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Does ethnicity matter? Bereavement outcomes in two ethnic groups living in the United Kingdom

Published online by Cambridge University Press:  03 March 2006

JONATHAN KOFFMAN ,
NORA DONALDSON ,
MATTHEW HOTOPF  and
IRENE J. HIGGINSON
JONATHAN KOFFMAN
Affiliation:
Department of Palliative Care, Policy and Rehabilitation, King's College London School of Medicine, London, UK
NORA DONALDSON
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
MATTHEW HOTOPF
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
IRENE J. HIGGINSON
Affiliation:
Department of Palliative Care, Policy and Rehabilitation, King's College London School of Medicine, London, UK
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Abstract

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.

Keywords

CarersBereavementDepressionEnd of lifePalliative careEthnicity
Type
Research Article
Information
Palliative & Supportive Care , Volume 3 , Issue 3 , September 2005 , pp. 183 - 190
Copyright
© 2005 Cambridge University Press

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References

REFERENCES

Acheson, D. (1998). Independent Inquiry into Inequalities in Health Report. London: The Stationery Office.
Addington-Hall, J. & McCarthy, M. (1995). Regional study of the care of the dying: Methods and sample characteristics. Palliative Medicine, 9, 27–35.Google Scholar
Addington-Hall, J., West, P., Karlsen, S., et al. (1999). Care in the Last Year of Life in Lambeth, Southwark and Lewisham: Final Report. London: Department of Palliative Care & Policy, King's College London.
Ahmad, W. (1993). Making black people sick: Race, ideology and health research. In 'Race' and Health in Contemporary Britain, Ahmad, W. (ed.), pp. 11–34. Buckingham: Open University Press.
Brennan, J. & Moynihan, C. (2004). Cancer in Context. Oxford: Oxford University Press.
Burnett, P., Middleton, W., Raphael, B., et al. (1997). Measuring core bereavement phenomena. Psychological Medicine, 27, 49–57.Google Scholar
Cartwright, A., Hockey, L., & Anderson, J.L. (1973). Life before Death. London.
Cowles, K.V. (1996). Cultural perspectives of grief: An expanded concept model. Journal of Advanced Nursing, 23, 287–294.Google Scholar
Doyle, D., Hanks, G., & MacDonald, N. (1998). Introduction. In Oxford Textbook of Palliative Medicine, 2nd ed., Doyle, D., Hanks, G. & MacDonald, N. (eds.), pp. 4–8. Oxford: Oxford University Press.
Firth, S. (2004). Cultural perspectives on loss and bereavement. In Loss, Change and Bereavement in Palliative Care, Luff, G., Oliviere, D. & Firth, P. (eds.), Buckingham: Open University Press.
Goldberg, D.P. (1986). Use of the General Health Questionnaire in Clinical Work. British Medical Journal, 293, 1188–1189.Google Scholar
Goldberg, D. & Williams, P. (1991). A User's Guide to the General Health Questionnaire. Windsor: NFER- Nelson.
Gunaratnam, Y. (2003). Researching ‘Race’ and Ethnicity: Methods, Knowledge and Power. London: Sage.
Higginson, I.J., Jarman, B., Astin, P., et al. (1999). Do social factors affect where patients die: An analysis of 10 years of cancer deaths in England. Journal of Public Health Medicine, 21, 22–28.Google Scholar
Higginson, I.J. & Koffman, J. (2003). Attitudes to timeliness of death and euthanasia among first generation black Caribbean and white patients and their families living in the United Kingdom. Journal of Palliative Medicine, 6, 245–249.Google Scholar
Jacob, K.S., Bhugra, D., & Mann, A.H. (1997). The validation of the 12-item General Health Questionnaire among ethnic Indian women living in the United Kingdom. Psychological Medicine, 27, 1215–1217.Google Scholar
Kissane, D.W., Bloch, S., & McKenzie, D.P. (1997). Family coping and bereavement outcome. Palliative Medicine, 11, 191–201.Google Scholar
Koffman, J. (2001). Rituals surrounding death and dying within the black Caribbean community. Palliative Care Today, 10, 7.Google Scholar
Koffman, J. & Higginson, I.J. (2004). Dying to be home? A comparison of preferred place of death of first generation black Caribbean and native-born white patients in the United Kingdom. Journal of Palliative Medicine, 7, 628–636.Google Scholar
Lambeth, Southwark and Lewisham Health Authority. (1999). 1997–1998 Annual Public Health Report, Lambeth, Southwark and Lewisham Health Authority.
Lowdell, C., Evandrou, M., Bardsley, M., et al. (2000). Health of Ethnic Minority Elders in London: Respecting Diversity. London: The Health of Londoners Project.
Lund, D.A., Caserta, M.S., & Dimond, M.F. (1989). Impact of spousal bereavement on the subjective well-being of older adults. In Older Bereaved Spouses: Research with Practical Applications. Series in Death Education, Ageing and Health Care, Lund, D.A. (ed.), pp. 3–15. New York: Hemisphere Publishing Corp.
Lundin, T. (1984). Morbidity following sudden and unexpected bereavement. British Journal of Psychiatry, 144, 84–88.Google Scholar
Main, J. (2000). Improving management of bereavement in general practice based on a survey of recently bereaved subjects in a single general practice. British Journal of General Practice, 50, 863–866.Google Scholar
Mehta, C.R. & Patel, N.R. (2003). A network algorithm for performing Fisher's exact test in r × c contingency tables. Journal of the American Statistical Association, 78, 427–434.Google Scholar
Nazroo, J.Y. (1997). Ethnicity and Mental Health. London: Policy Studies Institute.
Parkes, C.M. (2001). A historical overview of the scientific study of bereavement. In Handbook of Bereavement Research: Consequences, Coping and Care, Stroebe, M.S., Strobe, W. & Hansson, R.O. (eds.), pp. 25–47. Washington, DC: American Psychological Association.
Parkes, C.M., Benjamin, B., & Fitzgerald, R.G. (1969). Broken heart: A statistical study of increased mortality among widowers. British Medical Journal, 1, 740–743.Google Scholar
Phoenix, A. (1995). Practising feminist research: The intersection of gender and race in the research process? In Research Women's Lives from a Feminist Perspective, Maynard, M. & Purvis, J. (eds.), pp. 49–71. London: Taylor.
Rait, G. (1999). Commentary: Counting heads may mask cultural and social factors. British Medical Journal, 318, 305–306.Google Scholar
Schulz, R. & Scott, R. (1999). Caregiving as a risk for mortality. JAMA, 282, 2215–2219.Google Scholar
Senior, A. & Bhopal, R. (1994). Ethnicity as a variable in epidemiological research. British Medical Journal, 309, 327–330.Google Scholar
Shaw, C.M., Creed, F., Tomenson, B., et al. (1999). Prevalence of anxiety and depressive illness and help seeking behaviour in African Caribbeans and white Europeans: Two phase general population survey. British Medical Journal, 318, 302–306.Google Scholar
Thompson, L.W., Gallagher-Thompson, D., Futterman, A., et al. (1991). The effects of late-life spousal bereavement over a 30-month interval. Psychology and Aging, 6, 434–441.Google Scholar
Walsh, K., King, M., Jones, L., et al. (2002). Spiritual beliefs may affect bereavement: Prospective study. British Medical Journal, 324, 1551–1554.Google Scholar
Wiles, R., Jarrett, N., Payne, S., et al. (2002). Referrals for bereavement counselling in primary care: A qualitative study. Patient Education & Counselling, 48, 1, 79–85.Google Scholar