RESUMO
BACKGROUND: Sociologists, anthropologists, and psychologists agree that grief is a universal phenomenon. Reactions to it are, however, socially constructed and patterned. OBJECTIVE: To compare the outcomes of bereavement among family or close friends of deceased first-generation black Caribbean and white native-born patients living in the United Kingdom. DESIGN: Comparative cross-sectional questionnaire survey in three inner London health authorities administered 10 months after the patient's death. PARTICIPANTS: Family and close friends of 50 deceased first-generation black Caribbean and 50 native-born white patients with advanced disease. MAIN OUTCOME MEASURES: 28-item General Health Questionnaire (GHQ-28), Core Bereavement Items scale, a 17-item measure of grief. RESULTS: The intensity of grief, measured using the Core Bereavement Items was similar between the two groups. Seventy-two respondents had visited their family doctor subsequent to bereavement, and of these, black Caribbean respondents reported more psychological problems. Depression and anxiety measured by the GHQ-28 were significantly higher among black Caribbean respondents (28.00 vs. 21.2) (t-test = -2.28, p = 0.025). Multiple regression analysis revealed this difference was best accounted for by bereavement concerns such as legal and housing problems. CONCLUSIONS: This study has observed higher psychological morbidity among the bereaved Caribbean individuals. Family doctors are a source of support for three-quarters of respondents, and they may need to focus on the needs of black and minority ethnic minorities.
Assuntos
Luto , População Negra/psicologia , População Branca/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Estresse Psicológico/etnologia , Índias Ocidentais/etnologiaRESUMO
The present survey aimed to describe and compare the main needs and problems experienced by informal caregivers of Black Caribbean and White native-born patients in their last year of life. Out of the 106 Black Caribbean and 110 White patients identified as dying during the survey period, 50 interviews per ethnic group were conducted, a response rate of 47% and 45%. Out of these, 31 respondents representing Black Caribbean and 28 representing White dependants said that they bore the brunt of caregiving. Compared with those who cared for White dependants, those who cared for Black Caribbean dependants were more likely to be women (84% versus 46%, chi2 = 9.21, 1 d.f., asymptotic P = 0.002) and younger than 55 years of age (73% versus 37%, chi2 = 7.60, 1 d.f., asymptotic P = 0.006). The personal-care tasks which caregivers assisted their dependants with were similar, as were the informal resources they drew on. Many caregivers reported restrictions in their daily lives; this was more pronounced for those who cared for Black Caribbean dependants (chi2 = 6.40, 2 d.f., asymptotic P = 0.041, exact P = 0.039). Research is required to provide a qualitative narrative of the meaning caregivers from different communities ascribe to caring, and the formal and informal resources which they need to support them.
Assuntos
População Negra/etnologia , Cuidadores/estatística & dados numéricos , Doença Crônica/enfermagem , Relação entre Gerações , População Branca/etnologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Luto , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/enfermagem , Efeitos Psicossociais da Doença , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Neoplasias/etnologia , Neoplasias/enfermagem , Estudos Retrospectivos , Índias Ocidentais/etnologiaRESUMO
Attitudes to timeliness of death and euthanasia are little researched among people from different ethnic backgrounds or in socioeconomically deprived areas. We interviewed 50 bereaved family members of people from the black Caribbean community and 50 from the white community in the United Kingdom, using an established questionnaire, and compared reports of their and the reported patient views. In both groups more than two thirds of patients knew they might die, although in more than half of these cases no one had actually told them this. More than half of the respondents thought the deceased had died at the right time. One in five patients had talked about wanting to die sooner but this was not related to family members' own views. One patient in the black Caribbean group and two in the white group had talked about wanting euthanasia. The study highlights that communication with patients needs to be improved among both black Caribbean and white patients, but suggests that attitudes to timeliness of death are similar in both groups.