• Explain the steps required for diagnosis of mental disorders in diagnostic handbooks.• Identify current procedures for classifying and reporting prolonged grief disorder.
Prolonged grief disorder (PGD) was added to the 11th edition of the International Classification of Diseases in 2018 and to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders in its 2022 text revision. Thus, reporting and classifying PGD according to established guidelines has become fundamental for scientific research and clinical practice. Yet, PGD assessment instruments and criteria are still being developed and debated. The purpose of this article is to examine the adequacy of current procedures for classifying and reporting PGD in research and to suggest guidelines for future investigation and dissemination of knowledge. We outline the standard steps required for diagnosis and assessment of a mental disorder (notably, the administration of clinical interviews). In order to illustrate reporting about the presence/prevalence of PGD in recent scientific articles, we conducted a search of Scopus that identified 22 relevant articles published between 2019 and 2023. Our review of the literature shows that standard classification procedures are not (yet) followed. Prevalences of PGD are based on self-reported symptomatology, with rates derived from percentages of bereaved persons reaching a certain cutoff score on a questionnaire, without clinical interviewing. This likely results in systematic overestimation of prevalences. Nevertheless, the actual establishment of PGD prevalence was often stated in titles, abstracts, and results sections of articles. Further, the need for structured clinical interviews for diagnostic classification was frequently mentioned only among limitations in discussion sections-but was not highlighted. We conclude by providing guidelines for researching and reporting self-reported prolonged grief symptoms and the presence/prevalence of PGD.

The \'2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines\' are authored by a Task Force of experts in feline hospice and palliative care convened by the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care. They emphasize the specialized communication skills and ethical considerations that are associated with feline hospice and palliative care, with references to other feline practice guidelines for a more complete discussion of specific diseases, feline pain management best practices and cat friendly interactions. A comprehensive, multi-step hospice consultation allows for tailoring the approach to both the cat and the family involved in the care. The consultation includes establishing \'budgets of care\', a concept that greatly influences what can be done for the individual cat. The Guidelines acknowledge that each cat and caregiver will be different in this regard; and establishing what is reasonable, practical and ethical for the individual cat and caregiver is important. A further concept of the \'care unit\' is introduced, which is extrapolated from human hospice and palliative care, and encourages and empowers the caregiver to become a part of the cat\'s care every step of the way. Ethical considerations include a decision-making framework. The importance of comfort care is emphasized, and the latest information available about how to assess the quality of a cat\'s life is reviewed. Emotional health is as equally important as physical health. Hence, it is fundamental to recognize that compromised physical health, with pain and/or illness, impairs emotional health. A limited discussion on euthanasia is included, referring to the AAFP\'s End of Life Educational Toolkit for recommendations to help the caregiver and the veterinary professional ensure a peaceful passing and transition - one that reflects the best interests of the individual cat and caregiver.

Prolonged grief disorder (PGD) is a new mental health disorder, recently introduced in the International Classification of Diseases (ICD-11), World Health Organization Classification of Diseases (WHO). The new ICD-11 guidelines reflect an emerging wave of interest in the global applicability of mental disorders. However, the selection of diagnostic core features in different cultural contexts has yet to be determined. Currently, there is debate in the field over the global applicability of these guidelines. Using semi-structured interviews with 14 key informants, we explored the acceptability of ICD-11 guidelines for PGD according to Japanese health professionals as key informants. The interviews revealed symptoms of grief possibly missing in the ICD-11 PGD guidelines including somatization and concepts such as hole in the heart. Additionally, sociocultural barriers such as stigma and beliefs about the social desirability of emotions may challenge patients\' and clinicians\' acceptance of the new ICD-11 criteria.

