Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, Bessemer Road, London, UK.
School of Psychology, Swansea University, Wales, UK.
Palliat Med. 2023 Feb;37(2):221-234. doi: 10.1177/02692163221138620. Epub 2022 Nov 25.
Support from social networks is vital after the death of a partner. Lesbian, gay, bisexual and/or transgender (LGBT+) people can face disenfranchisement and isolation in bereavement. The Acceptance-Disclosure Model (of LGBT+ bereavement) posits that experiences are shaped by the extent to which individuals feel able to disclose their bereavement to others, and whether that loss is acknowledged appropriately.
To explore LGBT+ specific experiences of partner bereavement; determine decision-making processes regarding disclosure of relationships/identities; and appraise the Acceptance-Disclosure Model using primary qualitative data.
Exploratory in-depth qualitative interview study positioned within a social constructivist paradigm. Data were analysed using inductive and deductive reflexive thematic analysis.
SETTING/PARTICIPANTS: 21 LGBT+ people from across England bereaved of their civil partner/spouse.
Participants described LGBT+ specific stressors in bereavement: lack of recognition of their loss; inappropriate questioning; unwanted disclosure of gender history; and fears of discrimination when accessing support. Disclosure of LGBT+ identities varied across social networks. Some participants described hiding their identities and bereavement to preserve relationships, and challenging intersections between LGBT+ identities and other aspects of culture or self. These findings provide primary evidence to support the Acceptance-Disclosure Model.
LGBT+ people face additional stressors in bereavement. Not all LGBT+ people want to talk directly about their relationships/identities. Sensitive exploration of support needs, aligned with preferences around disclosure of identities, can help foster trust. Five recommendations for inclusive practice are presented. Further research should consider whether the Acceptance-Disclosure Model has utility to explain bereavement experiences for other isolated or disenfranchised groups.
伴侣去世后,来自社交网络的支持至关重要。女同性恋、男同性恋、双性恋和/或跨性别者(LGBT+)在丧偶时可能会面临被剥夺权利和孤立。LGBT+ 丧亲接受-披露模型(Acceptance-Disclosure Model of LGBT+ Bereavement)认为,个体对向他人披露丧亲经历的程度,以及这种损失是否得到适当承认,会影响他们的经历。
探讨 LGBT+ 特定的伴侣丧亲经历;确定向他人披露关系/身份的决策过程;并使用原始定性数据评估接受-披露模型。
探索性深入定性访谈研究,置于社会建构主义范式内。使用归纳和演绎反思性主题分析来分析数据。
设置/参与者:来自英格兰各地的 21 名 LGBT+ 丧偶者,失去了他们的民事伴侣/配偶。
参与者描述了丧亲之痛中的 LGBT+特定压力源:他们的损失未得到承认;不恰当的询问;性别历史被不必要地披露;以及在获得支持时害怕受到歧视。在社交网络中,LGBT+ 身份的披露情况各不相同。一些参与者描述了为了维护关系而隐藏自己的身份和丧亲之痛,以及在 LGBT+身份与文化或自我的其他方面之间的交叉点上的挑战。这些发现为支持接受-披露模型提供了初步证据。
LGBT+ 人群在丧亲之痛中面临额外的压力。并非所有 LGBT+人群都想直接谈论他们的关系/身份。对支持需求进行敏感的探索,与身份披露的偏好保持一致,可以帮助建立信任。提出了五项包容性实践建议。进一步的研究应考虑接受-披露模型是否对解释其他孤立或被剥夺权利的群体的丧亲经历有用。