Abel Julian, Kellehear Allan, Aoun Samar M
Compassionate Communities UK, Cornwall, UK.
Department of Nursing, College of Nursing and Health Sciences, Department of Medicine, The Robert Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
Ann Palliat Med. 2023 Jul;12(4):816-825. doi: 10.21037/apm-23-24. Epub 2023 Jun 13.
Bereavement, a specific kind of grief in response to a death, has been embedded in human history, in cultural patterns, with ritual, ceremony, and community kindness being the mainstay of grief support. The advent of professionalised grief counselling has seen the increasing domination of professional support as the best way to support someone bereaved, with a consequent loss of the varied forms of community support. The availability of professional grief counselling is limited, with only a small percentage of bereaved people accessing it or needing to access it. In this article, we argue for a realignment of professional grief services, strengthening community actions, and reorientation of health care in keeping with the Ottawa Charter for Health Promotion. Community sources of grief support are being reinvented in multiple ways. Professional services can develop links and relationships with these communities of support. A population-based public health approach to bereavement care is needed. This can only be achieved through communities and professionals working together. This partnership working underlines three implications for practice. These are (I) love and friendship must be the bedrock of support for grief and loss and the strengthening of these supports should be the priority for all therapeutic and social actions, (II) the multiple and varied community and civic sector sources of grief support should be the mainstay of the bereaved, and (III) bereavement professionals should work in the context of community, linking their clients with sustainable community supports.
丧亲之痛，一种因死亡而产生的特定悲痛，已深深融入人类历史和文化模式之中，仪式、典礼以及社区关怀是悲痛慰藉的主要支柱。随着专业化悲伤咨询的出现，专业支持作为帮助丧亲者的最佳方式日益占据主导地位，导致各种形式的社区支持逐渐缺失。专业悲伤咨询服务的可及性有限，只有一小部分丧亲者能够获得或需要获得此类服务。在本文中，我们主张根据《渥太华促进健康宪章》重新调整专业悲伤服务，加强社区行动，并重新定位医疗保健。社区悲伤支持来源正以多种方式被重塑。专业服务机构可以与这些支持社区建立联系。需要一种基于人群的公共卫生方法来提供丧亲关怀。这只有通过社区和专业人员共同努力才能实现。这种合作关系对实践有三点启示。即（I）爱与友谊必须是悲伤和失落支持的基石，加强这些支持应是所有治疗和社会行动的首要任务；（II）多样的社区和公民部门悲伤支持来源应是丧亲者的主要依靠；（III）丧亲关怀专业人员应在社区背景下开展工作，将他们的客户与可持续的社区支持联系起来。
