Social and Psychological Impact on Widows and Widowers

Widows and Widowers and Social and Psychological Impact

Young Widows and Widowers,Stages or Phases of Grief,Series of Tasks,Research Outcomes 

Young Widows and Widowers

     The recent research about widows and widowers addresses younger widowed persons rather than focusing mainly upon older widows, However, researchers have continued to concentrate upon the relatively short period of bereavement rather than the longer term circumstances of living alone. 

    Common concepts surrounding bereavement include: grief, stress, adaptation, coping, and social support. The work reflects four perspectives on bereavement: 

(a) as loss

(b) as a process of phases and stages

(c) as a stressor

(d) as a series of tasks

    Loss. Bacon, Condon, and Fernsler (2000) considered support and coping as key factors enabling adjustment to loss of a spouse. They explained why young widowed mothers might find it difficult to participate in a traditional support group. 

    In a descriptive study, they detailed the perceptions of 21 widows (age 31-50 years) about taking part in an electronic self help group. Responses to closed questions were reported using descriptive statistics; Responses to an open question soliciting feelings about participation were submitted to content analysis. 

    Most of the women had not taken part in an internet self help group previously. They rated the experience positively in reducing the sense of isolation and coping with loss.

Impact of Loneliness on Widow

    An intervention of four support group sessions was tested to determine its influence upon the affect and loneliness of widows over age 55 years (Stewart, Craig, MacPherson, & Alexander, 2001). With repeated measures, within subjects design standardized tools: tapped outcomes related to social support, affect, and loneliness. Perceptions of the intervention's impact were analyzed qualitatively. The intervention decreased the need for other support, enhanced positive affect, and increased satisfaction with support.

Stages or Phases of Grief

    Process of phases and stages. Hegge and Fischer (2000) differentiated grief responses of 22 senior widows (age 60-74 years) and 17 older widows (age 75-90 years). Concept analysis was used to detail frequent and troublesome problems, coping strategies, support systems, and goal adjustments. 

    There were no major differences by age groups. Grieving had four overlapping phases (numb shock, emotional turmoil, disorganization, and acceptance), which were briefer and less intense for older widows. Loneliness was the most common problem for both groups.

Duration and Stages of Grief 

    Steeves (2002) did a hermeneutic analysis of field notes and interviews with 29 older bereaved spouses in the rural South to capture data about the duration of grieving. The interviews began before a spouse's death and continued for up to 30 months. The rhythm of grief had three fluid stages: numbness, grief attacks or waves, and loneliness.

    Stressor. Referring to a spouse's death as a very stressful life event, Constantino, Sekula , and Rubinstein (2001) studied the effectiveness of the Bereavement Group Postvention (BGP) and the Social Group Postvention (SGP) on bereavement outcomes for 60 widowed survivors of the spouse's suicide. 

    Participants were randomized into the BGP or the SGP, taking part in a weekly 90-minute session for 8 weeks. There were no significant differences between groups on depression, psychological distress, grief, or social adjust ment at any time point (pretest, immediate, 6-month, and 12-month postvention). 

    For both groups, there was a significant reduction in depression, distress, and grief over time, and a significant increase in social adjustment. There was no evidence of a confounding effect due to duration of widowhood, but Constantino and colleagues did not rule it out. 

    Because there was no evidence of a differential effect for the two interventions, they suggested that participation in any social group might be beneficial. In a descriptive, mixed-methods study, sources and nature of social support perceived by 218 Finnish widows and widowers, aged 30 to 87 years, were discerned ( Kaunonen , Tarkka , Paunonen , &Laippala , 1999). 

    A standardized tool was used to appraise dimensions of grief, and qualitative data about coping sources were submitted to content analysis. The most common support sources were friends and family, and their time was the most precious resource offered.

    Daggett (2002) referred to spousal bereavement as a stressor requiring coping. Daggett used a phenomenological method to describe the grief experience of 8 middle-aged men who had been widowed from 6 months to 6 years. 

    Under a major theme of irreconciledable loss, the two categories responding to the loss and living through the loss were simultaneous occurrences, moving over time to reclamation and reconstruction of a life. 

    Daggett described the categories in terms of time based parameters, much like stages, although she had stated that stage based theories of bereavement did not capture individual differences in grief experiences.

