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Understanding Factors that Influence the Grieving Process
  1. Lisa Sheehy, Macmillan Palliative Care Clinical Nurse Specialist
  1. Kingston Hospital NHS Trust, London. Email: Lisa.Sheehy{at}


Grief is a universal response to loss. Despite its universality, variation exists in how it is experienced and expressed. In light of evidence from bereavement research over the last two decades, previous paradigms regarding grief and loss are changing, which has important implications for professionals, including nurses, who work in end-of-life care. Much research centres on the recognition of grief as a complex, multidimensional phenomenon that is influenced by a variety of external factors. Social, cultural and religious worldviews all influence grief reactions, informing individual response to death. When caring for dying patients and their relatives/loved ones, nurses must be aware of the process of grief and the factors that influence the bereavement process following the patient’s death. Lack of openness towards death and bereavement may affect the quality and range of support and care services made available to families. This article will focus on the bereavement experienced by adults. It will provide an overview of the theories of grief. The external factors that may affect the grief process will then be considered. Conflicts of interest: none

  • Bereavement
  • End-of-life care
  • Grief
  • Mourning

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