Supporting a cancer patient up until the end of life and then mourning the loss represents a long, and emotionally marking period that is potentially problematic for health professionals. In addition to individual and environmental characteristics-and related to death or to the relationship prior to death-the communication established between the doctor, patient, family members and other health professionals in the team, seems to determine how an individual experiences the loss and mourning process. Acknowledging the suffering of the bereavement without always being able to respond is neither easy nor trivial, requiring modified/appropriate knowledge and skills. The opportunity to share their experiences within a healthcare team and with external health care professionals guarantees an ethical approach, professional enrichment and limits the risk of burnouts. In order to offer guidance and potential solutions, the references specific to cancerology are regularly updated in France by the AFSOS (\"French Association of Supportive Cancer Care\"). This multidisciplinary effort, including professionals from different professional societies (AFSOS, SFFPO, SFAP) and coordinated by the cancerology network of Nouvelle Aquitaine (Onco-Nouvelle-Aquitaine), has resulted in the recent publication of two complementary resources that address bereavement. The first report provides theoretical guidelines, while the second proposes a more clinical approach on how to support a mourning individual. Thus, with regards to the clinical situation and contextualization of the aforementioned references, this article considers the dimensions of separation, bereavement, and supportive care and further discusses tools to help health professionals protect themselves when affronting these situations.

Many adolescents struggle with their grief and mental health issues after the death of a close person, such as a family member or a friend. Given the potentially devastating impact of the loss on the adolescent and their family, professional help can be warranted. However, little is known about how to best help these adolescents. This study aimed to address this gap by determining what help professionals (i.e., counselors) should provide to bereaved adolescents.
The Delphi method was used to achieve consensus regarding the importance of statements that describe actions a helping professional can take to help a bereaved adolescent. Statements were compiled through a systematic search of the scientific and grey literature, and reviewing interview data from a recent related research study with bereaved adolescents, parents and counselors. An expert panel (N = 49) comprising 16 adolescents, 14 parents and 19 helping professionals, rated each statement. Statements that were endorsed by at least 80% of panellists were considered consensus recommendations.
Panellists endorsed 130 out of 190 statements as appropriate actions. These included help for a bereaved adolescent being offered on an ongoing basis, with support to be provided flexibly to meet individual adolescent needs and to acknowledge the agency of the adolescent. Support after a loss by suicide should be tailored to address specific suicide-related issues. Parents of bereaved adolescents should also be offered support so that they are better equipped to help their bereaved adolescent.
This study identified consensus recommendations on how a helping professional might best help bereaved adolescents. It is hoped that these recommendations will guide helping professionals and enhance adolescent grief interventions.