 Series of Tasks 

    Series of interwoven tasks. Zonnebelt Smeenge and DeVries (2003) explained that stage based theories had given way to task theories of bereavement (Rando, 1993; Worden , 1991) involving spiraling or interwoven behaviors over time (Bowlby, 1981). 

    Zonnebelt Smeenge and DeVries highlighted the dual process model (Stroebe, M., &Schut , 1999) of simultaneous grief work relative to loss and to restoration. (Thus, the living through loss while responding 668/832 was not original to Daggett [2000].) 

    Viewing the model as consistent with task-related theory, they cited five bereavement tasks (Rando; Worden) and created a tool to determine the frequency and effectiveness of widowed persons' task-related interventions. They reported preliminary findings with 115 widowed persons (age 24 to 90 years, MD = 54). 

    Women found it more important to engage in activities leading to acceptance of the reality of death, whereas more men than women undertook activities to expediter age 45 years felt more positive about the future; More people older than 65 years had taken part in support groups. 

    Variables of resolution were positively correlated with duration of widowhood. Relatively few participants engaged in work to summarize and store memories of the spouse, so practitioners were encouraged to suggest activities enabling bereaved persons to directly address this task.

Research Outcomes 

    Two interpretive phenomenological studies were done with older rural widows. With five women, Swensen (1998) explored attachment to place, finding that home was the center of self, caring, and reach. DC Roberts and Cleveland (2001) studied the experience of living alone for nine widows who lived on islands near Maine. 

    The three essential themes were characterized as nautical metaphors, such as securely anchored in a safe harbor. Although the women were actively engaged, resilient, and resourceful, access to health care was a problem.

    Porter has used descriptive phenomenology to explore the essence of “older widows” health-related experiences. EJ Porter (1998a) found that 16 older urban and rural widows sought to keep the generations separate by continuing to live alone and by trying not to burden the children. 

    The intention of 9 older rural widows to stay close to shore for health care resulted in a new interpretation of access to care as familiarity with the care locale (Porter, EJ, 1998b). In a longitudinal study, EJ Porter (2001) described the transition of an older widow from her home to assisted living, secondary to changes in payment policies affecting the rural home care agency.

    Several studies were not focused on widowhood per se; instead, the researchers were interested in health as a variable affecting widowed persons. In the group studied by Wallace, Molavi , Hemphill, and Fields (1999), which consisted of 931 African Americans over the age of 65 years, neither the ability to perform activities of daily living nor the use of health care services was influenced by widowhood . 

    Among other issues, Crane and Warnes (2001) examined the role of widowhood as an influence upon homelessness in 18 persons over the age of 55 years. The authors concluded that although widow hood had a greater impact on men than on women, it can result in dramatic changes in lifestyle and living arrangements. 

    Finally, TR Fitzpatrick and Bosse (2000) studied the effects of employment on the health of $10 widowers (aged 39 to 86 years) up to 3 years after the spouse's death. Employment had a positive effect on the physical health of the widowers, but there was no evidence of an effect upon their mental health.

    Nurse researchers have tended to focus on older widowed persons (WP), primarily women (Porter, EJ, 2000). Recently, there has been a new and noteworthy interest in younger widows and WP of both genders. 

    However, without regard to age or gender, there has been an overemphasis on the relatively short period of bereavement and a neglect of the long-term issue of life as a WP. 

    In bereavement studies, most researchers have reviewed generic theories of coping or loss and undertaken qualitative studies with vague methods (such as concept analysis) and small samples. The work of Zonnebelt  Smeenge and deVries (2003) is a notable exception.

    Duration of widowhood is a critical variable in research on bereavement as well as studies of life alone, although few researchers noted this other than Constantino and colleagues (2001), Fitzpatrick and Bosse (2000), and Zonnebelt Smeenge and deVries ( 2003 ) . 

    Most nurse researchers other than Steeves (2002) and EJ Porter (2001) have used cross sectional designs; Longitudinal designs yield more information about living alone. Nurse researchers must explore the health related needs of vulnerable subgroups, such as widowers at risk for suicide and widows at risk for breast cancer. 

    Finally, scholars must attend to revealing the variations in the experience of widowhood among groups of WP who share key demographic characteristics.