintenance must identify the people likely to face severe effects of bereavement. The present study identified characteristics of mourners who experience severe grief within a year of bereavement to confirm whether this grief increased their reliance on Japanese medical and social services.
We conducted a nationwide postal survey of Japanese bereaved within the previous year, to compare those reporting daily or overwhelming 'heavy' grief to those with less heavy grief, in terms of demographic and socioeconomic details, daily work and non-work activity, frequency of medical and social service use.
SETTING/PARTICIPANTS: In 2019, with the support of the Ministry of Education and the All Japan Funeral Co-Operation, we distributed approximately 5500 questionnaires to Japanese who had presided at funerals within the past year for anonymous return. By January of 2020, we received 1078 complete voluntary responses from bereaved Japanese.
Half of the 'heavy grief' group (n=143) reported adverse effects on health and daily life, including needs for pharmacological, medical or welfare support. Losses of husbands or children were particularly connected to severe grief; 'unexpected' death from cancer caused the greatest shock. Employment (even part-time) buffered against severe grief; grief was greater for the unemployed and substantially worse for those who lost significant income at the same time as they lost loved ones.
These findings suggest that prior counselling should reduce the shock of bereavement and economic loss, which increases subsequent medical dependence. Medical professionals and community health workers can use the above factors to target in advance the family members in greatest danger of heavy grief, to intervene lest grief adversely affect their physical and psychological health after bereavement.
严重的悲伤会对失去亲人的家庭的健康产生不利影响，可能会给医疗和社区卫生服务带来负担。为了进行有效的社区健康维护，干预措施必须确定那些可能面临丧亲之痛严重影响的人。本研究旨在确定在丧亲后一年内经历严重悲伤的哀悼者的特征，以确认这种悲伤是否会增加他们对日本医疗和社会服务的依赖。
我们对日本在过去一年中丧偶的人进行了全国性的邮寄调查，比较了那些报告每天或压倒性的“沉重”悲伤的人与那些悲伤程度较轻的人，比较的方面包括人口统计学和社会经济细节、日常工作和非工作活动、医疗和社会服务的使用频率。
地点/参与者：2019 年，在日本文部科学省和全日本葬礼合作协会的支持下，我们向过去一年主持过葬礼的日本人分发了大约 5500 份问卷，要求匿名回复。到 2020 年 1 月，我们收到了 1078 份来自丧偶日本人的完整自愿回复。
一半的“沉重悲伤”组（n=143）报告了对健康和日常生活的不良影响，包括需要药物治疗、医疗或福利支持。丈夫或孩子的去世尤其与严重悲伤有关；癌症的“意外”死亡造成的打击最大。就业（即使是兼职）也能缓冲严重悲伤；失业者的悲伤情绪更大，而那些同时失去亲人又失去重要收入的人的悲伤情绪则更为严重。
这些发现表明，事先咨询可以减轻丧亲之痛和经济损失带来的冲击，从而增加后续对医疗的依赖。医疗专业人员和社区卫生工作者可以利用上述因素，提前确定最有可能出现严重悲伤的家庭成员，并进行干预，以免悲伤对他们丧亲后的身心健康产生不利影响。