BACKGROUND: For most parents, getting pregnant means having a child. Generally, the couple outlines plans and has expectations regarding the baby. When these plans are interrupted because of a perinatal loss, it turns out to be a traumatic experience for the family. Validating the grief of these losses has been a challenge to Brazilian society, which is evident considering the childbirth care offered to bereaved families in maternity wards. Positively assessed care that brings physical and emotional memories about the baby has a positive impact on the bereavement process that family undergoes. Therefore, this study aims to assess the effects supportive guidelines have on mental health. They were designed to assist grieving parents and their families while undergoing perinatal loss in public maternities in Ribeirão Preto, São Paulo state, Brazil.
METHODS: A mixed-methods (qualitative/quantitative), quasi-experimental (before/after) study. The intervention is the implementation of bereavement supportive guidelines for women who experienced a stillbirth or a neonatal death. A total of forty women will be included. Twenty participants will be assessed before and twenty will be assessed after the implementation of the guidelines. A semi-structured questionnaire and three scales will be used to assess the effects of the guidelines. Health care professionals and managers of all childbirth facilities will be invited to participate in focus group. Data will be analyzed using statistical tests, as well as thematic analysis approach.
CONCLUSIONS: The Perinatal Bereavement guidelines are a local adaptation of the Canadian and British corresponding guidelines. These guidelines have been developed based on the families\' needs of baby memories during the bereavement process and include the following aspects: (1) Organization of care into periods, considering their respective needs along the process; (2) Creation of the Bereavement Professional figure in maternity wards; (3) Adequacy of the institutional environment; (4) Communication of the guidance; (5) Creation of baby memories. We expect that the current project generates additional evidence for improving the mental health of women and families that experience a perinatal loss. Trial registration RBR-3cpthr For many couples, getting pregnant does not only mean carrying a baby, but also having a child. Most of the time, the couple has already made many plans and has expectations towards the child. When these plans are interrupted because of a perinatal loss, it turns out to be a traumatic experience for the family. In Brazilian culture, validating this traumatic grief is very difficult, especially when it happens too soon. The barriers can be noticed not only by the way society deals with the parents\' grief, but also when we see the care the grieving families receive from the health care establishment. Creating physical and emotional memories might bring the parents satisfaction regarding the care they receive when a baby dies. These memories can be built when there is good communication throughout the care received; shared decisions; the chance to see and hold the baby, as well as collect memories; privacy and continuous care during the whole process, including when there is a new pregnancy, childbirth and postnatal period. With this in mind, among the most important factors are the training of health staff and other professionals, the preparation of the maternity ward to support bereaved families and the continuous support to the professionals involved in the bereavement. This article proposes guidelines to support the families who are experiencing stillbirth and neonatal death. It may be followed by childbirth professionals (nurses, midwives, obstetricians and employees of a maternity ward), managers, researchers, policymakers or those interested in developing specific protocols for their maternity wards.
UNASSIGNED: CONTEXTO: Uma assistência avaliada positivamente por mães e pais que passaram pela perda perinatal permite a criação de memórias físicas e afetivas do bebê e possuem efeitos positivos no processo de luto da família. Este estudo avaliará os efeitos de uma diretriz de acolhimento na saúde mental de mulheres em processo de luto perinatal e neonatal em maternidades públicas do município de Ribeirão Preto (SP, Brasil). MéTODO: Estudo de métodos mistos (quantitativo e qualitativo), quase-experimental (antes e depois). A intervenção é a implementação de diretrizes de acolhimento ao luto de mulheres que tiveram um natimorto ou óbito neonatal. Um total de quarenta mulheres serão incluídas. Vinte participantes serão avaliadas antes, e vinte após a implementação da diretriz de acolhimento nas instituições. Serão aplicadas três escalas e uma entrevista semiestruturada para avaliar os efeitos da diretriz. Profissionais da saúde e gestores serão convidados a participar de grupos focais. Os dados serão analisados por meio de testes estatísticos, e sob a metodologia de análise temática. A diretriz de acolhimento contará com material baseado em diretrizes canadense e britânica. DISCUSSãO: As diretrizes brasileiras de luto perinatal propostas são uma adaptação local das diretrizes canadense e britânica. Baseamo-nos na necessidade da família por memórias físicas e afetivas da criança morta para facilitar a vivência do processo do luto. Elas incluem os seguintes aspectos: (1) organização dos períodos da assistência a partir de suas respectivas necessidades, (2) criação do papel do Profissional do Luto, (3) ambientação das instituições, (4) disseminação das diretrizes e (5) criação de memórias do bebê. Espera-se que o projeto gere evidências adicionais para melhorar a saúde mental de mulheres e famílias que vivenciam uma perda perinatal. Registro do estudo: RBR-3cpthr.

Bereavement care practice guidelines assist in delivering high-quality bereavement care. However, the quality of published guidelines is unknown. A systematic review was conducted to identify and evaluate the quality of the process used to develop bereavement care practice guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. A keyword search was conducted in MEDLINE-Complete, CINAHL-Complete, Health-Source (Nursing/Academic Edition), Psychology and Behavioral Sciences Collection, and an internet search engine in October 2017. Sixteen guidelines with differing scope and purpose but similar core values were identified from the grey literature and then appraised at high quality (n = 1), moderate quality (n = 4), or low quality (n = 11). The domains \"clarity of presentation\" and \"scope and purpose\" achieved the highest scores (mean ± SD 71.0 ± 27.6% and 64.4 ± 37.5%, respectively), while \"editorial independence\" showed the lowest mean score (9.2 ± 13.3%). While few of the bereavement care practice guidelines met the AGREE II quality standards related to their development process, neither the quality of the content of each guideline nor the in-context application was assessed by the AGREE II instrument. Ongoing development of practice guidelines may benefit from consideration and application of the framework outlined in the AGREE II or similar appraisal instrument.

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This article is an extended excerpt from the document Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines, rewritten to emphasize, expand upon, and clarify two key, interrelated concepts introduced in the Guidelines. First, everyone exposed to a suicide fatality, regardless of their relationship to the deceased, may require support services to ameliorate the effects of that exposure. Second, a systemic response to suicide ought to be organized around three levels of care, designed and implemented strategically to meet people\'s immediate needs, their need for ongoing support, and any clinical treatment needs that arise from their exposure to the fatality.

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