Cross-cultural Responses to Grief and Mourning
Grief, whether in response to the death of a loved one, to the loss of a
treasured possession, or to a significant life change, is a universal
occurrence that crosses all ages and cultures. However, there are many aspects
of grief about which little is known, including the role that cultural heritage
plays in an individual’s experience of grief and mourning.[1,2] Attitudes,
beliefs, and practices regarding death and grief are characterized and
described according to multicultural context, myth, mysteries, and mores that
describe cross-cultural relationships.[2]
The potential for contradiction between an individual’s intrapersonal
experience of grief and his or her cultural expression of grief can be
explained by the prevalent (though incorrect) synonymous use of the terms
grief (the highly personalized process of experiencing reactions to perceived
loss) and mourning (the socially or culturally defined behavioral displays of
grief).[3,4]
An analysis of the results of several focus groups, each consisting of
individuals from a specific culture, reveals that individual, intrapersonal
experiences of grief are similar across cultural boundaries. This is true even
considering the culturally distinct mourning rituals, traditions, and
behavioral expressions of grief experienced by the participants. Health care
professionals need to understand the part that may be played by cultural mourning practices in an individual’s overall grief experience if they are to provide culturally
sensitive care to their patients.[1]
In spite of legislation, health regulations, customs, and work rules that have
greatly influenced how death is managed in the United States, bereavement
practices vary in profound ways depending on one’s cultural background. When
assessing an individual’s response to the death of a loved one, clinicians
should identify and appreciate what is expected or required by the person’s
culture. Failing to carry out expected rituals can lead to an experience of
unresolved loss for family members.[5] This is often a daunting task when
health care professionals serve patients of many ethnicities.[2]
Helping family members cope with the death of a loved one includes showing
respect for the family’s cultural heritage and encouraging them to decide how
to commemorate the death. Clinicians
consider the following five questions particularly important to ask those who are coping with the emotional
aftermath of the death of a loved one:
- What are the culturally prescribed rituals for managing the dying process,
the body of the deceased, the disposal of the body, and commemoration of the death?
- What are the family’s beliefs about what happens after death?
- What does the family consider an appropriate emotional expression and
integration of the loss?
- What does the family consider to be the gender rules for handling the
death?
- Do certain types of death carry a stigma (e.g., suicide), or are certain
types of death especially traumatic for that cultural group (e.g., death of a
child)?[6]
Death, grief, and mourning are universal and natural aspects of the life
process. All cultures have evolved practices that best meet their needs for
dealing with death. Hindering these practices can disrupt
the necessary grieving process. Understanding these practices can help
clinicians to identify and develop ways to treat patients of other cultures
who are demonstrating atypical grief.[7] Given current ethnodemographic
trends, health care professionals need to address these cultural differences in
order to best serve these populations.[2]
References
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Cowles KV: Cultural perspectives of grief: an expanded concept analysis. J Adv Nurs 23 (2): 287-94, 1996.
[PUBMED Abstract]
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Irish DP, Lundquist KF, Nelson VJ, eds.: Ethnic Variations in Dying, Death, and Grief: Diversity in Universality. Washington, DC: Taylor & Francis, 1993.
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Rando TA: Treatment of Complicated Mourning. Champaign: Research Press, 1993.
-
Cowles KV, Rodgers BL: The concept of grief: a foundation for nursing research and practice. Res Nurs Health 14 (2): 119-27, 1991.
[PUBMED Abstract]
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McGoldrick M, Hines P, Lee E, et al.: Mourning rituals. Family Therapy Networker 10 (6): 28-36, 1986.
-
McGoldrick M, Almedia R, Hines PM, et al.: Mourning in different cultures. In: Walsh F, McGoldrick M, eds.: Living Beyond Loss: Death in the Family. New York: W.W. Norton & Company, 1991, pp 176-206.
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Eisenbruch M: Cross-cultural aspects of bereavement. II: Ethnic and cultural variations in the development of bereavement practices. Cult Med Psychiatry 8 (4): 315-47, 1984.
[PUBMED Abstract]
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